Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
Anticancer Res. 2023 Mar;43(3):1351-1359. doi: 10.21873/anticanres.16283.
BACKGROUND/AIM: In recent years, initial treatment for patients with high-risk metastatic castration-sensitive (mCS) prostate cancer (PC) has been shifting from vintage hormone therapy to upfront androgen receptor axis-targeted agents (ARAT), but the proportion of Asian patients enrolled in clinical trials investigating the effectiveness of ARAT use is low. We examined the outcomes of Japanese patients with mCSPC who received ARAT as second-line therapy or afterwards.
Among the PC patients receiving treatment at Kanazawa University Hospital from 2000 to 2019, 190 patients with mCSPC were enrolled in the study. Their characteristics and prognosis were retrospectively investigated.
All patients received androgen deprivation therapy (ADT) as initial treatment. A total of 142 (74.3%) of 190 patients had progression to castration-resistant PC (CRPC), of whom 77 (54.2%) received ARAT as second-line therapy or afterwards. The median overall survival (OS) of CRPC patients was 70.57 months and the median OS from CRPC was 44.88 months. The median OS of LATITUDE high-risk patients that used ARAT after the second-line treatment was 56.15 months, which was significantly longer than that of patients who did not use ARAT (hazard ratio=0.68, 95% confidence interval=0.40-1.15; p=0.0089).
The prognosis of LATITUDE high-risk patients with CRPC selected for initial ADT therapy had a good prognosis compared to findings in other studies. These results suggest that there is a possibility that a certain number of patients with LATITUDE high-risk may have good prognosis even if only conventional ADT is performed and ARAT is used after CRPC.
背景/目的：近年来，高危转移性去势敏感型（mCS）前列腺癌（PC）患者的初始治疗已从传统的激素治疗转变为雄激素受体轴靶向药物（ARAT）的一线治疗，但在评估 ARAT 使用效果的临床试验中，入组的亚洲患者比例较低。我们研究了接受 ARAT 二线或后续治疗的 mCSPC 日本患者的结局。
在金泽大学医院接受治疗的 PC 患者中，我们回顾性研究了 2000 年至 2019 年间入组的 190 例 mCSPC 患者的特征和预后。
所有患者均接受雄激素剥夺治疗（ADT）作为初始治疗。190 例 mCSPC 患者中，共有 142 例（74.3%）进展为去势抵抗性 PC（CRPC），其中 77 例（54.2%）接受 ARAT 二线或后续治疗。CRPC 患者的中位总生存期（OS）为 70.57 个月，CRPC 后的中位 OS 为 44.88 个月。LATITUDE 高危患者在二线治疗后使用 ARAT 的中位 OS 为 56.15 个月，明显长于未使用 ARAT 的患者（风险比=0.68，95%置信区间=0.40-1.15；p=0.0089）。
与其他研究相比，接受初始 ADT 治疗的 LATITUDE 高危 CRPC 患者的预后良好。这些结果表明，即使仅行常规 ADT，在 CRPC 后使用 ARAT，也有可能使一定比例的 LATITUDE 高危患者获得良好的预后。
