Clinical Outcomes and Testosterone Levels Following Continuous Androgen Deprivation in Patients with Relapsing or Locally Advanced Prostate Cancer: A Post Hoc Analysis of the ICELAND Study

被引：14

作者：

Tombal, Bertrand ^{[1
]}

Cornel, Erik B. ^{[4
]}

Persad, Raj ^{[5
]}

Stari, Anny ^{[6
]}

Gomez Veiga, Francisco ^{[7
,8
]}

Schulman, Claude ^{[2
,3
]}

机构：

[1] Clin Univ St Luc, Brussels, Belgium

[2] Clin E Cavell, Brussels, Belgium

[3] Univ Brussels, Brussels, Belgium

[4] Ziekenhuisgrp Twente, Dept Urol, Hengelo, Netherlands

[5] Univ Hosp Bristol Natl Hlth Serv Fdn Trust, Dept Urol, Bristol, Avon, England

[6] Astellas Pharma Med Affairs, Chertsey, England

[7] Salamanca Univ Hosp, Salamanca, Spain

[8] GITUR IBSAL, Translat Res Grp Urol, Salamanca, Spain

来源：

JOURNAL OF UROLOGY | 2017年 / 198卷 / 05期

关键词：

prostatic neoplasms; testosterone; prostate-specific antigen; leuprolide; mortality; THERAPY; INTERMITTENT; SUPPRESSION; ACETATE;

D O I：

10.1016/j.juro.2017.05.072

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Purpose: Lower serum testosterone levels correlate with improved cause specific survival and longer time to progression in year 1 of continuous androgen deprivation in men with prostate cancer. ICELAND was a large European study demonstrating the efficacy of leuprorelin (Eligard (R)) during continuous androgen deprivation. In this post hoc analysis we investigated serum testosterone levels within year 1 of continuous androgen deprivation to determine survival and time to progression. Materials and Methods: In ICELAND (ClinicalTrials.gov NCT00378690) patients with locally advanced or relapsing nonmetastatic prostate cancer and with prostate specific antigen 1 ng/ml or less following 6-month induction with leuprorelin 3-month depot 22.5 mg (plus bicalutamide 50 mg per day for 1 month) were randomized 1:1 to continuous androgen deprivation (361) or intermittent androgen deprivation (340) with leuprorelin for 36 months. Patients receiving continuous androgen deprivation were stratified by minimum, median and maximum testosterone levels during year 1 of therapy into 20 or less, greater than 20 to 50 and greater than 50 ng/dl subgroups. Cause specific survival and time to prostate specific antigen (castrate resistant prostate cancer) progression were analyzed. Results: A total of 90.1%, 83.5% and 74.5% of patients receiving continuous androgen deprivation achieved minimum, median and maximum serum testosterone levels of 20 ng/dl or less, respectively. Cause specific survival rates and time to prostate specific antigen progression did not differ among the testosterone subgroups. Conclusions: In patients receiving continuous androgen deprivation cause specific survival and time to prostate specific antigen progression did not differ according to testosterone levels in year 1 of therapy. This finding may in part be due to the induction period and the effectiveness of leuprorelin in lowering testosterone.

引用

页码：1054 / 1060

页数：7

共 14 条

[11]

Roche Diagnostics, 2012, EL IMM ECLIA IN VITR

[12] Intermittent Versus Continuous Androgen Deprivation Therapy in Patients with Relapsing or Locally Advanced Prostate Cancer: A Phase 3b Randomised Study (ICELAND) [J].