The Effect of Treatment Sequence on Overall Survival for Men With Metastatic Castration-resistant Prostate Cancer: A Multicenter Retrospective Study

Okita, Kazutaka; Narita, Shintaro; Takahashi, Masahiro; Sakurai, Toshihiko; Kawamura, Sadafumi; Hoshi, Senji; Ishida, Masanori; Kawaguchi, Toshiaki; Ishidoya, Shigeto; Shimoda, Jiro; Sato, Hiromi; Mitsuzuka, Koji; Ito, Akihiro; Tsuchiya, Norihiko; Arai, Yoichi; Habuchi, Tomonori; Οhyama, Chikara

doi:10.1016/j.clgc.2019.09.006

Cited by 16 publications

(13 citation statements)

References 41 publications

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“…Firstly, this study was limited by its retrospective design that might have caused selection bias. Secondly, with being devoid of clinical records to define the treatment failure, we could not analyze the treatment outcomes from the second-line treatment, especially in comparing survival outcomes according to sequential therapy [39,40]. Thirdly, the dosage/adherence of the treatment, e.g., relative dose intensity, in individuals was not considered in the present study.…”

Section: Discussionmentioning

confidence: 99%

Early Prostate-Specific Antigen (PSA) Change at Four Weeks of the First-Line Treatment Using Abiraterone and Enzalutamide Could Predict Early/Primary Resistance in Metastatic Castration-Resistant Prostate Cancer

Uchimoto

Komura

Fukuokaya

et al. 2021

Cancers

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The identification of early or primary resistance to androgen signaling inhibitors (ASIs) is of great value for the treatment of metastatic castration-resistant prostate cancer (mCRPC). This study evaluates the predictive value of prostate-specific antigen (PSA) response at dour weeks of first-line ASIs treatment for mCRPC patients. A total of 254 patients treated with ASIs (abiraterone acetate: AA and enzalutamide: Enz) at the first-line treatment are retrospectively analyzed. Patients are stratified according to the achievement of >30% PSA decline at 4 and 12 weeks from the treatment initiation. At four weeks of the treatment, 157 patients (61.8%) achieved >30% PSA decline from the baseline. Thereafter, 177 patients (69.7%) achieved >30% PSA decline at 12 weeks of the treatment. A multivariate analysis exhibits >30% PSA decline at four weeks as an independent predictor for overall survival (OS). We note that 30 of 97 (30.9%) patients who did not achieve >30% PSA decline at four weeks consequently achieved >30% PSA decline at 12 weeks, and had a comparable favorable three years OS rate as the 147 patients achieving >30% PSA decline at both 4 and 12 weeks. To identify the variables that discriminate the patient survival in 97 patients without achieving >30% PSA decline at four weeks, a multivariate analysis is performed. The duration of androgen deprivation therapy before CRPC ≤ 12 months and Eastern Cooperative Oncology Group Performance Status ≥ 1 are identified as independent predictors for shorter OS for those patients. These data offer a concept of early treatment switch after four weeks of first-line ASIs when not observing >30% PSA decline at four weeks—particularly in patients with a modest effect of ADT and poor performance status.

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Section: Discussionmentioning

confidence: 99%

Early Prostate-Specific Antigen (PSA) Change at Four Weeks of the First-Line Treatment Using Abiraterone and Enzalutamide Could Predict Early/Primary Resistance in Metastatic Castration-Resistant Prostate Cancer

Uchimoto

Komura

Fukuokaya

et al. 2021

Cancers

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“…Firstly, the study was limited by its retrospective design, which might have caused selection bias. Secondly, due to the lack of treatment records to define treatment failure, we were unable to further analyse treatment outcomes after second‐line treatment, in particular by a comparison of survival outcome according to sequential therapy [25,26]. Thirdly, we were unable to consider biological markers for treatment outcomes, including ARV7 [27].…”

Section: Discussionmentioning

confidence: 99%

Risk stratification for the prediction of overall survival could assist treatment decision‐making at diagnosis of castration‐resistant prostate cancer: a multicentre collaborative study in Japan

et al. 2020

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Objectives To assess whether a new risk stratification system according to predictors for overall survival (OS) at the diagnosis of metastatic castration‐resistant prostate cancer (mCRPC) could determine treatment outcomes and assist in treatment decision‐making. Patients and Methods Two independent clinical cohorts of patients, treated with androgen signalling inhibitors (ASIs: abiraterone and enzalutamide) or docetaxel as a first‐line treatment for mCRPC, were used in this study: a derivation cohort (196 patients with mCRPC) and an external validation cohort (211 patients with mCRPC). Results Three independent predictors for OS, including duration of initial androgen deprivation therapy <12 months before mCRPC diagnosis, alkaline phosphatase level >350 U/dL and haemoglobin level <11 g/dL at the diagnosis of mCRPC, were defined as risk factors. Patients with zero, one and multiple risk factors were assigned to a favourable‐, intermediate‐ and poor‐risk group, respectively. The median OS values in each risk group were well separated in the derivation cohort (P < 0.001) as well as in the validation cohort (P < 0.001). Of a total of 407 patients with mCRPC, 84 were assigned to the poor‐risk group with the median OS of 12 months. In this group, a trend towards longer OS favouring docetaxel compared to ASIs as the first‐line treatment (medians of 17 and 12 months, respectively) was observed. Conclusion The new risk group stratification system could predict patient survival at the diagnosis of mCRPC. Given the convenience of these risk definitions, physicians may be encouraged to consider these risk groups in daily practice.

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“…The application of the prostate-specific antigen (PSA) test has greatly improved the diagnosis and treatment of PC (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). However, PSA has become associated with the overdiagnosis of patients with the non-aggressive disease and displays limited usefulness in patients with castrationresistant PC (5,(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37). Therefore, there is an unmet need for novel diagnostic (detection of early-stage disease, and differentiation of benign from malignant disease), prognostic (prediction of disease outcome and monitoring of disease recurrence), and predictive (monitoring of the response to therapeutics and aiding treatment decisions) biomarkers.…”

Section: Introductionmentioning

confidence: 99%

Narrative review of urinary glycan biomarkers in prostate cancer

Hatakeyama¹,

Yoneyama²,

Tobisawa³

et al. 2021

Transl Androl Urol

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The Effect of Treatment Sequence on Overall Survival for Men With Metastatic Castration-resistant Prostate Cancer: A Multicenter Retrospective Study

Cited by 16 publications

References 41 publications

Early Prostate-Specific Antigen (PSA) Change at Four Weeks of the First-Line Treatment Using Abiraterone and Enzalutamide Could Predict Early/Primary Resistance in Metastatic Castration-Resistant Prostate Cancer

Early Prostate-Specific Antigen (PSA) Change at Four Weeks of the First-Line Treatment Using Abiraterone and Enzalutamide Could Predict Early/Primary Resistance in Metastatic Castration-Resistant Prostate Cancer

Risk stratification for the prediction of overall survival could assist treatment decision‐making at diagnosis of castration‐resistant prostate cancer: a multicentre collaborative study in Japan

Narrative review of urinary glycan biomarkers in prostate cancer

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