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- Title
The presence of lymph node metastases and time to castration resistance predict the therapeutic effect of enzalutamide for castration-resistant prostate cancer.
- Authors
Oka, Toshiki; Hatano, Koji; Okuda, Yohei; Yamamoto, Akinaru; Uemura, Toshihiro; Yamamichi, Gaku; Tomiyama, Eisuke; Ishizuya, Yu; Yamamoto, Yoshiyuki; Kato, Taigo; Kawashima, Atsunari; Fujita, Kazutoshi; Nonomura, Norio
- Abstract
Background: Enzalutamide is effective against castration-resistant prostate cancer (CRPC). However, it is unclear which patients would benefit more from enzalutamide treatment. Here, we analyzed patients who received enzalutamide as first-line therapy for CRPC and evaluated the factors that predict treatment response and prognosis. Methods: We retrospectively analyzed 101 patients treated with enzalutamide for CRPC at our institution. As primary endpoints we regarded the prostate-specific antigen (PSA) response rate and PSA–progression-free survival (PSA–PFS) from the start of enzalutamide treatment. Laboratory and imaging data were analyzed to predict treatment efficacy. Results: PSA reductions of ≥ 50% and ≥ 90% were observed in 78 (77%) and 47 (47%) patients, respectively, compared with the baseline. During the follow-up period, 67 (66%) patients showed PSA progression, with a median PSA–PFS of 11 months. Moreover, 31 patients (31%) died, with a median overall survival of 64 months. On multivariate analysis, lymph node metastases at the start of enzalutamide treatment [odds ratio (OR) 0.0575, 95% confidence interval (CI) 0.0105–0.316, p = 0.0010] and time to CRPC (OR 0.177, 95% CI 0.0428–0.731, p = 0.0167] were associated with ≥ 90% PSA response. Lymph node metastases (hazard ratio [HR] 3.00, 95% CI 1.48–6.09, p = 0.0023) and time to CRPC (HR 1.84, 95% CI 1.02–3.30, p = 0.0419) were also predictors of PSA–PFS on a multivariate model. Conclusions: Time to CRPC and lymph node metastasis were predictors of the PSA response rate and PSA–PFS.
- Subjects
CASTRATION-resistant prostate cancer; LYMPHATIC metastasis; TREATMENT effectiveness; PROSTATE-specific antigen; CASTRATION
- Publication
International Journal of Clinical Oncology, 2023, Vol 28, Issue 3, p427
- ISSN
1341-9625
- Publication type
Article
- DOI
10.1007/s10147-022-02288-5