Analyze of Risk Factors Affecting the Outcomes of Docetaxel-prednisone Combination in the Treatment of Metastatic Castration-resistant Prostate Cancer
Burak Arslan *
Department of Urology, Taksim Training and Research Hospital, Istanbul, Turkey
Mehmet Fatih Akbulut
Department of Urology, Haseki Training and Research Hospital, Istanbul, Turkey
Özkan Onuk
Department of Urology, Taksim Training and Research Hospital, Istanbul, Turkey
Aydın İsmet Hazar
Department of Urology, Taksim Training and Research Hospital, Istanbul, Turkey
Arif Özkan
Department of Urology, Taksim Training and Research Hospital, Istanbul, Turkey
Cem Tuğrul Gezmiş
Department of Urology, Taksim Training and Research Hospital, Istanbul, Turkey
Buğra Çetin
Department of Urology, Taksim Training and Research Hospital, Istanbul, Turkey
Memduh Aydın
Department of Urology, Taksim Training and Research Hospital, Istanbul, Turkey
*Author to whom correspondence should be addressed.
Abstract
Objective: To analyze potential factors affecting the outcomes of docetaxel and prednisone (DP) combination therapy in patients with castration resistant prostate cancer (CRPC).
Methods: A total of 272 patients were treated with DP chemotherapy for CRPC between April 2006 and January 2014. Patients received docetaxel (75 mg/m2) administered as ≥1-h intravenous infusion on day 1, every 3 weeks plus oral prednisone 5 mg twice daily starting on day 1 and continuing throughout the treatment. Patients were evaluated for prostate specific antigen (PSA) response, toxicity and factors affecting the treatment outcomes.
Results: 132 (48.6%) patients achieved a PSA response (47 complete and 85 partial response). There were no differences between PSA responders and PSA non-responders in terms of age, gleason score, initial PSA value and Eastern Cooperative Oncology Group (ECOG) performance status. Alkaline phosphatase (ALP) level of non-responders was significantly higher compared to PSA responders (p= 0.042), total serum protein levels (p=0.035) and albumin (p=0.012) were significantly lower in non-responder group. Median survival rate of PSA responders was significantly higher compared to PSA non-responders (19 months vs 14 months, p= 0.000). The most common grade 3-4 toxicity of chemotherapy was neutropenia which was observed in 95 (34.7%) patients.
Conclusions: Serum ALP, total protein and albumin levels can be used to predict treatment outcomes following docetaxel and prednisone combination therapy in patients with CRPC.
Keywords: Docetaxel, prostate specific antigen, castration resistant prostate cancer, neutropenia