Real‑world survival outcome comparing abiraterone acetate plus prednisone and enzalutamide for nonmetastatic castration‐resistant prostate cancer
Abstract Background There is little evidence of abiraterone acetate (AA) plus prednisone for patients with non‐metastatic castration‐resistant prostate cancer (nmCRPC). In this study, we conducted a comparative analysis of real‐world survival outcomes between AA plus prednisone and enzalutamide (Enz...
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-10-01
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| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.6536 |
| _version_ | 1797654511676817408 |
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| author | Takuya Tsujino Satoshi Tokushige Kazumasa Komura Wataru Fukuokaya Takahiro Adachi Yosuke Hirasawa Takeshi Hashimoto Atsuhiko Yoshizawa Masanobu Saruta Takaya Ohno Keita Nakamori Ryoichi Maenosono Kazuki Nishimura Shogo Yamazaki Taizo Uchimoto Takafumi Yanagisawa Keiichiro Mori Fumihiko Urabe Shunsuke Tsuzuki Kosuke Iwatani Shutaro Yamamoto Kiyoshi Takahara Teruo Inamoto Takahiro Kimura Yoshio Ohno Ryoichi Shiroki Haruhito Azuma |
| author_facet | Takuya Tsujino Satoshi Tokushige Kazumasa Komura Wataru Fukuokaya Takahiro Adachi Yosuke Hirasawa Takeshi Hashimoto Atsuhiko Yoshizawa Masanobu Saruta Takaya Ohno Keita Nakamori Ryoichi Maenosono Kazuki Nishimura Shogo Yamazaki Taizo Uchimoto Takafumi Yanagisawa Keiichiro Mori Fumihiko Urabe Shunsuke Tsuzuki Kosuke Iwatani Shutaro Yamamoto Kiyoshi Takahara Teruo Inamoto Takahiro Kimura Yoshio Ohno Ryoichi Shiroki Haruhito Azuma |
| author_sort | Takuya Tsujino |
| collection | DOAJ |
| description | Abstract Background There is little evidence of abiraterone acetate (AA) plus prednisone for patients with non‐metastatic castration‐resistant prostate cancer (nmCRPC). In this study, we conducted a comparative analysis of real‐world survival outcomes between AA plus prednisone and enzalutamide (Enz) in patients with nmCRPC, utilizing our consortium dataset. Materials and Methods The clinical records of 133 nmCRPC patients treated with first‐line Enz or AA plus prednisone were analyzed. The primary endpoints of the study were overall survival (OS) and cancer‐specific survival (CSS). Cumulative incidence function (CIF) using Fine and Gray models was also utilized to assess non‐cancer‐caused death considering the competing risk of cancer‐caused death. Results During a median follow‐up of 36 months, 34 patients (25.6%) had deceased, with a median OS of 99 months in the entire cohort. There were no significant differences in comorbidities between the Enz and AA groups. Time to PSA progression (TTPP: HR 0.81, 95% CI 0.51–1.30, P = 0.375) and CSS (HR 1.32, 95% CI 0.55–3.44, P = 0.5141) were comparable between the two groups. However, intriguingly, there was a trend towards shorter OS in patients treated with AA plus prednisone compared to Enz (HR 0.57, 95% CI 0.29–1.12, P = 0.0978, median of 99 and 69 months in Enz and AA groups, respectively). CIF analysis revealed that nmCRPC patients treated with AA plus prednisone were more likely to result in non‐cancer‐caused death than those treated with Enz (HR 5.22, 95% CI 1.88–14.50, P = 0.0014). Conclusions Our real‐world survival analysis suggests that while AA plus prednisone may demonstrate comparable treatment efficacy to Enz in the context of nmCRPC, there may be an increased risk of non‐cancer‐caused death. Physicians should take into consideration this information when making treatment decisions for patients with nmCRPC. |
| first_indexed | 2024-03-11T17:00:32Z |
| format | Article |
| id | doaj.art-a557172dfc5b4cd6bd24118ee1dcb769 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-03-11T17:00:32Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-a557172dfc5b4cd6bd24118ee1dcb7692023-10-20T10:25:44ZengWileyCancer Medicine2045-76342023-10-011219194141942210.1002/cam4.6536Real‑world survival outcome comparing abiraterone acetate plus prednisone and enzalutamide for nonmetastatic castration‐resistant prostate cancerTakuya Tsujino0Satoshi Tokushige1Kazumasa Komura2Wataru Fukuokaya3Takahiro Adachi4Yosuke Hirasawa5Takeshi Hashimoto6Atsuhiko Yoshizawa7Masanobu Saruta8Takaya Ohno9Keita Nakamori10Ryoichi Maenosono11Kazuki Nishimura12Shogo Yamazaki13Taizo Uchimoto14Takafumi Yanagisawa15Keiichiro Mori16Fumihiko Urabe17Shunsuke Tsuzuki18Kosuke Iwatani19Shutaro Yamamoto20Kiyoshi Takahara21Teruo Inamoto22Takahiro Kimura23Yoshio Ohno24Ryoichi Shiroki25Haruhito Azuma26Department of Urology Osaka Medical and Pharmaceutical University Takatsuki JapanDepartment of Urology Osaka Medical and Pharmaceutical University Takatsuki JapanDepartment of Urology Osaka Medical and Pharmaceutical University Takatsuki JapanDepartment of Urology The Jikei University School of Medicine Minato‐ku JapanDepartment of Urology Tokyo Medical University Shinjuku‐ku JapanDepartment of Urology Tokyo Medical University Shinjuku‐ku JapanDepartment of Urology Tokyo Medical University Shinjuku‐ku JapanDepartment of Urology Fujita‐Health University School of Medicine Toyoake JapanDepartment of Urology Fujita‐Health University School of Medicine Toyoake JapanDepartment of Urology Osaka Medical and Pharmaceutical University Takatsuki JapanDepartment of Urology Osaka Medical and Pharmaceutical University Takatsuki