Improved prognosis of de novo metastatic prostate cancer after an introduction of life-prolonging agents for castration-resistant prostate cancer

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发表日期：

2024年12月17日

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Tokiyoshi Tanegashima,
Masaki Shiota,
Naoki Terada,
Toshihiro Saito,
Akira Yokomizo,
Naoki Kohei,
Takayuki Goto,
Sadafumi Kawamura,
Yasuhiro Hashimoto,
Atsushi Takahashi,
Takahiro Kimura,
Ken-ichi Tabata,
Ryotaro Tomida,
Kohei Hashimoto,
Toshihiko Sakurai,
Toru Shimazui,
Shinichi Sakamoto,
Manabu Kamiyama,
Nobumichi Tanaka,
Koji Mitsuzuka,
Takuma Kato,
Shintaro Narita,
Hiroaki Yasumoto,
Shogo Teraoka,
Masashi Kato,
Takahiro Osawa,
Yoshiyuki Nagumo,
Hiroaki Matsumoto,
Hideki Enokida,
Takayuki Sugiyama,
Kentaro Kuroiwa,
Hiroshi Kitamura,
Toshiyuki Kamoto,
Masatoshi Eto

摘要

Background

In Japan, since 2014, new treatments such as androgen receptor signaling inhibitors and cabazitaxel have become applicable for metastatic castration-resistant prostate cancer (mCRPC), leading to dramatic changes in treatment options.

Objective

This study aims to evaluate the impact of recent advancements in treatment options on the overall survival (OS) of patients diagnosed with de novo metastatic castration-sensitive prostate cancer (mCSPC) in Japan.

Methods

A retrospective analysis was conducted on 2450 Japanese men diagnosed with de novo mCSPC between 2008 and 2018. Patients were stratified into two groups based on the period of diagnosis: an earlier period (2008–2013) and a later period (2014–2018). OS was compared between earlier and later periods using Kaplan–Meier analysis in total and propensity score matched subpopulation as well as risk-stratified subgroups.

Results

Patients diagnosed in the later period exhibited significantly improved OS compared to those diagnosed in the earlier period. The risk score, calculated based on ISUP grade group, LDH levels, and ALP levels, was a poor prognostic factor. In the later period, compared to the earlier period, there was no improvement in OS in the favorable-risk group, but a significant improvement was observed in the poor-risk group.

Conclusion

It was suggested that the introduction of novel androgen receptor signaling inhibitors and chemotherapy treatment regimens since 2014 has led to improved survival outcomes for patients with de novo mCSPC, particularly those with poor-risk profiles. The findings highlight the impact of recent advancements in treatment on the prognosis of patients with metastatic prostate cancer in Japan.