Cabazitaxel (Jevtana) & fluctuating PSA

[pjoshea13]

New study from Japan [1].

The overall survival of patients with the 'fluctuating' PSA pattern (12%) was significantly better than that of patients with the 'response' (28%) & 'primary resistance' (36%) patterns.

Patients should not be discouraged by a PSA increase while on Cabazitaxel.

-Patrick

ncbi.nlm.nih.gov/pubmed/313...

Jpn J Clin Oncol. 2019 Aug 1. pii: hyz110. doi: 10.1093/jjco/hyz110. [Epub ahead of print]

Prostate-specific antigen response patterns during cabazitaxel therapy in patients with metastatic castration-resistant prostate cancer.

Kanao K1, Ito T2, Takahara K3, Ando R4, Yasui T4, Shiroki R3, Miyake H2, Sumitomo M1,3.

Author information

1

Department of Urology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan.

2

Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan.

3

Department of Urology, Fujita Health University School of Medicine, Toyoake, Japan.

4

Department of Nephrourology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

Abstract

BACKGROUND:

The objective of this study was to categorize prostate-specific antigen (PSA) response during cabazitaxel therapy in patients with metastatic castration-resistant prostate cancer (mCRPC) into different patterns and to investigate the prognostic impact of the PSA response patterns.

METHODS:

We reviewed data from patients with mCRPC who had been treated with cabazitaxel therapy at four institutions belonging to Tokai Urologic Oncology Research Seminar. Patients eligible for this study had received at least three cycles of cabazitaxel treatment at three- or four-week intervals. The PSA response patterns were categorized as primary resistance (PR), response (RE), stabilization (ST), and fluctuating (FL). The overall survival (OS) was compared among the patterns.

RESULTS:

Data from a total of 50 patients were analyzed in this study. The number of patients exhibiting PR, RE, ST and FL patterns were 18 (36%), 14 (28%), 12 (24%) and 6 (12%), respectively. The median (95% CI) OS of patients with PR and RE patterns was 10.7 (5.6-15.9) and 14.9 (6.8-23.0) months, respectively, and was not reached for patients with ST and FL patterns. The OS of patients with the FL pattern was significantly better than that of patients with PR (P = 0.012) and RE (P = 0.010) patterns.

CONCLUSION:

There were some patients whose PSA were fluctuating during cabazitaxel therapy in patients with mCRPC. Because the prognosis of such patients was relatively good, the judgment to discontinue the cabazitaxel therapy after PSA rise followed by decrease should be made prudently.

© The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: [e-mail].

KEYWORDS:

cabazitaxel; castration-resistant prostate cancer; prostate-specific antigen response pattern

PMID: 31369101 DOI: 10.1093/jjco/hyz110

[HOPEFULSPOUSE]

WOW - Patrick - thanks so much for posting this! Made my day. My husband's PSA has been fluctuating - all over the place - during his 6 cycles so far. BUT - clinical he is doing so well that this onco is stumped. In fact - he is like a different person from when he started it - in terms of strength, energy, etc.

[Mathes72]

Glad I went to medical school.?

[j-o-h-n in reply to Mathes72]

I'm glad you did too Doc....

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 08/03/2019 12:53 PM DST