Prognostic significance of risk stratification in CHAARTED and LATITUDE studies among Japanese men with de novo metastatic prostate cancer

Shiota, Masaki; Namitome, Ryo; Kobayashi, Takeshi; Inokuchi, Junichi; Tatsugami, Katsunori; Eto, Masatoshi

doi:10.1111/iju.13870

Cited by 18 publications

(17 citation statements)

References 8 publications

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“…The prognostic value of high‐volume cancer has been demonstrated in de novo metastatic PCa patients 20,21 . The amount of bone metastases has also been reported as an independent prognostic factor for OS 22 .…”

Section: Discussionmentioning

confidence: 99%

“…The prognostic value of high-volume cancer has been demonstrated in de novo metastatic PCa patients. 20,21 The amount of bone metastases has also been reported as an independent prognostic factor for OS. 22 However, the clinical significance of the number of bone metastases has not been studied and differences exist in thresholds for the CHAARTED and LATITUDE criteria.…”

Section: Discussionmentioning

confidence: 99%

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How many bone metastases may be defined as high‐volume metastatic prostate cancer in Asians: A retrospective multicenter cohort study

et al. 2020

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Background Recent landmark randomized trials (CHAARTED and LATITUDE studies) have highlighted potent upfront therapy for “high‐volume” and “high‐risk” metastatic castration‐naïve prostate cancer (mCNPC). However, treatment response shows racial differences. We aimed to propose a novel definition for “high‐volume” prostate cancer in Asians. Methods We retrospectively pursued 426 patients with de novo mCNPC from multiple institutions between 1999 and 2017. All patients received androgen deprivation therapy alone as initial treatment. We evaluated the number of bone metastases at diagnosis to clarify the clinical significance for progression‐free survival and overall survival (OS). Statistical analyses were conducted using the Mann‐Whitney U test, Cox proportional hazard models, and Kaplan‐Meier methods. Results Median age and prostate‐specific antigen level were 73 years and 266.2 ng/ml, respectively. Median OS was 55.5 months in patients who met the CHAARTED high criteria (vs 33.1 months in the trial). We evaluated 5 thresholds in the number of bone metastases (≥4, ≥6, ≥11, ≥16, and ≥21) to investigate the prognostic values. Patients with ≥11 bone metastases showed the highest HR for OS (2.766). Patients with 11 to 20 bone metastases had a significantly shorter OS than those with ≤10 metastases (P = .0001). We, therefore, proposed modified CHAARTED and LATITUDE high criteria (extending bone metastases ≥11). In multivariate analysis, the modified criteria were the only independent prognostic factors for OS (P = .0272 and P = .042, respectively). Conversely, no significant differences in OS were seen between patients with 1 to 3 bone metastases and 4 to 10 (P = .7513). Conclusion Our exploratory study suggested ≥11 bone metastases as a suitable definition for “high‐volume” prostate cancer in Asians. A larger, prospective study is warranted to verify our findings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

How many bone metastases may be defined as high‐volume metastatic prostate cancer in Asians: A retrospective multicenter cohort study

et al. 2020

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“…Several previous studies have reported a higher response rate of ADT in Asian patients than in western patients, especially those of African and Caucasian descent [ 1 , 9 ]. In the present study, the CRPC-free survival was 56.9 months in the CHAARTED low-volume group, 12.5 months in the CHAARTED high-volume group, 37.3 months in the LATITUDE low-risk group, and 13.6 months in the LATITUDE high-risk group.…”

Section: Discussionmentioning

confidence: 99%

“…With the recent spread of prostate-specific antigen (PSA) health checks, the early-stage diagnosis of prostate cancer is becoming increasingly frequent. However, a substantial number of patients are still diagnosed with metastatic prostate cancer [ 1 , 2 ]. In the past, androgen deprivation therapy (ADT) was considered to be the standard treatment for metastatic hormone-naïve prostate cancer (mHNPC).…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of the LATITUDE and CHAARTED Risk Criteria for Predicting the Survival of Men with Bone Metastatic Hormone-Naïve Prostate Cancer Treated with Combined Androgen Blockade Therapy: Real-World Data from a Japanese Multi-Institutional Study

Kawahara

Yoneyama

Ohno

et al. 2020

BioMed Research International

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Background. The CHAARTED and LATITUDE trials demonstrated a prolonged overall survival (OS) for metastatic hormone-naïve prostate cancer (mHNPC) patients who receive up-front docetaxel or abiraterone acetate. These studies used their own risk criteria: CHAARTED trial defines high- and low-volume diseases and LATITUDE trial targeting a high-risk disease. The present study explored whether or not the CHAARTED and LATITUDE criteria were useful for predicting the outcome in Japanese bone mHNPC patients, including elderly patients (≥70 years). Methods. A total of 532 mHNPC patients diagnosed from 2004 to 2014 in multithird referral cancer centers were enrolled in this study. All patients had bone metastasis and received combined androgen blockade treatment as an initial hormonal therapy. Results. The number of patients with CHAARTED low-volume and high-volume diseases was 178 (33.5%) and 354 (66.5%), respectively. On the contrary, the number of patients with LATITUDE low-risk and high-risk diseases was 157 (29.5%) and 375 (70.5%), respectively. A total of 307 (57.7%) patients were defined as having both CHAARTED high-volume and LATITUDE high-risk disease. The median castration-resistant prostate cancer- (CRPC-) free survival was 12.5 months for the CHAARTED high volume, 56.9 months for the CHAARTED low volume, 13.6 months for the LATITUDE high risk, and 37.3 months for the LATITUDE low risk, respectively. The OS was 50.1 months in patients with CHAARTED high-volume disease, 95.1 months in patients with CHAARTED low-volume disease, 54.0 months in patients with LATITUDE high-risk disease, and 92.7 months in patients with LATITUDE low-risk disease, respectively. This trend was also observed in elderly (≥70 years old) patients. Conclusions. The patients with CHAARTED high-volume disease or LATITUDE high-risk disease showed a shorter CRPC-free survival and a shorter OS than those in the CHAARTED low-volume disease group or in the LATITUDE low-risk group among Asian Japanese bone metastatic HNPC patients.

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“…In this issue of the International Journal of Urology , Shiota et al . retrospectively evaluated the progression‐free survival and overall survival of Japanese men with de novo metastatic hormone‐naïve prostate cancer (mHSPC) who were stratified by the subclassifications that were defined in the CHAARTED and LATITUDE trials . They showed that the stratifications could clearly discriminate the prognoses of Japanese patients with mHSPC, and the prognosis of the “high” groups seemed to be better than that of Western populations.…”

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confidence: 99%

Editorial Comment to Prognostic significance of risk stratification in CHAARTED and LATITUDE studies among Japanese men with de novo metastatic prostate cancer

Inoue

2018

Int J of Urology

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Prognostic significance of risk stratification in CHAARTED and LATITUDE studies among Japanese men with de novo metastatic prostate cancer

Cited by 18 publications

References 8 publications

How many bone metastases may be defined as high‐volume metastatic prostate cancer in Asians: A retrospective multicenter cohort study

How many bone metastases may be defined as high‐volume metastatic prostate cancer in Asians: A retrospective multicenter cohort study

Prognostic Value of the LATITUDE and CHAARTED Risk Criteria for Predicting the Survival of Men with Bone Metastatic Hormone-Naïve Prostate Cancer Treated with Combined Androgen Blockade Therapy: Real-World Data from a Japanese Multi-Institutional Study

Editorial Comment to Prognostic significance of risk stratification in CHAARTED and LATITUDE studies among Japanese men with de novo metastatic prostate cancer

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