Survival following upfront chemotherapy for treatment-naïve metastatic prostate cancer: a real-world retrospective cohort study

Weiner, Adam B.; Ko, Oliver; Li, Eric V.; Vo, Amanda X.; Desai, Angel N.; Breen, Kieran J.; Nadler, Robert B.; Morgans, Alicia K.

doi:10.1038/s41391-020-00278-0

Cited by 8 publications

(16 citation statements)

References 20 publications

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“…These observations are highly consistent with NCDB-derived findings on the same topic (Weiner et al) (9). Conversely, to the best of our knowledge, no other reports identified a survival benefit in contemporary, metastatic prostate cancer patients exposed to chemotherapy compared to their chemotherapy naïve counterparts.…”

Section: Discussionsupporting

confidence: 92%

“…These variables, including performance status and comorbidities, were unavailable in the current study. Some of these variables, including comorbidities, were available in the Weiner et al study (9). Despite their availability, overall survival rates virtually perfectly agreed with rates recorded in the current study.…”

Section: Discussionsupporting

confidence: 74%

“…However, trial findings may be difficult to replicate in real-world conditions. Indeed, only one report demonstrated a modest benefit in overall survival after chemotherapy in contemporary, de novo metastatic prostate cancer patients (Weiner et al., National Cancer Database 2014-2015) ( 9 ). We addressed the same endpoint within the same study period.…”

Section: Introductionmentioning

confidence: 99%

“…Within a different, large-scale database (SEER), we focused on the most contemporary patients (2014-2015) diagnosed with de novo metastatic prostate cancer. We hypothesized that chemotherapy use may result in a survival benefit for de novo metastatic prostate cancer patients ( 9 ). Unlike Weiner et al., we relied on propensity score matching to maximally reduce potential differences between chemotherapy-exposed and chemotherapy-naïve patients.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Chemotherapy on Overall Survival in Contemporary Metastatic Prostate Cancer Patients

et al. 2021

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IntroductionRandomized clinical trials demonstrated improved overall survival in chemotherapy exposed metastatic prostate cancer patients. However, real-world data validating this effect with large scale epidemiological data sets are scarce and might not agree with trials. We tested this hypothesis.Materials and MethodsWe identified de novo metastatic prostate cancer patients within the Surveillance, Epidemiology, and End Results (SEER) database (2014-2015). Kaplan-Meier plots and Cox regression models tested for overall survival differences between chemotherapy-exposed patients vs chemotherapy-naïve patients. All analyses were repeated in propensity-score matched cohorts. Additionally, landmark analyses were applied to account for potential immortal time bias.ResultsOverall, 4295 de novo metastatic prostate cancer patients were identified. Of those, 905 (21.1%) patients received chemotherapy vs 3390 (78.9%) did not. Median overall survival was not reached at 30 months follow-up. Chemotherapy-exposed patients exhibited significantly better overall survival (61.6 vs 54.3%, multivariable HR:0.82, CI: 0.72-0.96, p=0.01) at 30 months compared to their chemotherapy-naïve counterparts. These findings were confirmed in propensity score matched analyses (multivariable HR: 0.77, CI:0.66-0.90, p<0.001). Results remained unchanged after landmark analyses were applied in propensity score matched population.ConclusionsIn this contemporary real-world population-based cohort, chemotherapy for metastatic prostate cancer patients was associated with better overall survival. However, the magnitude of overall survival benefit was not comparable to phase 3 trials.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of Chemotherapy on Overall Survival in Contemporary Metastatic Prostate Cancer Patients

et al. 2021

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“…These results are encouraging as the use of upfront chemotherapy is expected to increase, as consensus guidelines have been updated to reflect recent landmark trials [24] , [25] . Interestingly, we report higher OS than that in other recent published reports of data from real-world mHSPC patients who received upfront chemotherapy [26] , [27] .…”

Section: Discussioncontrasting

confidence: 80%

Effectiveness of Docetaxel for Metastatic Hormone-sensitive Prostate Cancer in Clinical Practice

