Effect of Chemotherapy on Overall Survival in Contemporary Metastatic Prostate Cancer Patients
IntroductionRandomized clinical trials demonstrated improved overall survival in chemotherapy exposed metastatic prostate cancer patients. However, real-world data validating this effect with large scale epidemiological data sets are scarce and might not agree with trials. We tested this hypothesis....
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.778858/full |
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| author | Benedikt Hoeh Benedikt Hoeh Christoph Würnschimmel Christoph Würnschimmel Rocco S. Flammia Rocco S. Flammia Benedikt Horlemann Gabriele Sorce Gabriele Sorce Francesco Chierigo Francesco Chierigo Zhe Tian Fred Saad Markus Graefen Michele Gallucci Alberto Briganti Carlo Terrone Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Derya Tilki Derya Tilki Luis A. Kluth Philipp Mandel Felix K. H. Chun Pierre I. Karakiewicz |
| author_facet | Benedikt Hoeh Benedikt Hoeh Christoph Würnschimmel Christoph Würnschimmel Rocco S. Flammia Rocco S. Flammia Benedikt Horlemann Gabriele Sorce Gabriele Sorce Francesco Chierigo Francesco Chierigo Zhe Tian Fred Saad Markus Graefen Michele Gallucci Alberto Briganti Carlo Terrone Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Derya Tilki Derya Tilki Luis A. Kluth Philipp Mandel Felix K. H. Chun Pierre I. Karakiewicz |
| author_sort | Benedikt Hoeh |
| collection | DOAJ |
| description | IntroductionRandomized clinical trials demonstrated improved overall survival in chemotherapy exposed metastatic prostate cancer patients. However, real-world data validating this effect with large scale epidemiological data sets are scarce and might not agree with trials. We tested this hypothesis.Materials and MethodsWe identified de novo metastatic prostate cancer patients within the Surveillance, Epidemiology, and End Results (SEER) database (2014-2015). Kaplan-Meier plots and Cox regression models tested for overall survival differences between chemotherapy-exposed patients vs chemotherapy-naïve patients. All analyses were repeated in propensity-score matched cohorts. Additionally, landmark analyses were applied to account for potential immortal time bias.ResultsOverall, 4295 de novo metastatic prostate cancer patients were identified. Of those, 905 (21.1%) patients received chemotherapy vs 3390 (78.9%) did not. Median overall survival was not reached at 30 months follow-up. Chemotherapy-exposed patients exhibited significantly better overall survival (61.6 vs 54.3%, multivariable HR:0.82, CI: 0.72-0.96, p=0.01) at 30 months compared to their chemotherapy-naïve counterparts. These findings were confirmed in propensity score matched analyses (multivariable HR: 0.77, CI:0.66-0.90, p<0.001). Results remained unchanged after landmark analyses were applied in propensity score matched population.ConclusionsIn this contemporary real-world population-based cohort, chemotherapy for metastatic prostate cancer patients was associated with better overall survival. However, the magnitude of overall survival benefit was not comparable to phase 3 trials. |
| first_indexed | 2024-12-17T21:05:20Z |
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| id | doaj.art-97dcbf84b04d492499e50361ac8d0cb7 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-17T21:05:20Z |
| publishDate | 2021-11-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-97dcbf84b04d492499e50361ac8d0cb72022-12-21T21:32:35ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-11-011110.3389/fonc.2021.778858778858Effect of Chemotherapy on Overall Survival in Contemporary Metastatic Prostate Cancer PatientsBenedikt Hoeh0Benedikt Hoeh1Christoph Würnschimmel2Christoph Würnschimmel3Rocco S. Flammia4Rocco S. Flammia5Benedikt Horlemann6Gabriele Sorce7Gabriele Sorce8Francesco Chierigo9Francesco Chierigo10Zhe Tian11Fred Saad12Markus Graefen13Michele Gallucci14Alberto Briganti15Carlo Terrone16Shahrokh F. Shariat17Shahrokh F. Shariat18Shahrokh F. Shariat19Shahrokh F. Shariat20Shahrokh F. Shariat21Shahrokh F. Shariat22Derya Tilki23Derya Tilki24Luis A. Kluth25Philipp Mandel26Felix K. H. Chun27Pierre I. Karakiewicz28Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, GermanyCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, CanadaCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, CanadaMartini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, GermanyCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, CanadaDepartment of Maternal-Child and Urological Sciences, Sapienza Rome University, Policlinico Umberto I Hospital, Rome, ItalyCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, CanadaCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, CanadaDivision of Experimental Oncology/Unit of Urology, Urological Research Institute, San Raffaele Scientific