Kazutaka Okita1, Shingo Hatakeyama2, Shintaro Narita3, Masahiro Takahashi4, Toshihiko Sakurai5, Sadafumi Kawamura6, Senji Hoshi7, Masanori Ishida8, Toshiaki Kawaguchi9, Shigeto Ishidoya10, Jiro Shimoda8, Hiromi Sato3, Koji Mitsuzuka4, Akihiro Ito4, Norihiko Tsuchiya5, Yoichi Arai6, Tomonori Habuchi3, Chikara Ohyama1. 1. Department of Urology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan. 2. Department of Urology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan. Electronic address: shingoh@hirosaki-u.ac.jp. 3. Department of Urology, Akita University School of Medicine, Hondo, Akita, Japan. 4. Department of Urology, Tohoku University School of Medicine, Aoba-ku, Sendai, Miyagi, Japan. 5. Department of Urology, Yamagata University School of Medicine, Yamagata, Yamagata, Japan. 6. Department of Urology, Miyagi Cancer Center, Shiote, Aijima, Natori, Miyagi, Japan. 7. Department of Urology, Yamagata Prefectural Central Hospital, Aoyanagi, Yamagata, Japan. 8. Department of Urology, Iwate Prefectural Isawa Hospital, Ryugabaab, Mizusawa-ku, Oshu, Iwate, Japan. 9. Department of Urology, Aomori Prefectural Central Hospital, Higashi-tsukurimichi, Aomori, Aomori, Japan. 10. Department of Urology, Sendai City Hospital, Nagamachi, Asuto, Taihaku-ku, Sendai, Miyagi, Japan.
Abstract
INTRODUCTION: We aimed to evaluate the treatment sequence for patients with metastatic castration-resistant prostate cancer (mCRPC) in real-world practice and compare overall survival in each sequential therapy. PATIENTS AND METHODS: We retrospectively evaluated 146 patients with mCRPC who were initially treated with androgen deprivation therapy as metastatic hormone-naive prostate cancer in 14 hospitals between January 2010 and March 2019. The agents for the sequential therapy included new androgen receptor-targeted agents (ART: abiraterone acetate or enzalutamide), docetaxel, and/or cabazitaxel. We evaluated the treatment sequence for mCRPC and the effect of sequence patterns on overall survival. RESULTS: The median age was 71 years. A total of 35 patients received ART-ART, 33 received ART-docetaxel, 68 received docetaxel-ART, and 10 received docetaxel-cabazitaxel sequences. The most prescribed treatment sequence was docetaxel-ART (47%), followed by ART-ART (24%). Overall survival calculated from the initial diagnosis reached 83, 57, 79, and 37 months in the ART-ART, ART-docetaxel, docetaxel-ART, and docetaxel-cabazitaxel, respectively. Multivariate Cox regression analyses showed no significant difference in overall survival between the first-line ART (n = 68) and first-line docetaxel (n = 78) therapies (hazard ratio [HR], 0.84; P = .530), between the ART-ART (n = 35) and docetaxel-mixed (n = 111) sequences (HR, 0.82; P = .650), and between the first-line abiraterone (n = 32) and first-line enzalutamide (n = 36) sequences (HR, 1.58; P = .384). CONCLUSION: The most prescribed treatment sequence was docetaxel followed by ART. No significant difference was observed in overall survival among the treatment sequences in real-world practice.
INTRODUCTION: We aimed to evaluate the treatment sequence for patients with metastatic castration-resistant prostate cancer (mCRPC) in real-world practice and compare overall survival in each sequential therapy. PATIENTS AND METHODS: We retrospectively evaluated 146 patients with mCRPC who were initially treated with androgen deprivation therapy as metastatic hormone-naive prostate cancer in 14 hospitals between January 2010 and March 2019. The agents for the sequential therapy included new androgen receptor-targeted agents (ART: abiraterone acetate or enzalutamide), docetaxel, and/or cabazitaxel. We evaluated the treatment sequence for mCRPC and the effect of sequence patterns on overall survival. RESULTS: The median age was 71 years. A total of 35 patients received ART-ART, 33 received ART-docetaxel, 68 received docetaxel-ART, and 10 received docetaxel-cabazitaxel sequences. The most prescribed treatment sequence was docetaxel-ART (47%), followed by ART-ART (24%). Overall survival calculated from the initial diagnosis reached 83, 57, 79, and 37 months in the ART-ART, ART-docetaxel, docetaxel-ART, and docetaxel-cabazitaxel, respectively. Multivariate Cox regression analyses showed no significant difference in overall survival between the first-line ART (n = 68) and first-line docetaxel (n = 78) therapies (hazard ratio [HR], 0.84; P = .530), between the ART-ART (n = 35) and docetaxel-mixed (n = 111) sequences (HR, 0.82; P = .650), and between the first-line abiraterone (n = 32) and first-line enzalutamide (n = 36) sequences (HR, 1.58; P = .384). CONCLUSION: The most prescribed treatment sequence was docetaxel followed by ART. No significant difference was observed in overall survival among the treatment sequences in real-world practice.
Authors: Shouki Bazarbashi; Wen-Pin Su; Siew W Wong; Ramanujam A Singarachari; Sudhir Rawal; Maria I Volkova; Diogo A Bastos Journal: Oncol Ther Date: 2021-07-08