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Kawai T, Taguchi S, Nozaki K, Kimura N, Oshina T, Iwaki T, Matsui H, Niimi A, Kamei J, Akiyama Y, Yamada Y, Sato Y, Yamada D, Kaneko T, Sawayanagi S, Nakayama H, Minamimoto R, Yamashita H, Miyazaki H, Fujimura T, Nakagawa T, Kume H. Prostate-specific antigen doubling time predicts the efficacy of site-directed therapy for oligoprogressive castration-resistant prostate cancer. Prostate Int 2023; 11:239-246. [PMID: 38196558 PMCID: PMC10772157 DOI: 10.1016/j.prnil.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/10/2023] [Accepted: 10/16/2023] [Indexed: 01/11/2024] Open
Abstract
Background In recent years, site-directed therapies (SDTs) targeting progressive lesions in patients with oligometastatic prostate cancer have attracted attention. However, whether they effectively treat oligoprogressive castration-resistant prostate cancer (CRPC) remains unclear. Here, we investigated the efficacy of SDT in patients with oligoprogressive CRPC and identified prognostic factors. Methods We reviewed 59 patients with oligoprogressive CRPC who underwent SDT targeting prostate or metastatic lesions between April 2014 and March 2022. We evaluated the associations between several pretreatment clinical variables and treatment procedures and a >50% prostate-specific antigen (PSA) response, progression-free survival (PFS), and time to next treatment (TTNT). Results A PSA response of >50% was observed in 66% of patients. The median PFS and TTNT were 8.3 months and 9.9 months, respectively. Patients with PSA doubling time ≥6 months showed a higher >50% PSA response rate (87% vs. 45%; P < 0.001), longer PFS (median, 15.0 vs. 5.0 months; P < 0.001), and longer TTNT (median, 16.3 vs. 5.9 months; P < 0.001) than patients with PSA doubling time <6 months. In multivariate analyses, a PSA doubling time of ≥6 months independently predicted a >50% PSA response, favorable PFS, and TTNT (P = 0.037, 0.025, and 0.017, respectively). Conclusion PSA doubling time of ≥6 months may be a key indicator of the favorable efficacy of SDT for oligoprogressive CRPC.
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Affiliation(s)
- Taketo Kawai
- Department of Urology, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Satoru Taguchi
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Keina Nozaki
- Department of Urology, Center Hospital of National Center for Global Health and Medicine, Shinjyuku-ku, Tokyo, Japan
| | - Naoki Kimura
- Department of Urology, Center Hospital of National Center for Global Health and Medicine, Shinjyuku-ku, Tokyo, Japan
| | - Takahiro Oshina
- Department of Urology, Center Hospital of National Center for Global Health and Medicine, Shinjyuku-ku, Tokyo, Japan
| | - Takuya Iwaki
- Department of Urology, Center Hospital of National Center for Global Health and Medicine, Shinjyuku-ku, Tokyo, Japan
| | - Hotaka Matsui
- Department of Urology, Center Hospital of National Center for Global Health and Medicine, Shinjyuku-ku, Tokyo, Japan
| | - Aya Niimi
- Department of Urology, Center Hospital of National Center for Global Health and Medicine, Shinjyuku-ku, Tokyo, Japan
| | - Jun Kamei
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yoshiyuki Akiyama
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yuta Yamada
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yusuke Sato
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Daisuke Yamada
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Tomoyuki Kaneko
- Department of Urology, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Subaru Sawayanagi
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hidetsugu Nakayama
- Department of Radiation Oncology, Center Hospital of National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Ryogo Minamimoto
- Department of Radiology, Division of Nuclear Medicine, Center Hospital of National Center for Global Health and Medicine, Shinjyuku-ku, Tokyo, Japan
| | - Hideomi Yamashita
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hideyo Miyazaki
- Department of Urology, Center Hospital of National Center for Global Health and Medicine, Shinjyuku-ku, Tokyo, Japan
| | - Tetsuya Fujimura
- Department of Urology, Jichi Medical University, Shimotsuke-shi, Tochigi, Japan
| | - Tohru Nakagawa
- Department of Urology, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Yoshida S, Takahara T, Tanaka H, Yokoyama M, Yoshimura R, Fujii Y. The role of prostate-specific antigen changes in predicting overall survival after progressive-site directed therapy for oligoprogressive castration-resistant prostate cancer. Int J Urol 2023; 30:616-617. [PMID: 37000986 DOI: 10.1111/iju.15185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Affiliation(s)
- Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Taro Takahara
- Department of Biomedical Engineering, Tokai University School of Engineering, Kanagawa, Japan
- Department of Radiology, Advanced Imaging Center, Yaesu Clinic, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Minato Yokoyama
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryoichi Yoshimura
- Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
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