Blood platelet volume predicts treatment-specific outcomes of metastatic castration-resistant prostate cancer
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ORIGINAL ARTICLE
Blood platelet volume predicts treatment‑specific outcomes of metastatic castration‑resistant prostate cancer Wataru Fukuokaya1 · Takahiro Kimura1 · Fumihiko Urabe1 · Shoji Kimura1 · Kojiro Tashiro1 · Shunsuke Tsuzuki1 · Yusuke Koike1 · Hiroshi Sasaki1 · Kenta Miki1 · Shin Egawa1 Received: 22 March 2020 / Accepted: 20 May 2020 © Japan Society of Clinical Oncology 2020
Abstract Background In the present guidelines for the management of metastatic castration-resistant prostate cancer (mCRPC), it is unclear who benefits most from androgen receptor axis-targeted agents (ARATs) or docetaxel as the first-line treatment. Methods We conducted a retrospective study to explore new treatment-specific biomarkers in mCRPC. A total of 211 patients with mCRPC who received either ARAT or docetaxel as first-line treatment were included. Patients were compared for radiographic progression and prostate-specific antigen (PSA) progression. Multivariable Cox regression models were used to assess the association between pretreatment biomarkers and risk of events. The statistical interaction between biomarkers and clinical outcomes was also evaluated. Results Of all analyzed biomarkers, multivariable Cox regression models identified MPV [≤ median (9.7 fL)] as an independent prognostic factor of radiographic progression [hazard ratio (HR), 2.35; 95% confidence interval (CI), 1.15–4.80; P = 0.019] and PSA progression (HR, 1.96; 95% CI, 1.01–3.95; P = 0.048) in patients treated with ARAT, whereas such associations were not observed in those treated with docetaxel. Interaction analyses showed that those initially treated with docetaxel have lower risk of radiographic progression (HR, 0.33; 95% CI, 0.13–0.79; P = 0.014) and PSA progression (HR, 0.48; 95% CI, 0.23–0.98; P = 0.044) than ARAT when MPV was small. Conclusions The present study identified pretreatment MPV as a significant treatment-specific prognostic factor of PSA and radiographic progression in patients with mCRPC who received first-line treatment. Furthermore, our results suggested that those with small MPV may better be treated initially with docetaxel than ARAT. Keywords Mean platelet volume · Castration-resistant prostate cancer · Abiraterone acetate · Enzalutamide · Docetaxel
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10147-020-01712-y) contains supplementary material, which is available to authorized users.
Prostate cancer is the second most commonly diagnosed malignancy and fifth leading cause of cancer-related death in men worldwide [1]. Although locally advanced and metastatic prostate cancers are often initially treated with
* Wataru Fukuokaya [email protected]
Hiroshi Sasaki [email protected]
Takahiro Kimura [email protected]
Kenta Miki [email protected]
Fumihiko Urabe [email protected]
1
Shoji Kimura shoji.kimura‑[email protected]
Department of Urology, The Jikei University School of Medicine, 3‑25‑8 Nishi‑shimbashi, Minato‑ku, Tokyo 105‑84
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