Lendorf

Petersen

Svendsen

et al. 2021

European Urology Open Science

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Background Addition of docetaxel to androgen deprivation therapy (ADT) for the treatment of metastatic hormone-sensitive prostate cancer (mHSPC) has been proved to be effective with an overall survival (OS) benefit in phase III clinical trials. The effectiveness of docetaxel with ADT in the general patient population remains unknown. Objective The purpose of this study is to report the clinical experience in mHSPC patients treated with 3rd-weekly docetaxel plus ADT in routine practice at two Danish institutions. Design, setting and participants A two-center retrospective study including consecutive mHSPC patients treated with 3rd-weekly docetaxel plus ADT was conducted. Outcome measurements and statistical analysis Outcomes of interest were OS, and biochemical and clinical progression-free survival. Results and limitations A total of 173 consecutive patients with mHSPC who received docetaxel every 3rd week plus ADT between June 2015 and February 2018 were included. Most patients had high-volume disease (85%). All six planned docetaxel cycles were delivered in 149 cases (86%). Of the patients, 106 (61%) were alive at the last follow-up. At a median follow-up of 42 (37.8–58.6) mo, the median OS was 51.6 (41.5–56.3) mo. Castration-resistant prostate cancer (CRPC) developed in 46% within 1 yr, with a median time to CRPC of 15.6 (13.0–18.1) mo. Prostate-specific antigen nadir ≤0.2 ng/l was achieved in 15% of patients after 6 mo of ADT and in 19% after 12 mo. Conclusions The effect of docetaxel for mHSPC patients treated in routine practice appears comparable with the overall efficacy reported in the literature. Selection of patients will influence the results in clinical practice and clinical studies. Patient summary In this report, we looked at the clinical effectiveness of docetaxel combined with androgen deprivation therapy in men with metastatic hormone-sensitive prostate cancer (mHSPC) in a Danish population. We found the effect of docetaxel treatment for mHSPC in the general population to be comparable with the overall efficacy reported in published studies.

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Survival Trend in Individuals With De Novo Metastatic Prostate Cancer After the Introduction of Doublet Therapy

Corsini,

Garmo,

Orrason

et al. 2023

JAMA Netw Open

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ImportanceRecently, life-prolonging treatments for patients with advanced prostate cancer have been introduced in clinical practice.ObjectiveTo investigate if the introduction of doublet therapy is associated with changes in survival on a population-basis.Design, Setting, and ParticipantsThis nationwide population-based cohort study used data from the Prostate Cancer data Base Sweden from 2008 to 2020. Men registered with de novo metastatic castration-sensitive prostate cancer (mCSPC) were included.ExposureThe proportion of men with mCSPC who received doublet therapy, ie, androgen deprivation therapy plus androgen receptor pathway inhibitor drugs or chemotherapy was assessed.Main Outcomes and MeasuresStandardized overall survival, taking age, comorbidity, and cancer characteristics into consideration, was estimated by use of a parametric survival model.ResultsA total of 11 382 men were included in this study (median [IQR] age, 74.0 [68-81] years). There was a shift toward less advanced prostate cancer during the study period with a decrease in median (IQR) prostate-specific antigen at diagnosis in men with mCSPC from 145 (39-571) ng/mL to 107 (27-426) ng/mL. Upfront treatment with doublet therapy in these men simultaneously increased from 1% (7 of 991) in 2016 to 44% (402 of 922) in 2020. The adjusted 5-year overall survival increased from 26% (95% CI, 25%-28%) from 2008 to 2012 to 35% (95% CI, 31%-40%) from 2017 to 2020. During the first 5 years after diagnosis, there was an increase in mean survival of 6 months, from 2.7 (95% CI, 2.6-2.8) years from 2008 to 2012 to 3.2 (95% CI, 3.1-3.1) years from 2017 to 2020.Conclusions and RelevanceIn parallel with improvements in treatment of advanced prostate cancer, a clinically meaningful increase in mean survival was observed in men with de novo mCSPC in Sweden between 2008 and 2020 in this study.

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Survival following upfront chemotherapy for treatment-naïve metastatic prostate cancer: a real-world retrospective cohort study

Cited by 8 publications

References 20 publications

Effect of Chemotherapy on Overall Survival in Contemporary Metastatic Prostate Cancer Patients

Effect of Chemotherapy on Overall Survival in Contemporary Metastatic Prostate Cancer Patients

Effectiveness of Docetaxel for Metastatic Hormone-sensitive Prostate Cancer in Clinical Practice

Survival Trend in Individuals With De Novo Metastatic Prostate Cancer After the Introduction of Doublet Therapy

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