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

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

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: We aimed to evaluate the treatment sequence for patients with metastatic castration-resistant prostate cancer (mCRPC) in real-world practice and compare overall survival in each sequential therapy. Patients and Methods: We retrospectively evaluated 146 patients with mCRPC who were initially treated with androgen deprivation therapy as metastatic hormone-naive prostate cancer in 14 hospitals between January 2010 and March 2019. The agents for the sequential therapy included new androgen receptor-targeted agents (ART: abiraterone acetate or enzalutamide), docetaxel, and/or cabazitaxel. We evaluated the treatment sequence for mCRPC and the effect of sequence patterns on overall survival. Results: The median age was 71 years. A total of 35 patients received ART-ART, 33 received ART-docetaxel, 68 received docetaxel-ART, and 10 received docetaxel-cabazitaxel sequences. The most prescribed treatment sequence was docetaxel-ART (47%), followed by ART-ART (24%). Overall survival calculated from the initial diagnosis reached 83, 57, 79, and 37 months in the ART-ART, ART-docetaxel, docetaxel-ART, and docetaxel-cabazitaxel, respectively. Multivariate Cox regression analyses showed no significant difference in overall survival between the first-line ART (n = 68) and first-line docetaxel (n = 78) therapies (hazard ratio [HR], 0.84; P = .530), between the ART-ART (n = 35) and docetaxel-mixed (n = 111) sequences (HR, 0.82; P = .650), and between the first-line abiraterone (n = 32) and first-line enzalutamide (n = 36) sequences (HR, 1.58; P = .384). Conclusion: The most prescribed treatment sequence was docetaxel followed by ART. No significant difference was observed in overall survival among the treatment sequences in real-world practice.

Original languageEnglish
Pages (from-to)e103-e111
JournalClinical Genitourinary Cancer
Volume18
Issue number2
DOIs
Publication statusPublished - 2020 Apr

Keywords

  • Castration-resistant prostate cancer
  • Metastasis
  • Overall survival
  • Treatment sequence

ASJC Scopus subject areas

  • Oncology
  • Urology

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    Okita, K., Hatakeyama, S., Narita, S., Takahashi, M., Sakurai, T., Kawamura, S., Hoshi, S., Ishida, M., Kawaguchi, T., Ishidoya, S., Shimoda, J., Sato, H., Mitsuzuka, K., Ito, A., Tsuchiya, N., Arai, Y., Habuchi, T., & Ohyama, C. (2020). The Effect of Treatment Sequence on Overall Survival for Men With Metastatic Castration-resistant Prostate Cancer: A Multicenter Retrospective Study. Clinical Genitourinary Cancer, 18(2), e103-e111. https://doi.org/10.1016/j.clgc.2019.09.006