Real-world outcomes in patients with metastatic castration-resistant prostate cancer beyond progression after upfront androgen receptor signaling inhibitor.

Autor: Yamamoto Y; Department of Urology, Kindai University, Nara Hospital, 1248-1 Otodacho, Ikoma, Nara, 630-0293, Japan. yamamotokindai@yahoo.co.jp., Fujimoto S; Department of Urology, Kindai University Hospital, Osaka, Japan., Hashimoto M; Department of Urology, Kindai University Hospital, Osaka, Japan., Minami T; Department of Urology, Kindai University Hospital, Osaka, Japan., Fukuokaya W; Department of Urology, The Jikei University Hospital, Tokyo, Japan., Yanagisawa T; Department of Urology, The Jikei University Hospital, Tokyo, Japan., Saruta M; Department of Urology, Fujita Health University Hospital, Aichi, Japan., Takahara K; Department of Urology, Fujita Health University Hospital, Aichi, Japan., Nishimura K; Department of Urology, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan., Tsujino T; Department of Urology, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan., Nakamori Y; Department of Urology, Tokyo Medical University Hospital, Tokyo, Japan., Hashimoto T; Department of Urology, Tokyo Medical University Hospital, Tokyo, Japan., Kimura T; Department of Urology, The Jikei University Hospital, Tokyo, Japan., Shiroki R; Department of Urology, Fujita Health University Hospital, Aichi, Japan., Azuma H; Department of Urology, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan., Ohno Y; Department of Urology, Tokyo Medical University Hospital, Tokyo, Japan., Fujita K; Department of Urology, Kindai University Hospital, Osaka, Japan.
Jazyk: angličtina
Zdroj: International journal of clinical oncology [Int J Clin Oncol] 2024 Dec; Vol. 29 (12), pp. 1946-1958. Date of Electronic Publication: 2024 Oct 01.
DOI: 10.1007/s10147-024-02637-6
Abstrakt: Background: Upfront androgen receptor signaling inhibitor (ARSI) along with androgen deprivation therapy is the current standard of care for metastatic castration-sensitive prostate cancer. However, evidence on second-line therapy after upfront ARSI is scarce. We aimed to evaluate the oncological outcome of ARSI versus docetaxel (DOC) after upfront ARSI therapy in a real-world clinical practice.
Methods: Subjects were metastatic castration-resistant prostate cancer (mCRPC) patients who had progressed within 2 years of upfront ARSI therapy and received ARSI (ARSI group) or DOC (DOC group) as a second-line therapy. Second-line progression-free survival (second-line PFS), and second-line overall survival (second-line OS) were assessed. Propensity score matching (PSM) was used to adjust the clinicopathological features and treatment patterns.
Results: A total of 101 mCRPC patients, 68 in the ARSI group, and 33 in the DOC group, were included in this analysis. Median second-line PFS was 6.3 months in the ARSI group and 4.9 months in the DOC group (p = 0.21). Median second-line OS was 25.0 months in the ARSI group and 14.2 months in the DOC group (p = 0.06). Prostate-specific antigen nadir ≤ 0.2 ng/ml during upfront ARSI therapy was significantly associated with improved second-line PFS. After PSM, no significant difference in second-line PFS and second-line OS were observed between the two groups.
Conclusion: ARSI or DOC has comparable oncologic outcomes in terms of second-line PFS and second-line OS. Further prospective research with longer follow-ups will be needed to identify the optimal treatment after upfront ARSI therapy.
Competing Interests: Declarations. Conflict of interest: Takahiro Kimura received honoraria from Astellas, AstraZeneca, Bayer, Janssen, Sanofi, and Takeda. Kazutoshi Fujita received honoraria from Astellas, Bristol Myers Squibb, Janssen, MSD, and Ono.
(© 2024. The Author(s) under exclusive licence to Japan Society of Clinical Oncology.)
Databáze: MEDLINE
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