Real-world survival outcomes of adding docetaxel or abiraterone in patients with high-volume metastatic castration-sensitive prostate cancer: historically controlled, propensity score matched comparison with androgen deprivation therapy

Narita, Shintaro; Kimura, Takahiro; Hatakeyama, Shingo; Hata, Kenichi; Yanagisawa, Takafumi; Maita, Shinya; Chiba, Shuji; Sato, Hiromi; Kashima, Soki; Koizumi, Atsushi; Yamamoto, Ryohei; Takayama, Kenji; Okane, Katsumi; Ishida, Taiichiro; Horikawa, Yohei; Kumazawa, Teruaki; Shimoda, Jiro; Suzuki, Takehiro; Οhyama, Chikara; Egawa, Shin; Nomura, Kyoko; Habuchi, Tomonori

doi:10.1007/s00345-022-03963-y

Cited by 14 publications

(11 citation statements)

References 29 publications

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“…However, this does not mean that the use of ARAT agents early in the initial treatment is futile. Regarding high-volume cases, Narita et al ( 27 ) reported that upfront use of abiraterone significantly improved OS when compared to ADT/CAB treatment. Considering these results, we recommend that ARAT reagents should be used from the time of initial hormonal therapy to obtain the maximum therapeutic effect.…”

Section: Discussionmentioning

confidence: 99%

Androgen receptor axis‑targeted agents are not superior to conventional hormonal therapy for treatment of metastatic prostate cancer

et al. 2022

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The present study aimed to use real-world Japanese data to compare the treatment outcome of conventional hormonal therapy to that of using androgen receptor axis-targeted (ARAT) agents for patients with metastatic castration-resistant prostate cancer. The overall survival between the conventional hormonal therapy group and the ARAT agent therapy group was compared using a group of 75 Japanese patients who were treated for metastatic castration-resistant prostate cancer. A subgroup analysis was carried out and the risk factors that affected overall survival (OS) were determined. The median OS from the time of prostate-specific antigen recurrence was 73.1 months in the ARAT group and 45.2 months in the conventional treatment group (P=0.414). Although OS tended to be slightly longer in the ARAT group, the difference between the groups was not significant. Subgroup analysis suggested that the therapeutic outcome of using ARAT agents tended to be less beneficial in patients who were older, and in those with a higher tumor volume or low Gleason grade. In conclusion, use of ARAT agents did not impart a significant survival benefit to patients with metastatic castration-resistant prostate cancer when compared with survival rates in response to conventional therapy. However, there was some clinical benefit when ARAT agents were used after patients developed castration-resistant prostate cancer. These findings suggest that up-front therapy using ARAT agents at the time of the initial hormone therapy can impart clinical benefit in Japanese patients with metastatic prostate cancer.

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Section: Discussionmentioning

confidence: 99%

Androgen receptor axis‑targeted agents are not superior to conventional hormonal therapy for treatment of metastatic prostate cancer

et al. 2022

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“…We used the Michinoku Japan Urological Cancer Study Group database 21 and the Hirosaki University database to retrospectively evaluate 281 patients with high tumor burden mCSPC who were initially treated with conventional ADT (medical or surgical castration ± bicalutamide) between January 2014 and December 2021. We also used the Jikei University School of Medicine, Hirosaki University School of Medicine, and Akita University School of Medicine (JHA) database 14,22 to retrospectively evaluate patients who were treated with upfront DTX or ABI plus prednisolone ( n = 298) between March 2016 and June 2021. The JHA database included 11 participating institutions.…”

Section: Methodsmentioning

confidence: 99%

“…9 The clinical benefits of upfront intensive therapy have been reported including ADT plus docetaxel (DTX) for metastatic castration-sensitive PC (mCSPC), ADT plus abiraterone acetate (ABI), ADT plus enzalutamide, and ADT plus apalutamide in clinical trials [10][11][12][13] and real-world practice. [14][15][16][17] However, the clinical benefits for older patients remain unclear because the median age of most study participants was 65-70 years, and only approximately 20% were aged ≥75 years. [10][11][12][13]18,19,20 Additionally, subgroup analyses showed marginal efficacy of oncological outcomes in patients aged ≥75 years.…”

