Prognostic outcomes in Japanese patients with metastatic castration-sensitive prostate cancer: Comparative assessments between conventional androgen deprivation therapy (ADT) and ADT with novel androgen receptor signal inhibitor

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology Pub Date : 2024-05-19 DOI:10.1111/iju.15498

Hiromitsu Watanabe, Keita Nakane, Kiyoshi Takahara, Taku Naiki, Takahiro Yasui, Ryoichi Shiroki, Takuya Koie, Hideaki Miyake

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引用次数: 0

Abstract

Objective

The objective of this study was to compare the prognostic outcomes between metastatic castration-sensitive prostate cancer (mCSPC) patients receiving conventional androgen deprivation therapy (ADT) and those receiving ADT plus a novel androgen-receptor signaling inhibitor (ARSI) in routine clinical practice in Japan.

Methods

This was conducted as a retrospective multicenter study including 581 mCSPC patients, consisting of 305 receiving ADT alone or in combination with bicalutamide (group 1) and 276 receiving ADT plus one of the following ARSIs: abiraterone acetate, apalutamide, or enzalutamide (group 2). Prognostic outcomes between these 2 groups were comprehensively compared.

Results

In the entire cohort, prostate-specific antigen—progression-free survival (PSA-PFS) in group 2 was significantly longer than that in group 1, while no significant difference was noted in overall survival (OS) between the two groups. In patients corresponding to the LATITUDE high-risk group, however, both PSA-PFS and OS in group 2 were significantly longer than those in group 1. Of several factors examined, the following were identified as independent predictors of poor PSA-PFS in the entire cohort as well as the LATITUDE high-risk group: high C-reactive protein, high lactate dehydrogenase, high alkaline phosphatase, high Gleason score, and group 1. Furthermore, it was possible to precisely classify both the entire cohort and LATITUDE high-risk group into 3 risk groups regarding PSA-PFS according to the positive numbers of independent factors: positive for ≤1 factor, favorable; 2 factors, intermediate; and ≥3 factors, poor.

Conclusion

Combined use of ARSIs with ADT could improve the prognostic outcomes of mCSPC patients, particularly those in the LATITUDE high-risk group, in real-world clinical practice in Japan.

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日本转移性阉割敏感性前列腺癌患者的预后：传统雄激素剥夺疗法（ADT）与使用新型雄激素受体信号抑制剂的 ADT 的比较评估。

研究目的本研究旨在比较日本常规临床实践中接受传统雄激素剥夺疗法（ADT）和接受ADT加新型雄激素受体信号转导抑制剂（ARSI）的转移性阉割敏感性前列腺癌（mCSPC）患者的预后结果：该研究是一项回顾性多中心研究，包括581名mCSPC患者，其中305人接受ADT单独治疗或与比卡鲁胺联合治疗（第1组），276人接受ADT联合以下一种ARSI：醋酸阿比特龙、阿帕鲁胺或恩扎鲁胺（第2组）。对这两组的预后结果进行了综合比较：在整个队列中，第2组的前列腺特异性抗原-无进展生存期（PSA-PFS）明显长于第1组，而两组的总生存期（OS）无明显差异。但在 LATITUDE 高危组中，第 2 组的 PSA-PFS 和 OS 均明显长于第 1 组。在所研究的几个因素中，以下因素被认为是整个队列和 LATITUDE 高危组中 PSA-PFS 较差的独立预测因素：高 C 反应蛋白、高乳酸脱氢酶、高碱性磷酸酶、高 Gleason 评分和第 1 组。此外，根据独立因素的阳性数量，可以将整个队列和LATITUDE高风险组精确划分为3个PSA-PFS风险组：≤1个因素阳性，为良好组；2个因素阳性，为中等组；≥3个因素阳性，为不良组：结论：在日本的实际临床实践中，ARSIs与ADT联合使用可改善mCSPC患者的预后，尤其是LATITUDE高危组中的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Urology 医学-泌尿学与肾脏学

CiteScore

4.70

自引率

11.50%

发文量

340

审稿时长

3 months

期刊介绍： International Journal of Urology is the official English language journal of the Japanese Urological Association, publishing articles of scientific excellence in urology. Submissions of papers from all countries are considered for publication. All manuscripts are subject to peer review and are judged on the basis of their contribution of original data and ideas or interpretation.