Another 'Time to PSA Nadir' [TTN] study.

[pjoshea13]

New Chinese study of Docetaxel, TTN & overall survival. [1]

"In this study, we retrospectively reviewed the data from 71 eligible Chinese patients who received docetaxel chemotherapy from 2009 to 2016 in our hospital and experienced a reduction of prostate-specific antigen (PSA) level ≥50% during the treatment ..."

"the median of TTN was 17 weeks. Patients with TTN ≥17 weeks had a longer response time to chemotherapy compared to TTN <17 weeks (42.83 vs 21.50 weeks ...)."

"The time to PSA progression in patients with TTN ≥17 weeks was 11.44 weeks compared to 5.63 weeks when TTN was <17 weeks."

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/289...

Asian J Androl. 2017 Sep 12. doi: 10.4103/aja.aja_34_17. [Epub ahead of print]

PSA time to nadir as a prognostic factor of first-line docetaxel treatment in castration-resistant prostate cancer: evidence from patients in Northwestern China.

Wu KJ1, Pei XQ1, Tian G1, Wu DP1, Fan JH1, Jiang YM1, He DL1.

Author information

Abstract

Docetaxel-based chemotherapy remains the first-line treatment for patients with metastatic castration-resistant prostate cancer (mCRPC) in China; however, the prognostic factors associated with effects in these patients are still controversial. In this study, we retrospectively reviewed the data from 71 eligible Chinese patients who received docetaxel chemotherapy from 2009 to 2016 in our hospital and experienced a reduction of prostate-specific antigen (PSA) level ≥50% during the treatment and investigated the potential role of time to nadir (TTN) of PSA. TTN was defined as the time from start of chemotherapy to the nadir of PSA level during the treatment. Multivariable Cox regression models and Kaplan-Meier analysis were used to predict overall survival (OS). In these patients, the median of TTN was 17 weeks. Patients with TTN ≥17 weeks had a longer response time to chemotherapy compared to TTN <17 weeks (42.83 vs 21.50 weeks, P < 0.001). The time to PSA progression in patients with TTN ≥17 weeks was 11.44 weeks compared to 5.63 weeks when TTN was <17 weeks. We found several factors to be associated with OS, including TTN (hazard ratio [HR]: 3.937, 95% confidence interval [CI]: 1.502-10.309, P = 0.005), PSA level at the diagnosis of cancer (HR: 4.337, 95% CI: 1.616-11.645, P = 0.004), duration of initial androgen deprivation therapy (HR: 2.982, 95% CI: 1.104-8.045, P = 0.031), neutrophil-to-lymphocyte ratio (HR: 3.963, 95% CI: 1.380-11.384, P = 0.011), and total PSA response (Class 1 [<0 response] compared to Class 2 [0-50% response], HR: 3.978, 95% CI: 1.278-12.387, P = 0.017). In conclusion, TTN of PSA remains an important prognostic marker in predicting therapeutic outcome in Chinese population who receive chemotherapy for mCRPC and have >50% PSA remission.

PMID: 28905815

[dockam]

So, this study confirms others that the longer the TTN and the lower the nadir - the better the prognosis. But this was a study with chemo and mCRPC patients. I was one of the fortunate ones that got ADT and chemo simultaneously in 2015. The CHAARTED study showed an increase in OS of 17 months. I had a nadir of 0.2 Aug 2016 - 16 months after the 15 chemos, but was able to get down to 0.1 in August 2017 with supplemental meds and fasting

Fight On - Randy

[rococo]

Initially you should have a good response to these, adt and probabably others but the rate slows over time and thats a good thing