Teppei Okamoto1, Daisuke Noro1, Shingo Hatakeyama2, Shintaro Narita3, Koji Mitsuzuka4, Toshihiko Sakurai5, Sadafumi Kawamura6, Senji Hoshi7, Jiro Shimoda8, Toshikazu Tanaka9, Toshiaki Kawaguchi9, Shigeto Ishidoya10, Akihiro Ito4, Norihiko Tsuchiya5, Tomonori Habuchi3, Chikara Ohyama1. 1. Department of Urology, Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan. 2. Department of Urology, Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan. shingoh@hirosaki-u.ac.jp. 3. Department of Urology, Akita University School of Medicine, 1-1-1, Hondo, Akita, 010-8543, Japan. 4. Department of Urology, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan. 5. Department of Urology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata, Yamagata, 990-9585, Japan. 6. Department of Urology, Miyagi Cancer Center, 47-1, Nodayama, Shiote, Aijima, Natori, Miyagi, 981-1293, Japan. 7. Department of Urology, Yamagata Prefectural Central Hospital, 1800, Aoyanagi, Yamagata, 990-2292, Japan. 8. Department of Urology, Iwate Prefectural Isawa Hospital, 61, Ryugabaab, Mizusawa-ku, Oshu, Iwate, 023-0864, Japan. 9. Department of Urology, Aomori Prefectural Central Hospital, 2-1-1, Higashi-tsukurimichi, Aomori, Aomori, 030-8553, Japan. 10. Department of Urology, Sendai City Hospital, 1-1-1, Nagamachi, Asuto, Taihaku-ku, Sendai, Miyagi, 982-8502, Japan.
Abstract
BACKGROUND: Anemia has been a known prognostic factor in metastatic hormone-sensitive prostate cancer (mHSPC). We therefore examined the effect of anemia on the efficacy of upfront abiraterone acetate (ABI) in patients with mHSPC. METHODS: We retrospectively evaluated 66 mHSPC patients with high tumor burden who received upfront ABI between 2018 and 2020 (upfront ABI group). We divided these patients into two groups: the anemia-ABI group (hemoglobin < 13.0 g/dL, n = 20) and the non-anemia-ABI group (n = 46). The primary objective was to examine the impact of anemia on the progression-free survival (PFS; clinical progression or PC death before development of castration resistant PC) of patients in the upfront ABI group. Secondary objectives included an evaluation of the prognostic significance of upfront ABI and a comparison with a historical cohort (131 mHSPC patients with high tumor burden who received androgen deprivation therapy (ADT/complete androgen blockade [CAB] group) between 2014 and 2019). RESULTS: We found that the anemia-ABI group had a significantly shorter PFS than the non-anemia-ABI group. A multivariate Cox regression analysis showed that anemia was an independent prognostic factor of PFS in the upfront ABI group (hazard ratio, 4.66; P = 0.014). Patients in the non-anemia-ABI group were determined to have a significantly longer PFS than those in the non-anemia-ADT/CAB group (n = 68) (P < 0.001). However, no significant difference was observed in the PFS between patients in the anemia-ABI and the anemia-ADT/CAB groups (n = 63). Multivariate analyses showed that upfront ABI could significantly prolong the PFS of patients without anemia (hazard ratio, 0.17; P < 0.001), whereas ABI did not prolong the PFS of patients with anemia. CONCLUSION: Pretreatment anemia was a prognostic factor among mHSPC patients who received upfront ABI. Although the upfront ABI significantly improved the PFS of mHSPC patients without anemia, its efficacy in patients with anemia might be limited.
BACKGROUND:Anemia has been a known prognostic factor in metastatic hormone-sensitive prostate cancer (mHSPC). We therefore examined the effect of anemia on the efficacy of upfront abiraterone acetate (ABI) in patients with mHSPC. METHODS: We retrospectively evaluated 66 mHSPC patients with high tumor burden who received upfront ABI between 2018 and 2020 (upfront ABI group). We divided these patients into two groups: the anemia-ABI group (hemoglobin < 13.0 g/dL, n = 20) and the non-anemia-ABI group (n = 46). The primary objective was to examine the impact of anemia on the progression-free survival (PFS; clinical progression or PC death before development of castration resistant PC) of patients in the upfront ABI group. Secondary objectives included an evaluation of the prognostic significance of upfront ABI and a comparison with a historical cohort (131 mHSPC patients with high tumor burden who received androgen deprivation therapy (ADT/complete androgen blockade [CAB] group) between 2014 and 2019). RESULTS: We found that the anemia-ABI group had a significantly shorter PFS than the non-anemia-ABI group. A multivariate Cox regression analysis showed that anemia was an independent prognostic factor of PFS in the upfront ABI group (hazard ratio, 4.66; P = 0.014). Patients in the non-anemia-ABI group were determined to have a significantly longer PFS than those in the non-anemia-ADT/CAB group (n = 68) (P < 0.001). However, no significant difference was observed in the PFS between patients in the anemia-ABI and the anemia-ADT/CAB groups (n = 63). Multivariate analyses showed that upfront ABI could significantly prolong the PFS of patients without anemia (hazard ratio, 0.17; P < 0.001), whereas ABI did not prolong the PFS of patients with anemia. CONCLUSION: Pretreatment anemia was a prognostic factor among mHSPC patients who received upfront ABI. Although the upfront ABI significantly improved the PFS of mHSPC patients without anemia, its efficacy in patients with anemia might be limited.
Authors: Keiichiro Mori; Florian Janisch; Hadi Mostafaei; Ivan Lysenko; Pierre I Karakiewicz; Dmitry V Enikeev; Alberto Briganti; Shoji Kimura; Shin Egawa; Shahrokh F Shariat Journal: Clin Genitourin Cancer Date: 2019-12-13 Impact factor: 2.872
Authors: Christopher J Sweeney; Yu-Hui Chen; Michael Carducci; Glenn Liu; David F Jarrard; Mario Eisenberger; Yu-Ning Wong; Noah Hahn; Manish Kohli; Matthew M Cooney; Robert Dreicer; Nicholas J Vogelzang; Joel Picus; Daniel Shevrin; Maha Hussain; Jorge A Garcia; Robert S DiPaola Journal: N Engl J Med Date: 2015-08-05 Impact factor: 91.245
Authors: Karim Fizazi; NamPhuong Tran; Luis Fein; Nobuaki Matsubara; Alfredo Rodriguez-Antolin; Boris Y Alekseev; Mustafa Özgüroğlu; Dingwei Ye; Susan Feyerabend; Andrew Protheroe; Peter De Porre; Thian Kheoh; Youn C Park; Mary B Todd; Kim N Chi Journal: N Engl J Med Date: 2017-06-04 Impact factor: 91.245