Takafumi Yanagisawa1,2, Takahiro Kimura3, Kenichi Hata3,4, Shintaro Narita5, Shingo Hatakeyama6, Keiichiro Mori3, Takayuki Sano3, Takashi Otsuka3, Yuya Iwamoto3, Yuki Enei3, Minoru Nakazono3, Keigo Sakanaka3, Kosuke Iwatani3, Akihiro Matsukawa3, Mahito Atsuta3, Hideomi Nishikawa3, Shunsuke Tsuzuki3, Jun Miki3, Tomonori Habuchi5, Chikara Ohyama6, Shahrokh F Shariat7,8,9,10,11,12,13, Shin Egawa3. 1. Department of Urology, The Jikei University School of Medicine, 3-19-18, Nishi-shimbashi, Minato-ku, Tokyo, 105-8471, Japan. t.yanagisawa.jikei@gmail.com. 2. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. t.yanagisawa.jikei@gmail.com. 3. Department of Urology, The Jikei University School of Medicine, 3-19-18, Nishi-shimbashi, Minato-ku, Tokyo, 105-8471, Japan. 4. Department of Urology, Atsugi City Hospital, Kanagawa, Japan. 5. Department of Urology, Akita University School of Medicine, Akita, Japan. 6. Department of Urology, Division of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Aomori, Japan. 7. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. 8. Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia. 9. Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan. 10. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA. 11. Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic. 12. Department of Urology, Weill Cornell Medical College, New York, NY, USA. 13. Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.
Abstract
PURPOSE: The aim of this study was to investigate the oncologic efficacy of combining docetaxel with androgen deprivation therapy (ADT) versus nonsteroidal antiandrogen (NSAA) with ADT in patients with high-volume metastatic hormone-sensitive prostate cancer (mHSPC) with focus on the effect of sequential therapy in a real-world clinical practice setting. METHODS: The records of 382 patients who harbored high-volume mHSPC, based on the CHAARTED criteria, and had received ADT with either docetaxel (n = 92) or NSAA (bicalutamide) (n = 290) were retrospectively analyzed. The cohorts were matched by one-to-one propensity scores based on patient demographics. Overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), including time to castration-resistant prostate cancer (CRPC), and time to second-line progression (PFS2) were compared. 2nd-line PFS defined as the time from CRPC diagnosis to progression after second-line therapy was also compared. RESULTS: After matching, a total of 170 patients were retained: 85 patients treated with docetaxel + ADT and 85 patients treated with NSAA + ADT. The median OS and CSS for docetaxel + ADT versus NSAA + ADT were not reached (NR) vs. 49 months (p = 0.02) and NR vs. 55 months (p = 0.02), respectively. Median time to CRPC and PFS2 in patients treated with docetaxel + ADT was significantly longer compared to those treated with NSAA (22 vs. 12 months; p = 0.003 and, NR vs. 28 months; p < 0.001, respectively). There was no significant difference in 2nd-line PFS between the two groups. CONCLUSIONS: Our analysis suggested that ADT with docetaxel significantly prolonged OS and CSS owing to a better time to CRPC and PFS2 in comparison to NSAA + ADT in high-volume mHSPC.
PURPOSE: The aim of this study was to investigate the oncologic efficacy of combining docetaxel with androgen deprivation therapy (ADT) versus nonsteroidal antiandrogen (NSAA) with ADT in patients with high-volume metastatic hormone-sensitive prostate cancer (mHSPC) with focus on the effect of sequential therapy in a real-world clinical practice setting. METHODS: The records of 382 patients who harbored high-volume mHSPC, based on the CHAARTED criteria, and had received ADT with either docetaxel (n = 92) or NSAA (bicalutamide) (n = 290) were retrospectively analyzed. The cohorts were matched by one-to-one propensity scores based on patient demographics. Overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), including time to castration-resistant prostate cancer (CRPC), and time to second-line progression (PFS2) were compared. 2nd-line PFS defined as the time from CRPC diagnosis to progression after second-line therapy was also compared. RESULTS: After matching, a total of 170 patients were retained: 85 patients treated with docetaxel + ADT and 85 patients treated with NSAA + ADT. The median OS and CSS for docetaxel + ADT versus NSAA + ADT were not reached (NR) vs. 49 months (p = 0.02) and NR vs. 55 months (p = 0.02), respectively. Median time to CRPC and PFS2 in patients treated with docetaxel + ADT was significantly longer compared to those treated with NSAA (22 vs. 12 months; p = 0.003 and, NR vs. 28 months; p < 0.001, respectively). There was no significant difference in 2nd-line PFS between the two groups. CONCLUSIONS: Our analysis suggested that ADT with docetaxel significantly prolonged OS and CSS owing to a better time to CRPC and PFS2 in comparison to NSAA + ADT in high-volume mHSPC.
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