scholarly journals The Effect of Upfront Intensive Therapy on Primary Resistance in Metastatic Castration-sensitive Prostate Cancer: A Multicenter Retrospective Study

2021 ◽  
Author(s):  
Toshikazu Tanaka ◽  
Shingo Hatakeyama ◽  
Daisuke Noro ◽  
Hirotake Kodama ◽  
Sakae Konishi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Real World ◽  
Medical Records ◽  
Intensive Therapy ◽  
Tumor Burden ◽  
Castration Resistant Prostate Cancer ◽  
Primary Resistance ◽  
Free Survival ◽  
Oncological Outcomes ◽  
Castration Resistant

Abstract We investigated the effect of upfront intensive therapy on primary resistance in patients with metastatic castration-sensitive prostate cancer (mCSPC) in real-world practice. We retrospectively evaluated the medical records of 348 patients with newly diagnosed mCSPC who had a high tumor-burden between January 2008 and May 2021. We compared the oncological outcomes between patients who received conventional androgen deprivation therapy ± bicalutamide (ADT group) and those treated with upfront intensive therapies (upfront group). The primary purpose was comparing the rate of primary resistance between the ADT and upfront groups. The primary resistance was defined as a castration-resistant prostate cancer (CRPC) progression < 6 or < 12 months. The secondary purposes were comparing the CRPC-free survival and overall survival (OS) between the ADT and upfront groups, and assessing safety in the upfront group. We identified 206 and 142 patients for the ADT and upfront groups, respectively. We found the rate of CRPC progression < 6 and < 12 months was significantly lower in the upfront group (9.2% and 18%, respectively) than that in the ADT group (21% and 51%, respectively). The upfront therapy was significantly associated with favorable CRPC-free survival and OS than that in the ADT group in propensity-score adjusted models. A higher rate of any grade adverse events was observed in the upfront docetaxel (94%) than that of the upfront abiraterone (34%) or apalutamide/enzalutamide (39%). In conclusion, the upfront intensive therapy significantly improved the rate of primary resistance and oncological outcomes in patients with mCSPC in real-world practice.

scholarly journals Metastatic Castration-Resistant Prostate Cancer Previously Treated With Docetaxel-Based Chemotherapy: Treatment Patterns From the PROXIMA Prospective Registry

2018 ◽  
pp. 1-12 ◽  
Author(s):  
Hideyuki Akaza ◽  
Giuseppe Procopio ◽  
Choosak Pripatnanont ◽  
Gaetano Facchini ◽  
Sergio Fava ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Real World ◽  
Progression Free Survival ◽  
Treatment Patterns ◽  
Treatment Modalities ◽  
Treatment Sequence ◽  
Castration Resistant Prostate Cancer ◽  
Free Survival ◽  
Castration Resistant ◽  
Previously Treated

Purpose There is a major clinical need to devise an optimal treatment sequence for the multiple therapy options available for patients with metastatic castration-resistant prostate cancer (mCRPC). In the absence of prospective clinical trials, sequencing information can be derived from large, real-world registry studies. Patients and Methods PROXIMA (Treatment Patterns in Patients With Metastatic Castration-Resistant Prostate Cancer Previously Treated With Docetaxel-Based Chemotherapy) is a large, global, prospective registry study evaluating real-world treatment patterns of patients with mCRPC who experience disease progression during or after docetaxel therapy. Patients were enrolled worldwide between 2011 and 2014. Treatments were determined by the treating physicians and recorded in categories of chemotherapy, hormonal therapy, targeted therapy, immunotherapy, and palliative therapy. Treatment sequencing patterns, response to treatment, and types of progression were recorded and analyzed. Progression-free survival and overall survival with different treatment modalities were analyzed using Kaplan–Meier method. Results Treatment patterns were evaluated in 903 patients. Therapy selection was influenced by region. Hormonal therapy (57.5%) and taxane chemotherapy (26.4%) were the most frequently administered first subsequent treatments after docetaxel. Tumor responses to first subsequent treatment were observed in 22.6% of evaluable patients. Overall survival and progression-free survival did not differ significantly across different treatment modalities. Conclusion Identifying an optimal treatment sequence is vital for improving the care of patients with mCRPC. The PROXIMA registry provided a representative sample of global data on real-world treatment patterns for patients with mCRPC previously treated with docetaxel. These data can be used to devise optimal therapy sequences and inform treatment decisions.

scholarly journals Symptomatic skeletal related events (SSE) and SSE-free-survival in real world castration-resistant prostate cancer (CRPC) patients: Results from CAPRI

2018 ◽  
Vol 29 ◽  
pp. viii282-viii283
Author(s):  
M. Kuppen ◽  
H.M. Westgeest ◽  
A.J.M. van den Eertwegh ◽  
J. Van Moorselaar ◽  
N. Mehra ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Real World ◽  
Castration Resistant Prostate Cancer ◽  
Free Survival ◽  
Castration Resistant ◽  
Skeletal Related Events

scholarly journals Oncological Outcomes of Metastasis-Directed Therapy in Oligorecurrent Prostate Cancer Patients Following Radical Prostatectomy

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2271
Author(s):  
Gaëtan Devos ◽  
Charlien Berghen ◽  
Henri Van Eecke ◽  
Arthur Vander Stichele ◽  
Hendrik Van Poppel ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Serum Testosterone ◽  
Castration Resistant Prostate Cancer ◽  
Free Survival ◽  
Tertiary Referral Center ◽  
Oncological Outcomes ◽  
Castration Resistant ◽  
Kaplan Meier

