Serum testosterone level as possible predictive marker in androgen receptor axis-targeting agents and taxane chemotherapies for castration-resistant prostate cancer

Urol Oncol. 2019 Mar;37(3):180.e19-180.e24. doi: 10.1016/j.urolonc.2018.10.020. Epub 2018 Nov 13.

Abstract

Purpose: Currently, several therapeutic options for castration-resistant prostate cancer (CRPC) are available, for which predictive biomarkers have not been established. Therefore, we aimed to reveal the association between pretreatment serum testosterone level and antitumor outcomes when treated with androgen receptor axis-targeting agents and taxane chemotherapies for CRPC.

Patients and methods: The present study included Japanese patients with metastatic prostate cancer whose serum testosterone levels during androgen-deprivation therapy were available. The antitumor outcomes when treated with enzalutamide, abiraterone, docetaxel, and cabazitaxel with clinicopathological parameters including serum testosterone levels during androgen-deprivation therapy, as well as prognoses including progression-free survival and overall survival, were examined.

Results: Progression-free survival among men with higher serum testosterone level was superior to that among men with lower serum testosterone level when treated with enzalutamide. On the contrary, progression-free survival and overall survival among men with higher serum testosterone level were significantly inferior to those among men with lower serum testosterone level when treated with docetaxel and cabazitaxel, respectively.

Conclusions: The present study indicated distinct prognostic values of serum testosterone level when treated with androgen receptor axis-targeting agent and taxane chemotherapy for CRPC, suggesting that serum testosterone level may be useful predictive biomarker to navigate the appropriate therapy in patients with CRPC.

Keywords: Abiraterone; Cabazitaxel; Docetaxel; Enzalutamide; Testosterone.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Androgen Antagonists / therapeutic use
  • Androstenes / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Benzamides
  • Biomarkers, Tumor / blood*
  • Docetaxel / therapeutic use
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Neoplasm Grading
  • Nitriles
  • Phenylthiohydantoin / analogs & derivatives
  • Phenylthiohydantoin / therapeutic use
  • Progression-Free Survival
  • Prostate / pathology
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms, Castration-Resistant / blood
  • Prostatic Neoplasms, Castration-Resistant / drug therapy*
  • Prostatic Neoplasms, Castration-Resistant / mortality
  • Receptors, Androgen / metabolism
  • Taxoids / therapeutic use
  • Testosterone / blood*

Substances

  • AR protein, human
  • Androgen Antagonists
  • Androstenes
  • Benzamides
  • Biomarkers, Tumor
  • Nitriles
  • Receptors, Androgen
  • Taxoids
  • Docetaxel
  • Phenylthiohydantoin
  • Testosterone
  • cabazitaxel
  • enzalutamide
  • Prostate-Specific Antigen
  • abiraterone