Open AccessKetoconazole in Taiwanese castration-resistant prostate cancer patients: Evaluation of response rates, durations, and predictors
Author(s) -
Bing-Juin Chiang,
Yeong-Shiau Pu,
Hong-Jeng Yu,
Chao-Yuan Huang
Publication year - 2012
Publication title -
urological science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.155
H-Index - 8
eISSN - 1879-5234
pISSN - 1879-5226
DOI - 10.1016/j.urols.2012.04.004
Subject(s) - medicine , ketoconazole , prostate cancer , urology , orchiectomy , prostate specific antigen , adverse effect , group b , castration , prostate , antiandrogen , cancer , oncology , hormone , antifungal , dermatology
Background/purposeTo evaluate the efficacy of ketoconazole in castration-resistant prostate cancer.Materials and methodsWe reviewed the medical records of consecutive patients with pathologically confirmed prostate cancer from May 2006 to December 2008. The inclusion criteria were: (1) receiving 200 or 400 mg ketoconazole three times daily and replacement doses of prednisolone; (2) antiandrogen withdrawal for at least 2 months before ketoconazole treatment; and (3) no prior cytotoxic agents or other CYP17 inhibitors. Treatment consisted of ketoconazole at 200 mg three times daily (Group A) and 400 mg three times daily (Group B). Patients' characteristics, time to prostate-specific antigen (PSA) progression, duration of PSA response, and adverse events were evaluated.ResultsOf the 37 patients in Group A, 14 (37.8%) experienced a PSA response. Of the seven patients in Group B, four (57.1%) experienced a PSA response. Median durations of time to progression in those who experienced a > 50% PSA decline were 7.5 and 11.5 months in Group A and Group B, respectively. Median duration of PSA response was 5.5 and 9.0 months in Group A and Group B, respectively. There was no difference in the PSA response or time to progression between the two groups. Orchiectomy had a borderline unfavorable effect on the PSA response rate (p = 0.067).ConclusionThe present study demonstrated that ketoconazole contributed to the PSA response in patients with castration-resistant prostate cancer. The efficacy and toxicity profiles were comparable to those in previous studies. Orchiectomy had a borderline unfavorable effect on PSA response rate. Further studies are required to confirm the efficacy of ketoconazole therapy in surgically castrated patients