JapanDepartment of Urology Osaka Medical and Pharmaceutical University Takatsuki JapanDepartment of Urology Osaka Medical and Pharmaceutical University Takatsuki JapanDepartment of Urology Osaka Medical and Pharmaceutical University Takatsuki JapanDepartment of Urology Osaka Medical and Pharmaceutical University Takatsuki JapanDepartment of Urology The Jikei University School of Medicine Minato‐ku JapanDepartment of Urology The Jikei University School of Medicine Minato‐ku JapanDepartment of Urology The Jikei University School of Medicine Minato‐ku JapanDepartment of Urology The Jikei University School of Medicine Minato‐ku JapanDepartment of Urology The Jikei University School of Medicine Minato‐ku JapanDepartment of Urology The Jikei University School of Medicine Minato‐ku JapanDepartment of Urology Fujita‐Health University School of Medicine Toyoake JapanDepartment of Urology Osaka Medical and Pharmaceutical University Takatsuki JapanDepartment of Urology The Jikei University School of Medicine Minato‐ku JapanDepartment of Urology Tokyo Medical University Shinjuku‐ku JapanDepartment of Urology Fujita‐Health University School of Medicine Toyoake JapanDepartment of Urology Osaka Medical and Pharmaceutical University Takatsuki JapanAbstract Background There is little evidence of abiraterone acetate (AA) plus prednisone for patients with non‐metastatic castration‐resistant prostate cancer (nmCRPC). In this study, we conducted a comparative analysis of real‐world survival outcomes between AA plus prednisone and enzalutamide (Enz) in patients with nmCRPC, utilizing our consortium dataset. Materials and Methods The clinical records of 133 nmCRPC patients treated with first‐line Enz or AA plus prednisone were analyzed. The primary endpoints of the study were overall survival (OS) and cancer‐specific survival (CSS). Cumulative incidence function (CIF) using Fine and Gray models was also utilized to assess non‐cancer‐caused death considering the competing risk of cancer‐caused death. Results During a median follow‐up of 36 months, 34 patients (25.6%) had deceased, with a median OS of 99 months in the entire cohort. There were no significant differences in comorbidities between the Enz and AA groups. Time to PSA progression (TTPP: HR 0.81, 95% CI 0.51–1.30, P = 0.375) and CSS (HR 1.32, 95% CI 0.55–3.44, P = 0.5141) were comparable between the two groups. However, intriguingly, there was a trend towards shorter OS in patients treated with AA plus prednisone compared to Enz (HR 0.57, 95% CI 0.29–1.12, P = 0.0978, median of 99 and 69 months in Enz and AA groups, respectively). CIF analysis revealed that nmCRPC patients treated with AA plus prednisone were more likely to result in non‐cancer‐caused death than those treated with Enz (HR 5.22, 95% CI 1.88–14.50, P = 0.0014). Conclusions Our real‐world survival analysis suggests that while AA plus prednisone may demonstrate comparable treatment efficacy to Enz in the context of nmCRPC, there may be an increased risk of non‐cancer‐caused death. Physicians should take into consideration this information when making treatment decisions for patients with nmCRPC.https://doi.org/10.1002/cam4.6536abiraterone acetateandrogen receptor signaling inhibitorcastration‐resistant prostate cancerenzalutamidenonmetastatic castration‐resistant prostate cancer |
| spellingShingle | Takuya Tsujino Satoshi Tokushige Kazumasa Komura Wataru Fukuokaya Takahiro Adachi Yosuke Hirasawa Takeshi Hashimoto Atsuhiko Yoshizawa Masanobu Saruta Takaya Ohno Keita Nakamori Ryoichi Maenosono Kazuki Nishimura Shogo Yamazaki Taizo Uchimoto Takafumi Yanagisawa Keiichiro Mori Fumihiko Urabe Shunsuke Tsuzuki Kosuke Iwatani Shutaro Yamamoto Kiyoshi Takahara Teruo Inamoto Takahiro Kimura Yoshio Ohno Ryoichi Shiroki Haruhito Azuma Real‑world survival outcome comparing abiraterone acetate plus prednisone and enzalutamide for nonmetastatic castration‐resistant prostate cancer Cancer Medicine abiraterone acetate androgen receptor signaling inhibitor castration‐resistant prostate cancer enzalutamide nonmetastatic castration‐resistant prostate cancer |
| title | Real‑world survival outcome comparing abiraterone acetate plus prednisone and enzalutamide for nonmetastatic castration‐resistant prostate cancer |
| title_full | Real‑world survival outcome comparing abiraterone acetate plus prednisone and enzalutamide for nonmetastatic castration‐resistant prostate cancer |
| title_fullStr | Real‑world survival outcome comparing abiraterone acetate plus prednisone and enzalutamide for nonmetastatic castration‐resistant prostate cancer |
| title_full_unstemmed | Real‑world survival outcome comparing abiraterone acetate plus prednisone and enzalutamide for nonmetastatic castration‐resistant prostate cancer |
| title_short | Real‑world survival outcome comparing abiraterone acetate plus prednisone and enzalutamide for nonmetastatic castration‐resistant prostate cancer |
| title_sort | real world survival outcome comparing abiraterone acetate plus prednisone and enzalutamide for nonmetastatic castration resistant prostate cancer |
| topic | abiraterone acetate androgen receptor signaling inhibitor castration‐resistant prostate cancer enzalutamide nonmetastatic castration‐resistant prostate cancer |
| url | https://doi.org/10.1002/cam4.6536 |
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