Clinical Characteristics of Patients with Metastatic Castration-resistant Prostate Cancer After Treatment with Combined Androgen Blockade

Overview

Journal BMC Urol

Publisher Biomed Central

Specialty Urology

Date 2023 Apr 28

PMID 37118708

Authors

Daisuke Obinata

Sho Hashimoto

Hideaki Uchida

Ken Nakahara

Tsuyoshi Yoshizawa

Junichi Mochida

Kenya Yamaguchi

Satoru Takahashi

Affiliations

Soon will be listed here.

Abstract

Background: Although the second-generation androgen receptor inhibitors and taxanes have recently been recommended for the initial treatment of metastatic prostate cancer, bicalutamide and flutamide are still used in a large number of cases. Therefore, it is important to elucidate the clinical characteristics of these treated CRPC cases and their sensitivity to the currently used therapeutic agents. We aimed to examine the outcomes of metastatic castration-resistant prostate cancer following combined androgen blockade as initial therapy at our institution.

Methods: Ninety-four patients who developed metastatic castration-resistant prostate cancer after hormonal treatment with combined nonsteroidal androgen receptor antagonists and continuous androgen deprivation therapy between January 2015 and December 2020 were included. The presence of visceral metastases, duration of efficacy of each treatment, and overall survival after castration-resistant prostate cancer were evaluated.

Results: Patients with a longer duration of castration-resistant prostate cancer tended to have a longer response duration to subsequent enzalutamide administration (p = 0.003). Patients who achieved a 90% reduction in prostate-specific antigen levels with enzalutamide had a significantly better castration-resistant prostate cancer prognosis (p = 0.002). Meanwhile, those with visceral metastases at the time of castration-resistant prostate cancer diagnosis had a significantly poorer prognosis (p < 0.001). A positive correlation was observed between the treatment efficacy of abiraterone and taxanes for castration-resistant prostate cancer.

Conclusion: The study provides scientific evidence to support that patients with longer time to castration-resistant prostate cancer are more sensitive to enzalutamide, and the use of abiraterone between docetaxel and cabazitaxel has favorable prognostic impact. These findings provide instrumental evidence that can enable better treatment selection for prostate cancer patients.

Citing Articles

Characterization of PSA dynamics and oncological outcomes in patients with metastatic hormone-sensitive prostate cancer treated with androgen receptor signaling inhibitors.

Yamada Y, Sato K, Sakamoto S, Tsujino T, Saito S, Nishimura K Int J Clin Oncol. 2024; 30(3):539-550.

PMID: 39656401 PMC: 11842405. DOI: 10.1007/s10147-024-02676-z.

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