The effect of time to castration resistance on overall survival and success of docetaxel treatment in castration resistant prostate cancer patients

Evren Suer, Nurullah Hamidi, Cagri Akpinar, Mehmet Ilker Gokce, Omer Gulpinar, Kadir Turkolmez, Yasar Beduk, Sumer Baltaci



Introduction: To investigate the prognostic role of time to castration resistance(TTCR) in patients who have received solely Docetaxel chemotherapy regimen(DCR) for castration resistant prostate cancer(CRPC). 

Methods: Between Jan 2004 and Dec 2015, data of 162 patients who have received DCR for CRPC are detected. Patients were divided into three groups according to TTCR: Group 1(?12 months), group 2(13-24 months), and group 3(>24 months). Data of age, clinical stage, Gleason grade(GG), previous treatments, site of metastases, Prostate-specific antigen (PSA) values, TTCR, overall survival, biochemical progression free survival(PFS) and PSA response to docetaxel were recorded.

Result: The mean age of the 162 patients was 74.4±8.5. Data on mean age, type of castration, adding estramustine to docetaxel, secondary hormonal manipulation, Gleason grade, clinical T stage at initial diagnosis and site of metastases were comparable between three groups. All PSA values were statistically significant higher in group 1 than other groups. PSA response to docetaxel was 59.2% in all patient and it was worse in group 1 than other groups(P=.009). Two years OS rates were 7.6%, 25% and 32.3% in group 1, 2 and 3, respectively. Median survival rates were 7, 14 and 23 months in group 1, 2 and 3, respectively, and this difference was statistically significant (P=.016). On multivariate analysis, TTCR was found to be independent prognostic factor for overall survival and response to docetaxel treatment.

Conclusion: TTCR appears to be an independent prognostic factor for patients who are candidates for DCR.

Full Text:

Just Accepted



Horwich A, Hugosson J, de Reijke T, et al. Prostate cancer: ESMO consensus conference guidelines 2012. Ann Oncol 2013; 24: 1141-62.

Tangen CM, Hussain MH, Higano CS, et al. Improved overall survival trends of men with newly diagnosed M1 prostate cancer: a SWOG phase III trial experience (S8494, S8894 and S9346). J Urol 2012; 188: 1164-9.

Tannock, IF, de Wit R, Berry WR, et al. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med 2004; 351: 1502-12

Beer TM, Armstrong AJ, Sternberg CN, et al. Enzalutamide in men with chemotherapy-naive metastatic prostate cancer (mCRPC): results of phase III PREVAIL study. J Clin Oncol 2014; 32: LBA1 (abstr).

Fizazi K, Scher HI, Molina A, et al. Abiraterone acetate for treatment of metastaticcastration-resistant prostate cancer: final overall survival analysis of the COU-AA-301 randomised, double-blind, placebo-controlledphase 3 study. Lancet Oncol 2012; 13 : 983-92.

Kantoff PW, Higano CS, Shore ND, et al. Sipuleucel-Timmunotherapy for castration-resistant prostate cancer. N Engl J Med 2010; 363: 411-22.

Sartor O, Coleman R, Nilsson S, et al. Effect of radium-223dichloride on symptomatic skeletal events in patients withcastration-resistant prostate cancer and bone metastases: resultsfrom a phase 3, double-blind, randomised trial. Lancet Oncol 2014;15: 738-46.

Bournakis E, Efstathiou E, Varkaris A, et al. Time to castration resistance is an independent predictor of castrationresistant prostate cancer survival. Anticancer Res 2011; 31: 1475-82.

Loriot Y, Eymard JC, Patrikidou, A., et al. Prior long response to androgen deprivation predicts response to next-generation androgen receptor axis targeted drugs in castration resistant prostate cancer. Eur J Cancer 2015; 51: 1946-52.

Petrylak DP, Tangen CM, Hussain MH, et al. Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer. N Engl J Med 2004; 351: 1513-20.

Armstrong AJ, Garrett-Mayer ES, Yang YC, et al. A contemporary prognostic nomogram for men with hormone-refractory metastatic prostate cancer: a TAX327 study analysis. Clin Cancer Res 2007;13: 6396-403.

Heidenreich A, Pfister D. Treatment decisions for metastatic castration-resistant prostate cancer progressing after docetaxel chemotherapy: the role of cabazitaxel in the continuum of care. Eur Urol 2012; 62:1201-4.

Loriot Y, Massard C, Albiges L, et al. Personalizing treatment in patients with castrate-resistant prostate cancer: a study of predictive factors for secondary endocrine therapies activity. J Clin Oncol 2012;30(suppl 5; abstr 213)

Bellmunt J, Kheoh T, Yu MK, et al. Prior Endocrine Therapy Impact on Abiraterone Acetate Clinical Efficacy in Metastatic Castration-resistant Prostate Cancer: Post-hoc Analysis of Randomised Phase 3 Studies. Eur Urol 2016; 69: 924-32.

Stewart AJ, Scher HI, Chen MH, et al. Prostate-specific antigen nadir and cancer-specific mortality following hormonal therapy for prostate-specific antigen failure. J Clin Oncol 2005; 23:6556-60.


Creative Commons License 
This work is licensed under a Creative Commons Attribution 3.0 License