Development of Nomogram to Non-steroidal Antiandrogen Sequential Alternation in Prostate Cancer for Predictive Model

作者：Kamiya Naoto; Suzuki Hiroyoshi^*; Nishimura Kensaku; Fujii Motohiro; Okegawa Takatsugu; Matsuda Tadashi; Morita Tatsuo; Takihana Yoshio; Ozono Seiichiro; Namiki Mikio; Matsubara Akio; Ichikawa Tomohiko; Miki Tsuneharu

来源：Japanese Journal of Clinical Oncology, 2014, 44(3): 263-269.

DOI：10.1093/jjco/hyt230

• prostate cancer
• nomogram
• alternation
• hormone therapy

Objectives: To clarify clinical predictors for a prostate-specific antigen decrease %26gt;= 50% in response to alternative non-steroidal antiandrogen therapy and to develop a nomogram to predict the prostate-specific antigen decrease %26gt;= 50% in response to alternative non-steroidal antiandrogen therapy in patients with advanced prostate cancer that relapsed after initial combined androgen blockade. We previously reported that combined androgen blockade with an alternative non-steroidal antiandrogen is effective for advanced prostate cancer that has relapsed after initial combined androgen blockade. %26lt;br%26gt;Methods: We enrolled 161 patients from 14 medical institutions with histologically confirmed prostate cancer who had been treated with combination therapy and in whom cancer progressed after first-line combined androgen blockade therapy. A nomogram for the prostate-specific antigen decrease %26gt;= 50% from baseline prostate-specific antigen in response to alternative non-steroidal antiandrogen therapy was developed based on the final logistic regression model. %26lt;br%26gt;Results: Overall prostate-specific antigen decreased %26gt;= 50% in 75 of 161 patients (46.6%) in response to alternative non-steroidal antiandrogen therapy. Using five independent risk factors (initial serum level of prostate-specific antigen, hemoglobin, C-reactive protein, prostate-specific antigen nadir to second hormone therapy and Gleason sum), a nomogram was developed for the prediction of prostate-specific antigen decrease %26gt;= 50% in response to alternative nonsteroidal antiandrogen therapy. The receiver operating characteristic curve showed that the accuracy of the predicted probability was 72.5% for the model. %26lt;br%26gt;Conclusions: This predictive nomogram could predict the prostate-specific antigen decrease %26gt;= 50% in response to alternative non-steroidal antiandrogen therapy and might be of benefit to determine the sequential treatment strategy in patients with relapse after first combined androgen blockade.

• 出版日期2014-3