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Role of Androgen Deprivation Treatment in Patients With Castration-Resistant Prostate Cancer, Receiving Docetaxel-Based Chemotherapy

Lee, Jae-Lyun MD, PhD*; Eun Kim, Jeong MD*; Ahn, Jin-Hee MD, PhD*; Lee, Dae-Ho MD, PhD*; Lee, Junghsin MD, PhD*; Kim, Choung-Soo MD, PhD; Hyuk Hong, Jun MD, PhD; Hong, Bumsik MD, PhD; Song, Cheryn MD, PhD; Ahn, Hanjong MD, PhD

American Journal of Clinical Oncology: April 2011 - Volume 34 - Issue 2 - p 140-144
doi: 10.1097/COC.0b013e3181d2ed7d
Original Articles: Genitourinary
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Objectives: To assess the impact of continued androgen deprivation therapy (ADT) in patients with castration-resistant prostate cancer (CRPC) receiving first-line docetaxel-based chemotherapy.

Methods: A retrospective review was performed on 78 patients fulfilling the criteria for CRPC who were treated with docetaxel-based chemotherapy over 5 years.

Results: Thirty-nine patients received concurrent ADT (ADT group), whereas 39 patients discontinued ADT (No-ADT group). PSA response rates were 66.7% for ADT patients and 48.7% for No-ADT patients (P = 0.27). The median progression-free survival and overall survival were 5.0 months and 24.8 months for ADT patients and 4.9 months and 22.1 months for No-ADT patients, respectively (P = 0.57, P = 0.94). Follow-up testosterone levels were available in 13 patients of the No-ADT group and none of them recovered a normal serum testosterone level over a median follow-up duration of 8.3 months from ADT discontinuation. ADT was recommenced in 21 of 39 patients in the No-ADT group and, of these, 6 (29%) achieved a PSA response.

Conclusion: Clinical outcomes were not significantly different when patients with CRPC received concurrent ADT, or were not so treated, when receiving first-line docetaxel-based chemotherapy. Despite ADT withdrawal, serum testosterone level did not recover to the noncastrated level during the period of chemotherapy, and reinduction of hormone sensitivity occurred in about one-quarter of patients.

From the Departments of *Oncology, and †Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Presented, in part, at 2009 Genitourinary Cancer Symposium, February 26–28, 2009, Orlando, FL.

Reprints: Jae-Lyun Lee, MD, PhD, Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Songpa-gu, Seoul, 138–736, Korea. E-mail: jaelyun@amc.seoul.kr.

© 2011 Lippincott Williams & Wilkins, Inc.