AI Article Synopsis
- The study aimed to compare the outcomes of metastatic castration-sensitive prostate cancer patients receiving standard androgen deprivation therapy (ADT) versus those receiving ADT combined with a new androgen-receptor signaling inhibitor (ARSI) in Japan.
- A retrospective analysis of 581 patients revealed that those on the combination therapy had longer prostate-specific antigen-progression-free survival (PSA-PFS), especially among high-risk patients, although overall survival rates were similar between both groups.
- Key factors like high Gleason score and certain blood marker levels indicated worse PSA-PFS outcomes, allowing researchers to categorize patients into risk groups based on these predictors.
Article 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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| http://dx.doi.org/10.1111/iju.15498 | DOI Listing |
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