TY - JOUR
T1 - Predicting time to castration resistance with androgen-receptor signaling inhibitors in hormone-sensitive prostate cancer
T2 - data from ULTRA-Japan Consortium
AU - Uchimoto, Taizo
AU - Iwatsuki, Kengo
AU - Komura, Kazumasa
AU - Fukuokaya, Wataru
AU - Adachi, Takahiro
AU - Hirasawa, Yosuke
AU - Hashimoto, Takeshi
AU - Yoshizawa, Atsuhiko
AU - Saruta, Masanobu
AU - Fujimoto, Saizo
AU - Minami, Takafumi
AU - Yamamoto, Yutaka
AU - Yamazaki, Shogo
AU - Takai, Tomoaki
AU - Sakamoto, Moritoshi
AU - Nakajima, Yuki
AU - Nishimura, Kazuki
AU - Maenosono, Ryoichi
AU - Tsujino, Takuya
AU - Nakamura, Ko
AU - Fukushima, Tatsuo
AU - Nishio, Kyosuke
AU - Yoshikawa, Yuki
AU - Yamamoto, Shutaro
AU - Iwatani, Kosuke
AU - Urabe, Fumihiko
AU - Mori, Keiichiro
AU - Yanagisawa, Takafumi
AU - Tsuduki, Shunsuke
AU - Takahara, Kiyoshi
AU - Inamoto, Teruo
AU - Fujita, Kazutoshi
AU - Kimura, Takahiro
AU - Ohno, Yoshio
AU - Shiroki, Ryoichi
AU - Azuma, Haruhito
N1 - Publisher Copyright:
© The Author(s) under exclusive licence to Japan Society of Clinical Oncology 2024.
PY - 2025/1
Y1 - 2025/1
N2 - Background: Androgen-receptor signaling inhibitors (ARSIs) become the new standard of care for metastatic hormone-sensitive prostate cancer (mHSPC). It is unknown whether time to castration resistance (TTCR), when using the first-line ARSIs, offers predictive value in mHSPC. We sought to assess the clinical outcomes for mHSPC patients treated with first-line ARSIs focusing on the TTCR. Methods: Data from the ULTRA-Japan study cohort from five academic institutes (496 mHSPC patients) were retrospectively analyzed. Results: The median overall survival (OS) in the total cohort was 80 months with a median follow-up of 18 months. Of 496 patients, 332 (67%), 82 (16.5%), and 82 (16.5%) were treated with first-line abiraterone acetate + prednisone, enzalutamide, and apalutamide, respectively. During the follow-up, a total of 155 (31%) were diagnosed with mCRPC with a median TTCR of 10 months. In those 155 patients, TTCR > 12 months is an independent predictor of longer OS from the first-line ARSIs. Cox regression analysis of the TTCR from initiating first-line ARSI in 496 mHSPC patients revealed three variables as independent predictors of shorter TTCR, including Gleason’s score (GS) ≥ 9, the extent of disease (EOD) ≥ 2, and the presence of liver metastasis. Conclusion: Our results indicate that mHSPC patients with those three features are likely to have primary resistance to first-line ARSIs (doublet therapy), thus requiring consideration of other options, such as the recent triplet approach.
AB - Background: Androgen-receptor signaling inhibitors (ARSIs) become the new standard of care for metastatic hormone-sensitive prostate cancer (mHSPC). It is unknown whether time to castration resistance (TTCR), when using the first-line ARSIs, offers predictive value in mHSPC. We sought to assess the clinical outcomes for mHSPC patients treated with first-line ARSIs focusing on the TTCR. Methods: Data from the ULTRA-Japan study cohort from five academic institutes (496 mHSPC patients) were retrospectively analyzed. Results: The median overall survival (OS) in the total cohort was 80 months with a median follow-up of 18 months. Of 496 patients, 332 (67%), 82 (16.5%), and 82 (16.5%) were treated with first-line abiraterone acetate + prednisone, enzalutamide, and apalutamide, respectively. During the follow-up, a total of 155 (31%) were diagnosed with mCRPC with a median TTCR of 10 months. In those 155 patients, TTCR > 12 months is an independent predictor of longer OS from the first-line ARSIs. Cox regression analysis of the TTCR from initiating first-line ARSI in 496 mHSPC patients revealed three variables as independent predictors of shorter TTCR, including Gleason’s score (GS) ≥ 9, the extent of disease (EOD) ≥ 2, and the presence of liver metastasis. Conclusion: Our results indicate that mHSPC patients with those three features are likely to have primary resistance to first-line ARSIs (doublet therapy), thus requiring consideration of other options, such as the recent triplet approach.
KW - Abiraterone acetate
KW - Androgen-receptor signaling inhibitors
KW - Apalutamide
KW - Enzalutamide
KW - Metastatic hormone-sensitive prostate cancer
KW - Time to castration resistance
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U2 - 10.1007/s10147-024-02649-2
DO - 10.1007/s10147-024-02649-2
M3 - Article
C2 - 39467994
AN - SCOPUS:85207545100
SN - 1341-9625
VL - 30
SP - 123
EP - 133
JO - International Journal of Clinical Oncology
JF - International Journal of Clinical Oncology
IS - 1
M1 - 659135
ER -