Institute, Milan, ItalyCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, CanadaDepartment of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, ItalyCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, CanadaCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, CanadaMartini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, GermanyDepartment of Maternal-Child and Urological Sciences, Sapienza Rome University, Policlinico Umberto I Hospital, Rome, ItalyDivision of Experimental Oncology/Unit of Urology, Urological Research Institute, San Raffaele Scientific Institute, Milan, ItalyDepartment of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, ItalyDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, AustriaDepartment of Urology, Weill Cornell Medical College, New York, NY, United StatesDepartment of Urology, University of Texas Southwestern, Dallas, TX, United States0Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czechia1Institute for Urology and Reproductive Health, Sechenov First Moscow State Medical University, Moscow, Russia2Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, JordanMartini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany3Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, GermanyDepartment of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, GermanyDepartment of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, GermanyDepartment of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, GermanyCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, CanadaIntroductionRandomized clinical trials demonstrated improved overall survival in chemotherapy exposed metastatic prostate cancer patients. However, real-world data validating this effect with large scale epidemiological data sets are scarce and might not agree with trials. We tested this hypothesis.Materials and MethodsWe identified de novo metastatic prostate cancer patients within the Surveillance, Epidemiology, and End Results (SEER) database (2014-2015). Kaplan-Meier plots and Cox regression models tested for overall survival differences between chemotherapy-exposed patients vs chemotherapy-naïve patients. All analyses were repeated in propensity-score matched cohorts. Additionally, landmark analyses were applied to account for potential immortal time bias.ResultsOverall, 4295 de novo metastatic prostate cancer patients were identified. Of those, 905 (21.1%) patients received chemotherapy vs 3390 (78.9%) did not. Median overall survival was not reached at 30 months follow-up. Chemotherapy-exposed patients exhibited significantly better overall survival (61.6 vs 54.3%, multivariable HR:0.82, CI: 0.72-0.96, p=0.01) at 30 months compared to their chemotherapy-naïve counterparts. These findings were confirmed in propensity score matched analyses (multivariable HR: 0.77, CI:0.66-0.90, p<0.001). Results remained unchanged after landmark analyses were applied in propensity score matched population.ConclusionsIn this contemporary real-world population-based cohort, chemotherapy for metastatic prostate cancer patients was associated with better overall survival. However, the magnitude of overall survival benefit was not comparable to phase 3 trials.https://www.frontiersin.org/articles/10.3389/fonc.2021.778858/fullchemotherapyoverall survivalmetastatic prostate cancerSEERcontemporary |
| spellingShingle | Benedikt Hoeh Benedikt Hoeh Christoph Würnschimmel Christoph Würnschimmel Rocco S. Flammia Rocco S. Flammia Benedikt Horlemann Gabriele Sorce Gabriele Sorce Francesco Chierigo Francesco Chierigo Zhe Tian Fred Saad Markus Graefen Michele Gallucci Alberto Briganti Carlo Terrone Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Derya Tilki Derya Tilki Luis A. Kluth Philipp Mandel Felix K. H. Chun Pierre I. Karakiewicz Effect of Chemotherapy on Overall Survival in Contemporary Metastatic Prostate Cancer Patients Frontiers in Oncology chemotherapy overall survival metastatic prostate cancer SEER contemporary |
| title | Effect of Chemotherapy on Overall Survival in Contemporary Metastatic Prostate Cancer Patients |
| title_full | Effect of Chemotherapy on Overall Survival in Contemporary Metastatic Prostate Cancer Patients |
| title_fullStr | Effect of Chemotherapy on Overall Survival in Contemporary Metastatic Prostate Cancer Patients |
| title_full_unstemmed | Effect of Chemotherapy on Overall Survival in Contemporary Metastatic Prostate Cancer Patients |
| title_short | Effect of Chemotherapy on Overall Survival in Contemporary Metastatic Prostate Cancer Patients |
| title_sort | effect of chemotherapy on overall survival in contemporary metastatic prostate cancer patients |
| topic | chemotherapy overall survival metastatic prostate cancer SEER contemporary |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.778858/full |
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