The Effect of Treatment Sequence on Overall Survival for Men With Metastatic Castration-resistant Prostate Cancer: A Multicenter Retrospective Study |
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| Institution: | 1. Department of Urology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan;2. Department of Urology, Akita University School of Medicine, Hondo, Akita, Japan;3. Department of Urology, Tohoku University School of Medicine, Aoba-ku, Sendai, Miyagi, Japan;4. Department of Urology, Yamagata University School of Medicine, Yamagata, Yamagata, Japan;5. Department of Urology, Miyagi Cancer Center, Shiote, Aijima, Natori, Miyagi, Japan;6. Department of Urology, Yamagata Prefectural Central Hospital, Aoyanagi, Yamagata, Japan;7. Department of Urology, Iwate Prefectural Isawa Hospital, Ryugabaab, Mizusawa-ku, Oshu, Iwate, Japan;8. Department of Urology, Aomori Prefectural Central Hospital, Higashi-tsukurimichi, Aomori, Aomori, Japan;9. Department of Urology, Sendai City Hospital, Nagamachi, Asuto, Taihaku-ku, Sendai, Miyagi, Japan;1. Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan;2. Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan;3. Department of Urology, Graduate School of Medicine, University of Toyama, Toyama, Japan;4. Department of Urology, Mutsu General Hospital, Mutsu, Japan;5. Department of Urology, Aomori Prefectural Central Hospital, Aomori, Japan;1. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany;2. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Quebec, Canada;3. Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany;4. Department of Urology, University Hospital Mainz, Mainz, Germany;5. Department of Urology, University Hospital Frankfurt, Frankfurt, Germany;6. Department of Radiation Oncology, University Hospital Hamburg-Eppendorf, Hamburg, Germany;7. Department of Pathology, University Hospital Hamburg-Eppendorf, Hamburg, Germany;1. Department of Internal Medicine, Amphia Ziekenhuis, Breda, The Netherlands;2. Institute for Medical Technology Assessment, Erasmus School of Health Policy and Management, Rotterdam, The Netherlands;3. Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands;4. Department of Medical Oncology, Erasmus MC Daniel den Hoed Cancer Center, Rotterdam, The Netherlands;5. Department of Internal Medicine, Isala, Zwolle, The Netherlands;6. Department of Internal Medicine, Tergooi Ziekenhuizen, Hilversum, The Netherlands;7. Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands;8. Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands;9. Department of Urology, Maxima Medisch Centrum, Veldhoven, The Netherlands;10. Department of Internal Medicine, Northwest Clinics, Alkmaar, The Netherlands;11. Department of Internal Medicine, Meander Medisch Centrum, Amersfoort, The Netherlands;12. Department of Internal Medicine, Reinier de Graaf Gasthuis and Reinier Haga Prostate Cancer Centre, Delft, The Netherlands;13. Department of Internal Medicine, Diakonessenhuis, Utrecht, The Netherlands;14. Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;15. Department of Internal Medicine, Albert Schweitzer Ziekenhuis, Dordrecht, The Netherlands;16. Department of Internal Medicine, Medical Center, Leeuwarden, The Netherlands;17. Department of Internal Medicine, MCH-Bronovo Ziekenhuis, ‘s-Gravenhage, The Netherlands;18. Division of Internal Medicine (MOD) and Oncogenomics, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands;19. Institute for Medical Technology Assessment, Erasmus School of Health Policy and Management, Rotterdam, The Netherlands;20. Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands;1. Medical Oncology Department, Santa Chiara Hospital, Trento, Italy;2. Medical Oncology Department, University Medical Centre, Leiden, the Netherlands;3. Division of Clinical Studies, Prostate Cancer Targeted Therapies Group, Royal Marsden NHS Foundation Trust, Sutton, United Kingdom;4. Division of Internal Medicine (MOD) and Oncogenomics, Netherlands Cancer Institute, Amsterdam, the Netherlands;5. Copenhagen Prostate Cancer Center, Rigshospitalet, Copenhagen, Denmark;6. Klinik und Poliklinik für Urologie, Klinikum rechts der Isar der Technischen Universität München, München, Germany;7. Department of Medicine, University of Washington School of Medicine, Seattle, WA;8. Oncology Department, ARETAIEIO University Hospital of Athens, IASO General Clinic of Athens, Athens, Greece;9. Department of Oncology, Yitzhak Shamir Medical Center, Assaf Harofe Campus Harofeh Medical Center, Sackler School of Medicine, Tel-Aviv, Israel;10. Medical Oncology Department, Istituto Oncologico Veneto, Padua, Italy;11. Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy;12. Medical Oncology Department, Azienda Ospedaliera Universitaria S. Luigi Gonzaga, Orbassano, Italy;13. Medical Oncology Department, Azienda Ospedaliera Universitaria, Pisa, Italy;14. Epidemiology & Clinical Trials Office, General Hospital, Mirano, Italy;15. Oncology Unit, Università Cattolica del Sacro Cuore, Fondazione Policlinico “A. Gemelli”, Rome, Italy;16. Biostatistical Unit, Regina Elena National Cancer Institute, Rome, Italy;17. Service de cancérologie médicale, Hôpital Européen Georges Pompidou, René Descartes University, Paris, France;1. Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan;2. Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan;1. Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan;2. Department of Urology, Miyazaki University, Miyazaki, Japan;3. Department of Urology, Jikei University School of Medicine, Tokyo, Japan;4. Department of Breast and Medical Oncology, National Cancer Center Hospital East, Chiba, Japan |
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| Abstract: | IntroductionWe 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 MethodsWe 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.ResultsThe 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).ConclusionThe 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. |
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| Keywords: | Castration-resistant prostate cancer Metastasis Overall survival Treatment sequence |
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