Should We Try Antiandrogen Withdrawal in Castration-Resistant Prostate Cancer Patients? Insights From a Retrospective Study

Hiroshi Hongo, Takeo Kosaka, Ryuichi Mizuno, Taisuke Ezaki, Kazuhiro Matsumoto, Shinya Morita, Kazunobu Shinoda, Toshiaki Shinojima, Eiji Kikuchi, Akira Miyajima, Mototsugu Oya

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: It remains uncertain whether those with response to antiandrogen withdrawal (AAW) have a better prognosis. We investigated the predictors of a better response to AAW and overall survival after acquiring resistance to first-line androgen deprivation therapy inpatients with castration-resistant prostate cancer (CRPC). Patients and Methods: We retrospectively reviewed the medical records of 87 CRPC patients treated at Keio University Hospital. Sixty-seven of 87 CRPC patients underwent AAW. We analyzed clinicopathologic parameters to identify predictors of survival in CRPC patients and investigated predictors of good response to AAW. Results: Younger age, longer duration of androgen deprivation therapy before CRPC development, and better response to AAW were independent favorable prognostic factors for overall survival. Although better response to AAW was a favorable prognostic factor in this study, trying AAW was not significantly related to overall survival. Duration of hormone therapy was significantly longer in those whose disease responded to AAW (69.9 ± 11.0 months) than those with no response (45.3 ± 5.2 months). Conclusion: The prognostic benefit of AAW was not clearly determined in this study. However, AAW might be beneficial in patients who have favorable prognostic factors for a response to AAW-that is, those who have received hormone therapy for a long period. However, AAW should not be done in patients who do not have favorable factors and who had a high prostate-specific antigen level at the time of their prostate cancer diagnosis.

Original languageEnglish
JournalClinical Genitourinary Cancer
DOIs
Publication statusAccepted/In press - 2016 Jan 24

Fingerprint

Androgen Antagonists
Castration
Prostatic Neoplasms
Retrospective Studies
Survival
Androgens
Hormones
Therapeutics
Prostate-Specific Antigen
Medical Records
Inpatients

Keywords

  • Androgen deprivation therapy
  • Antiandrogen withdrawal syndrome
  • Hormone therapy
  • Nonsteroidal antiandrogens
  • Prostate-specific antigen

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Should We Try Antiandrogen Withdrawal in Castration-Resistant Prostate Cancer Patients? Insights From a Retrospective Study. / Hongo, Hiroshi; Kosaka, Takeo; Mizuno, Ryuichi; Ezaki, Taisuke; Matsumoto, Kazuhiro; Morita, Shinya; Shinoda, Kazunobu; Shinojima, Toshiaki; Kikuchi, Eiji; Miyajima, Akira; Oya, Mototsugu.

In: Clinical Genitourinary Cancer, 24.01.2016.

Research output: Contribution to journalArticle

@article{13d6d0d6537e4ad08eeb4e7c7662e3a4,
title = "Should We Try Antiandrogen Withdrawal in Castration-Resistant Prostate Cancer Patients? Insights From a Retrospective Study",
abstract = "Background: It remains uncertain whether those with response to antiandrogen withdrawal (AAW) have a better prognosis. We investigated the predictors of a better response to AAW and overall survival after acquiring resistance to first-line androgen deprivation therapy inpatients with castration-resistant prostate cancer (CRPC). Patients and Methods: We retrospectively reviewed the medical records of 87 CRPC patients treated at Keio University Hospital. Sixty-seven of 87 CRPC patients underwent AAW. We analyzed clinicopathologic parameters to identify predictors of survival in CRPC patients and investigated predictors of good response to AAW. Results: Younger age, longer duration of androgen deprivation therapy before CRPC development, and better response to AAW were independent favorable prognostic factors for overall survival. Although better response to AAW was a favorable prognostic factor in this study, trying AAW was not significantly related to overall survival. Duration of hormone therapy was significantly longer in those whose disease responded to AAW (69.9 ± 11.0 months) than those with no response (45.3 ± 5.2 months). Conclusion: The prognostic benefit of AAW was not clearly determined in this study. However, AAW might be beneficial in patients who have favorable prognostic factors for a response to AAW-that is, those who have received hormone therapy for a long period. However, AAW should not be done in patients who do not have favorable factors and who had a high prostate-specific antigen level at the time of their prostate cancer diagnosis.",
keywords = "Androgen deprivation therapy, Antiandrogen withdrawal syndrome, Hormone therapy, Nonsteroidal antiandrogens, Prostate-specific antigen",
author = "Hiroshi Hongo and Takeo Kosaka and Ryuichi Mizuno and Taisuke Ezaki and Kazuhiro Matsumoto and Shinya Morita and Kazunobu Shinoda and Toshiaki Shinojima and Eiji Kikuchi and Akira Miyajima and Mototsugu Oya",
year = "2016",
month = "1",
day = "24",
doi = "10.1016/j.clgc.2016.02.014",
language = "English",
journal = "Clinical Genitourinary Cancer",
issn = "1558-7673",
publisher = "Elsevier",

