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dc.contributor.authorRescigno, P
dc.contributor.authorLorente, D
dc.contributor.authorBianchini, D
dc.contributor.authorFerraldeschi, R
dc.contributor.authorKolinsky, MP
dc.contributor.authorSideris, S
dc.contributor.authorZafeiriou, Z
dc.contributor.authorSumanasuriya, S
dc.contributor.authorSmith, AD
dc.contributor.authorMehra, N
dc.contributor.authorJayaram, A
dc.contributor.authorPerez-Lopez, R
dc.contributor.authorMateo, J
dc.contributor.authorParker, C
dc.contributor.authorDearnaley, DP
dc.contributor.authorTunariu, N
dc.contributor.authorReid, A
dc.contributor.authorAttard, G
dc.contributor.authorde Bono, JS
dc.date.accessioned2016-11-21T11:47:45Z
dc.date.issued2016-11
dc.identifier.citationEuropean urology, 2016, 70 (5), pp. 724 - 731
dc.identifier.issn0302-2838
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/217
dc.identifier.eissn1873-7560
dc.identifier.doi10.1016/j.eururo.2016.02.055
dc.description.abstractBackground The availability of multiple new treatments for metastatic castration-resistant prostate cancer (mCRPC) mandates earlier treatment switches in the absence of a response. A decline in prostate-specific antigen (PSA) is widely used to monitor treatment response, but is not validated as an intermediate endpoint for overall survival (OS).Objective To evaluate the association between early PSA decline and OS following abiraterone acetate (AA) treatment.Design, setting, and participants We identified mCRPC patients treated with AA before or after docetaxel at the Royal Marsden NHS Foundation Trust between 2006 and 2014. Early PSA decline was defined as a 30% decrease in PSA at 4 wk relative to baseline, and early PSA rise as a 25% increase.Outcome measurements and statistical analysis Association with OS was analyzed using multivariate Cox regression and log-rank analyses. Spearman's rho correlation coefficient (r) was calculated to evaluate the association between PSA changes at 4 wk and 12 wk.Results and limitations There were 274 patients eligible for this analysis. A 30% PSA decline at 4 wk was associated with longer OS (25.8 vs 15.1 mo; hazard ratio [HR] 0.47, p<0.001), and a 25% PSA rise at 4 wk with shorter OS (15.1 vs 23.8 mo; HR 1.7, p=0.001) in both univariate and multivariable models. The percentage PSA decline at 4 wk was significantly correlated with the percentage PSA change at 12 wk (r=0.82; p<0.001). Patients achieving a 30% PSA decline at 4 wk were 11.7 times more likely to achieve a 50% PSA decrease at 12 wk (sensitivity 90.9%, specificity 79.4%). Limitations include the retrospective design of this analysis.Conclusions Patients not achieving 30% PSA decline after 4 wk of AA have a lower likelihood of achieving PSA response at 12 wk and significantly inferior OS. Prospective multicentre validation studies are needed to confirm these findings.Patient summary Prostate-specific antigen (PSA) is commonly used to evaluate response to treatment in metastatic castration-resistant prostate cancer. Expert recommendations discourage reliance on PSA changes earlier than 12 wk after treatment initiation. Our data suggest that early PSA changes are associated with survival in patients receiving abiraterone acetate.
dc.formatPrint-Electronic
dc.format.extent724 - 731
dc.languageeng
dc.language.isoeng
dc.subjectHumans
dc.subjectNeoplasm Metastasis
dc.subjectTaxoids
dc.subjectProstate-Specific Antigen
dc.subjectAntineoplastic Agents
dc.subjectDrug Monitoring
dc.subjectNeoplasm Staging
dc.subjectRegistries
dc.subjectSurvival Analysis
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectMale
dc.subjectStatistics as Topic
dc.subjectProstatic Neoplasms, Castration-Resistant
dc.subjectAbiraterone Acetate
dc.subjectUnited Kingdom
dc.subjectDocetaxel
dc.subjectOutcome Assessment, Health Care
dc.titleProstate-specific Antigen Decline After 4 Weeks of Treatment with Abiraterone Acetate and Overall Survival in Patients with Metastatic Castration-resistant Prostate Cancer.
dc.typeJournal Article
dcterms.dateAccepted2016-02-21
rioxxterms.versionofrecord10.1016/j.eururo.2016.02.055
rioxxterms.licenseref.startdate2016-11
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfEuropean urology
pubs.issue5
pubs.notesNo embargo
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Therapeutics
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Therapeutics/Cancer Biomarkers
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Cancer Biomarkers
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Prostate Cancer Targeted Therapy Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Treatment Resistance
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR/Students
pubs.organisational-group/ICR/Students/PhD and MPhil
pubs.organisational-group/ICR/Students/PhD and MPhil/16/17 Starting Cohort
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Therapeutics
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Therapeutics/Cancer Biomarkers
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Cancer Biomarkers
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Prostate Cancer Targeted Therapy Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Treatment Resistance
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR/Students
pubs.organisational-group/ICR/Students/PhD and MPhil
pubs.organisational-group/ICR/Students/PhD and MPhil/16/17 Starting Cohort
pubs.publication-statusPublished
pubs.volume70
pubs.embargo.termsNo embargo
icr.researchteamCancer Biomarkersen_US
icr.researchteamProstate Cancer Targeted Therapy Groupen_US
icr.researchteamClinical Academic Radiotherapy (Dearnaley)en_US
icr.researchteamTreatment Resistanceen_US
dc.contributor.icrauthorSumanasuriya, Seminien
dc.contributor.icrauthorRescigno, Pasqualeen
dc.contributor.icrauthorDearnaley, Daviden
dc.contributor.icrauthorDe Bono, Johannen
dc.contributor.icrauthorAttard, Gerhardten
dc.contributor.icrauthorParker, Chrisen
dc.contributor.icrauthorTunariu, Ninaen
dc.contributor.icrauthorMateo Valderrama, Joaquinen


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