Several retrospective and a few prospective studies have shown that metastasis-directed therapy (MDT) could delay clinical progression and postpone the initiation of systemic treatment in oligorecurrent prostate cancer (PCa) patients. However, these endpoints are strongly influenced by variables such as concomitant use of androgen deprivation therapy (ADT) and follow-up imaging protocols. The aim of this manuscript was to assess palliative ADT- and metastatic castration-resistant prostate cancer (mCRPC)-free survival as long-term oncological outcomes in oligorecurrent PCa treated by MDT. We retrospectively identified consecutive post-prostatectomy oligorecurrent PCa patients treated by MDT (salvage lymphadenectomy, radiotherapy, or metastasectomy) at our tertiary referral center. Patients were eligible for inclusion if they developed recurrence following radical prostatectomy, had ≤5 metastatic lesions on imaging and had a serum testosterone >50 ng/dL or a testosterone suppression therapy-free interval of >2 years prior to the first MDT as an assumption of recovered serum testosterone (if no testosterone measurement available). Patients with castration-resistant or synchronous oligometastatic PCa at the time of first MDT were excluded. Repeated MDTs were allowed, as well as a period of concomitant ADT. Kaplan–Meier analyses were performed to assess palliative ADT-free and mCRPC-free survival. We identified 191 eligible patients who underwent MDT. Median follow-up from first MDT until last follow-up or death was 45 months (IQR 27–70; mean 51 months). Estimated median palliative-ADT free survival was 66 months (95% CI 58–164) and estimated median mCRPC-free survival was not reached (mean 117 months, 95% CI 103–132). In total, 314 MDTs were performed and 25 patients (13%) received ≥3 MDTs. This study demonstrated that (repeated) MDT is feasible and holds promise in terms of palliative ADT-free and mCRPC-free survival for patients with oligorecurrent PCa. However, these findings should be confirmed in prospective randomized controlled trials.

scholarly journals Effectiveness of abiraterone acetate plus prednisone in chemotherapy-naïve patients with metastatic castration-resistant prostate cancer in a large prospective real-world cohort: the ABItude study

2020 ◽  
Vol 12 ◽  
pp. 175883592096872
Author(s):  
Giuseppe Procopio ◽  
Vincenzo Emanuele Chiuri ◽  
Monica Giordano ◽  
Giovanna Mantini ◽  
Roberto Maisano ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Clinical Practice ◽  
Real World ◽  
Radiographic Progression ◽  
Specific Antigen ◽  
Progression Free Survival ◽  
Castration Resistant Prostate Cancer ◽  
Free Survival ◽  
Castration Resistant

Background: Real-world data on chemotherapy-naïve patients with metastatic castration-resistant prostate cancer (mCRPC) treated with abiraterone plus prednisone are limited, largely deriving from small retrospective studies. Methods: ABitude is an Italian, observational, prospective, multicenter study of mCRPC patients receiving abiraterone plus prednisone in clinical practice. Chemotherapy-naïve mCRPC patients were consecutively enrolled at abiraterone start (February 2016 to June 2017) and are being followed for 3 years, with evaluation approximately every 6 months. Several clinical and patients reported outcomes were examined. Results: In this second interim analysis, among 481 enrolled patients, 453 were evaluable for analyses. At baseline, the median age was 77 years and ~69% of patients had comorbidities (mainly cardiovascular diseases). Metastases were located mainly at bones and lymph nodes; 8.4% of patients had visceral metastases. During a median follow-up of 18 months, 1- and 2-year probability of radiographic progression-free survival were 73.9% and 56.2%, respectively; the corresponding rates for overall survival were 87.3% and 70.4%. In multivariable analyses, the number of bone metastases significantly affected radiographic progression-free survival and overall survival. During abiraterone plus prednisone treatment, 65% of patients had a ⩾50% prostate-specific antigen decline, and quality of life remained appreciably high. Among symptomatic patients according to the Brief Pain Inventory) (32%), scores significantly declined after 6 months of treatment. Overall, eight patients (1.7%) had serious adverse reactions to abiraterone. Conclusions: Abiraterone plus prednisone is effective and safe for chemotherapy-naïve mCRPC patients in clinical practice.

scholarly journals Next-generation androgen receptor inhibitors in non-metastatic castration-resistant prostate cancer

2020 ◽  
Vol 12 ◽  
pp. 175883592097813
Author(s):  
Pernelle Lavaud ◽  
Clément Dumont ◽  
Constance Thibault ◽  
Laurence Albiges ◽  
Giulia Baciarello ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Androgen Receptor ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Next Generation ◽  
Castration Resistant Prostate Cancer ◽  
Free Survival ◽  
Castration Resistant ◽  
Recent Advances

Until recently, continuing androgen deprivation therapy (ADT) and closely monitoring patients until evolution towards metastatic castration-resistant prostate cancer (CRPC) were recommended in men with non-metastatic CRPC (nmCRPC). Because delaying the development of metastases and symptoms in these patients is a major issue, several trials have investigated next-generation androgen receptor (AR) axis inhibitors such as apalutamide, darolutamide, and enzalutamide in this setting. This review summarizes the recent advances in the management of nmCRPC, highlighting the favourable impact of next-generation AR inhibitors on metastases-free survival, overall survival and other clinically meaningful endpoints.

Sign in / Sign up

Export Citation Format

Share Document