Section: Introductionmentioning

confidence: 99%

“…PC prevalence increases in the elderly population, and the incidence is highest among men aged ≥70 years 9 . The clinical benefits of upfront intensive therapy have been reported including ADT plus docetaxel (DTX) for metastatic castration‐sensitive PC (mCSPC), ADT plus abiraterone acetate (ABI), ADT plus enzalutamide, and ADT plus apalutamide in clinical trials 10–13 and real‐world practice 14–17 . However, the clinical benefits for older patients remain unclear because the median age of most study participants was 65–70 years, and only approximately 20% were aged ≥75 years 10–13,18,19,20 .…”

Section: Introductionmentioning

confidence: 99%

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Effect of upfront intensive therapy on oncological outcomes in older patients with high tumor burden metastatic castration‐sensitive prostate cancer: A multicenter retrospective study

et al. 2022

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Background The effect of upfront intensive therapy on the prognosis of older patients with metastatic castration‐sensitive prostate cancer (mCSPC) remains unclear. Thus, we assessed the impact of older age (≥75 years) on oncological outcomes in mCSPC patients with a high tumor burden. Methods This multicenter retrospective study included 252 patients aged ≥75 years treated with either upfront or conventional therapy between 2014 and 2021. We compared castration‐resistant prostate cancer (CRPC)‐free survival (FS) and overall survival (OS) between patients with androgen deprivation therapy (ADT) plus upfront intensive therapy (docetaxel [DTX] or abiraterone acetate [ABI] plus prednisolone) and conventional therapy (ADT monotherapy or ADT combined with bicalutamide). We evaluated the effect of upfront intensive therapy on prognosis by multivariable Cox regression analysis. Results The 231 patients enrolled in our study were classified in the conventional group (n = 148) or the upfront group (n = 104; DTX = 27 and ABI = 77). The upfront group had significantly prolonged CRPC‐FS and OS compared with the conventional group, and this was also the case in the background‐adjusted multivariable Cox regression analysis. Conclusion Patients aged ≥75 years who received upfront intensive therapy had significantly longer CRPC‐FS and OS compared with similar age patients treated with conventional therapy in real‐world practice. The oncological benefit may not diminish in this older population.

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“…Androgen deprivation therapy (ADT) has remained the mainstay of treatment for patients with metastatic hormone‐sensitive prostate cancer (mHSPC) for more than 70 years 1 . Although initially effective, castration‐resistance eventually develop in almost all patients with advanced prostate cancer 2 . Recent studies from three large, randomized, phase 3 clinical trials have indicated longer overall survival periods in patients receiving upfront docetaxel chemotherapy plus ADT for high‐volume mHSPC 3–5 .…”

Section: Introductionmentioning

confidence: 99%

Rupture of liver metastasis in high‐volume metastatic prostate cancer patient on androgen deprivation therapy combined with upfront docetaxel chemotherapy

Hata¹,

Tanaka²,

Takahashi³

et al. 2022

IJU Case Reports

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Real-world survival outcomes of adding docetaxel or abiraterone in patients with high-volume metastatic castration-sensitive prostate cancer: historically controlled, propensity score matched comparison with androgen deprivation therapy

Cited by 14 publications

References 29 publications

Androgen receptor axis‑targeted agents are not superior to conventional hormonal therapy for treatment of metastatic prostate cancer

Androgen receptor axis‑targeted agents are not superior to conventional hormonal therapy for treatment of metastatic prostate cancer

Effect of upfront intensive therapy on oncological outcomes in older patients with high tumor burden metastatic castration‐sensitive prostate cancer: A multicenter retrospective study

Rupture of liver metastasis in high‐volume metastatic prostate cancer patient on androgen deprivation therapy combined with upfront docetaxel chemotherapy

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