Shintaro Narita1, Takahiro Kimura2, Shingo Hatakeyama3, Kenichi Hata2, Takafumi Yanagisawa2, Shinya Maita4, Shuji Chiba5, Hiromi Sato6, Soki Kashima6, Atsushi Koizumi6, Ryohei Yamamoto6, Koichiro Takayama7, Katsumi Okane8, Toshiya Ishida9, Yohei Horikawa10, Teruaki Kumazawa11, Jiro Shimoda4, Takehiro Suzuki12, Chikara Ohyama3, Shin Egawa2, Kyoko Nomura13, Tomonori Habuchi6. 1. Department of Urology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. naritashintaro@gmail.com. 2. Department of Urology, The Jikei University School of Medicine, Tokyo, Japan. 3. Department of Urology, Hirosaki University School of Medicine, Hirosaki, Japan. 4. Department of Urology, Iwate Prefectural Isawa Hospital, Mizusawa, Japan. 5. Department of Urology, Yuri Kumiai General Hospital, Honjo, Japan. 6. Department of Urology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. 7. Department of Urology, Yokote City Hospital, Yokote, Japan. 8. Department of Urology, Akita Kosei Medical Center, Akita, Japan. 9. Department of Urology, Akita City Hospital, Akita, Japan. 10. Department of Urology, Akita Red Cross Hospital, Akita, Japan. 11. Department of Urology, Omagari Kosei Medical Center, Daisen, Japan. 12. Department of Urology, Hiraka General Hospital, Yokote, Japan. 13. Department of Public Health, Akita University School of Medicine, Akita, Japan.
Abstract
PURPOSE: This study investigated the impact of treatment intensification with upfront docetaxel (DOC) or abiraterone (ABI) plus prednisolone on survival outcomes in patients with metastatic castration-sensitive prostate cancer (mCSPC) by comparing it with androgen deprivation therapy (ADT) monotherapy or combined androgen blockade (CAB) using propensity score matching (PSM). METHODS: Outcomes from 278 CHAARTED high-volume patients receiving upfront DOC (92 patients) or upfront ABI (186 patients) were compared to those from 354 patients receiving ADT or CAB. PSM was conducted to assess castration-resistant prostate cancer-free survival (CRPCFS) and overall survival (OS). RESULTS: After PSM, patient distributions between the three groups were well balanced. After 1:1 PSM, patients receiving upfront ABI had significantly better CRPCFS than those receiving ADT/CAB or upfront DOC [hazard ratio (HR) 0.39; 95% CI 0.27-0.56 vs. HR 0.50; 95% CI 0.30-0.82, respectively]. No significant difference in CRPCFS was observed between the upfront DOC and ADT/CAB groups (HR 0.75; 95% CI 0.50-1.12). Patients receiving upfront DOC and upfront ABI had significantly better OS than those receiving ADT/CAB (HR 0.54; 95% CI 0.0.30-0.98 vs. HR 0.49; 95% CI 0.29-0.84, respectively). However, no significant difference in OS was observed between upfront ABI and upfront DOC (hazard ratio 0.84; 95% CI 0.34-2.06). CONCLUSION: The comparison of real-world retrospective cohorts showed that treatment intensification with upfront DOC or upfront ABI promoted better OS compared to ADT alone or CAB in patients with high-volume mCSPC after PSM. However, no difference in OS was observed between upfront DOC and upfront ABI.
PURPOSE: This study investigated the impact of treatment intensification with upfront docetaxel (DOC) or abiraterone (ABI) plus prednisolone on survival outcomes in patients with metastatic castration-sensitive prostate cancer (mCSPC) by comparing it with androgen deprivation therapy (ADT) monotherapy or combined androgen blockade (CAB) using propensity score matching (PSM). METHODS: Outcomes from 278 CHAARTED high-volume patients receiving upfront DOC (92 patients) or upfront ABI (186 patients) were compared to those from 354 patients receiving ADT or CAB. PSM was conducted to assess castration-resistant prostate cancer-free survival (CRPCFS) and overall survival (OS). RESULTS: After PSM, patient distributions between the three groups were well balanced. After 1:1 PSM, patients receiving upfront ABI had significantly better CRPCFS than those receiving ADT/CAB or upfront DOC [hazard ratio (HR) 0.39; 95% CI 0.27-0.56 vs. HR 0.50; 95% CI 0.30-0.82, respectively]. No significant difference in CRPCFS was observed between the upfront DOC and ADT/CAB groups (HR 0.75; 95% CI 0.50-1.12). Patients receiving upfront DOC and upfront ABI had significantly better OS than those receiving ADT/CAB (HR 0.54; 95% CI 0.0.30-0.98 vs. HR 0.49; 95% CI 0.29-0.84, respectively). However, no significant difference in OS was observed between upfront ABI and upfront DOC (hazard ratio 0.84; 95% CI 0.34-2.06). CONCLUSION: The comparison of real-world retrospective cohorts showed that treatment intensification with upfront DOC or upfront ABI promoted better OS compared to ADT alone or CAB in patients with high-volume mCSPC after PSM. However, no difference in OS was observed between upfront DOC and upfront ABI.
Authors: Simon Conroy; Thomas Gilbert; Andrew Street; Helen C Roberts; Stuart Parker Journal: Lancet Date: 2018 Dec 22 -Jan 4 2019 Impact factor: 79.321
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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
Authors: Keiichiro Mori; Hadi Mostafaei; Reza Sari Motlagh; Benjamin Pradere; Fahad Quhal; Ekaterina Laukhtina; Victor M Schuettfort; Gero Kramer; Mohammad Abufaraj; Pierre I Karakiewicz; Takahiro Kimura; Shin Egawa; Shahrokh F Shariat Journal: BJU Int Date: 2021-07-21 Impact factor: 5.969