}

TY - JOUR

T1 - Should We Try Antiandrogen Withdrawal in Castration-Resistant Prostate Cancer Patients? Insights From a Retrospective Study

AU - Hongo, Hiroshi

AU - Kosaka, Takeo

AU - Mizuno, Ryuichi

AU - Ezaki, Taisuke

AU - Matsumoto, Kazuhiro

AU - Morita, Shinya

AU - Shinoda, Kazunobu

AU - Shinojima, Toshiaki

AU - Kikuchi, Eiji

AU - Miyajima, Akira

AU - Oya, Mototsugu

PY - 2016/1/24

Y1 - 2016/1/24

N2 - Background: It remains uncertain whether those with response to antiandrogen withdrawal (AAW) have a better prognosis. We investigated the predictors of a better response to AAW and overall survival after acquiring resistance to first-line androgen deprivation therapy inpatients with castration-resistant prostate cancer (CRPC). Patients and Methods: We retrospectively reviewed the medical records of 87 CRPC patients treated at Keio University Hospital. Sixty-seven of 87 CRPC patients underwent AAW. We analyzed clinicopathologic parameters to identify predictors of survival in CRPC patients and investigated predictors of good response to AAW. Results: Younger age, longer duration of androgen deprivation therapy before CRPC development, and better response to AAW were independent favorable prognostic factors for overall survival. Although better response to AAW was a favorable prognostic factor in this study, trying AAW was not significantly related to overall survival. Duration of hormone therapy was significantly longer in those whose disease responded to AAW (69.9 ± 11.0 months) than those with no response (45.3 ± 5.2 months). Conclusion: The prognostic benefit of AAW was not clearly determined in this study. However, AAW might be beneficial in patients who have favorable prognostic factors for a response to AAW-that is, those who have received hormone therapy for a long period. However, AAW should not be done in patients who do not have favorable factors and who had a high prostate-specific antigen level at the time of their prostate cancer diagnosis.

AB - Background: It remains uncertain whether those with response to antiandrogen withdrawal (AAW) have a better prognosis. We investigated the predictors of a better response to AAW and overall survival after acquiring resistance to first-line androgen deprivation therapy inpatients with castration-resistant prostate cancer (CRPC). Patients and Methods: We retrospectively reviewed the medical records of 87 CRPC patients treated at Keio University Hospital. Sixty-seven of 87 CRPC patients underwent AAW. We analyzed clinicopathologic parameters to identify predictors of survival in CRPC patients and investigated predictors of good response to AAW. Results: Younger age, longer duration of androgen deprivation therapy before CRPC development, and better response to AAW were independent favorable prognostic factors for overall survival. Although better response to AAW was a favorable prognostic factor in this study, trying AAW was not significantly related to overall survival. Duration of hormone therapy was significantly longer in those whose disease responded to AAW (69.9 ± 11.0 months) than those with no response (45.3 ± 5.2 months). Conclusion: The prognostic benefit of AAW was not clearly determined in this study. However, AAW might be beneficial in patients who have favorable prognostic factors for a response to AAW-that is, those who have received hormone therapy for a long period. However, AAW should not be done in patients who do not have favorable factors and who had a high prostate-specific antigen level at the time of their prostate cancer diagnosis.

KW - Androgen deprivation therapy

KW - Antiandrogen withdrawal syndrome

KW - Hormone therapy

KW - Nonsteroidal antiandrogens

KW - Prostate-specific antigen

UR - http://www.scopus.com/inward/record.url?scp=84962278144&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84962278144&partnerID=8YFLogxK

U2 - 10.1016/j.clgc.2016.02.014

DO - 10.1016/j.clgc.2016.02.014

M3 - Article

C2 - 27036975

AN - SCOPUS:84962278144

JO - Clinical Genitourinary Cancer

JF - Clinical Genitourinary Cancer

SN - 1558-7673

ER -