Oncotarget

Research Papers:

The prognostic implication of intraductal carcinoma of the prostate in metastatic castration-resistant prostate cancer and its potential predictive value in those treated with docetaxel or abiraterone as first-line therapy

Jinge Zhao, Pengfei Shen, Guangxi Sun, Ni Chen, Jiandong Liu, Xin Tang, Rui Huang, Diming Cai, Jing Gong, Xingming Zhang, Zhibin Chen, Xiang Li, Qiang Wei, Peng Zhang, Zhenhua Liu, Jiyan Liu and Hao Zeng _

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Oncotarget. 2017; 8:55374-55383. https://doi.org/10.18632/oncotarget.19520

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Abstract

Jinge Zhao1,*, Pengfei Shen1,*, Guangxi Sun1,*, Ni Chen2,*, Jiandong Liu1, Xin Tang3, Rui Huang4, Diming Cai5, Jing Gong2, Xingming Zhang1, Zhibin Chen1, Xiang Li1, Qiang Wei1, Peng Zhang1, Zhenhua Liu1, Jiyan Liu3 and Hao Zeng1

1Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China

2Department of Pathology, West China Hospital, Sichuan University, Chengdu, 610041, China

3Department of Oncology, West China Hospital, Sichuan University, Chengdu, 610041, China

4Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China

5Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, 610041, China

*These authors contributed equally to this work

Correspondence to:

Hao Zeng, email: [email protected]

Jiyan Liu, email: [email protected]

Keywords: metastatic castration-resistant prostate cancer, intraductal carcinoma of prostate, docetaxel, abiraterone, prognosis

Received: January 25, 2017     Accepted: July 12, 2017     Published: July 24, 2017

ABSTRACT

Intraductal carcinoma of the prostate (IDC-P) is recognized as a newly pathological entity in 2016 WHO classification. It’s role in metastatic castration-resistant prostate cancer (CRPC) remains obscure. We aimed to explore the association of IDC-P with clinical outcome and to further identify its potential predictive role in making first-line treatment decisions for mCRPC. We retrospectively analyzed data of 131 mCRPC patients. IDC-P was diagnosed by re-biopsy at the time of mCRPC. Among total patients, 45 and 41 received abiraterone or docetaxel as first-line therapies, respectively. PSA response, PSA progression-free survival (PSA-PFS) and overall survival (OS) from mCRPC to death were analyzed using Kaplan-Meier curves, Log-rank test, Cox regression models and Harrell’s C-index. The incidence of IDC-P in mCRPC reached 47.3%. IDC-P was not only related to rapid PSA progression, but also associated with a 20-month decrease in OS. Among IDC-P(-) patients, PSA response, PSA-PFS and OS were comparable in abiraterone-treated and docetaxel-treated groups. In contrast, among IDC-P(+) patients, PSA response rate is higher in abiraterone-treated group vs. docetaxel-treated group (52.4% vs. 21.7%; p = 0.035). Also, PSA-PFS and OS were much longer in the IDC-P(+) abiraterone-treated group vs. the docetaxel-treated group (PSA-PFS: 13.5 vs.6.0 months, p = 0.012; OS: not reach vs.14.7 months, p = 0.128). Overall, IDC-P in mCRPC from re-biopsy was an independent prognosticator for clinical outcome. Abiraterone was observed having a better therapeutic efficacy than docetaxel as the first-line therapy in IDC-P(+) mCRPC patients. Thus, we suggest IDC-P should be considered as a novel predictive marker helping physicians making treatment decisions for mCRPC.


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