Trends in the Use of Second-Generation Androgen Receptor Axis Inhibitors for Metastatic Hormone-Sensitive Prostate Cancer and Clinical Factors Predicting Biological Recurrence

Abstract

The advent of second-generation androgen receptor axis-targeted agents (ARATs) has revolutionized the treatment of metastatic hormone-sensitive prostate cancer (mHSPC). Biochemical recurrence-free survival (BRFS) was used to compare the efficacy of each ARAT. This multicenter retrospective study included 581 patients with newly diagnosed mHSPC who received first-line hormone therapy. The characteristics of patients treated with different ARATs were compared as well as changes in the usage of each drug over time. For BRFS, the apalutamide (Apa) and enzalutamide (Enza) groups, as well as the abiraterone acetate (Abi) and Apa/Enza groups, were compared. In addition, multivariate analysis was performed to determine predictive factors for biochemical recurrence (BCR). The use of second-generation ARATs tended to increase after May 2020. No significant difference in BRFS was found between patients receiving Apa and Enza (p = 0.490) and those receiving Abi or Apa/Enza (p = 0.906). Multivariate analysis revealed that the neutrophil-to-lymphocyte ratio (NLR) ≥ 2.76 and PSA ≥ 0.550 ng/mL were independent predictors of BCR. There were no significant differences in patient characteristics or BRFS in patients with mHSPC receiving different ARATs as first-line treatment. NLR and PSA may be prognostic factors following the first-line treatment of patients with mHSPC.

The Negative Impact of Inflammation-Related Parameters in Prostate Cancer after Robot-Assisted Radical Prostatectomy: A Retrospective Multicenter Cohort Study in Japan (the MSUG94 Group)

“…Several studies have shown that many types of malignant neoplasms play an important role in the carcinogenic process and survival with respect to systemic inflammation [6][7][8][9][10][11][12][13][14][15][16]24]. Tumor cells themselves release cytokines and chemokines, which are thought to circulate and induce a systemic inflammatory response [25], resulting in changes in neutrophils, lymphocytes, and platelets [26].…”

“…The relationships between inflammation-related parameters and tumorigenesis have been widely studied in various tumors [6][7][8][9][10]. In particular, PCa, which is a systemic, multifactorial disease, has been extensively investigated [11][12][13][14][15][16]. Inflammatory cells and mediators in the tumor microenvironment are known to mediate the inflammatory response and further interact with the tumor and peritumoral cells in an autocrine and/or paracrine manner [17].…”