1
|
Suzuki K, Shiraishi Y, Furukawa J, Okamura Y, Bando Y, Hara T, Okada K, Terakawa T, Hyodo Y, Chiba K, Teishima J, Nakano Y, Miyake H. Clinical Outcomes and Risk Stratification in Patients With Metastatic Hormone-Sensitive Prostate Cancer Treated With New-Generation Androgen Receptor Signaling Inhibitors. Clin Genitourin Cancer 2024; 22:102140. [PMID: 39018723 DOI: 10.1016/j.clgc.2024.102140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/13/2024] [Accepted: 06/12/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Optimal drug selection for metastatic hormone-sensitive prostate cancer (mHSPC) remains unclear. We therefore assessed the clinical outcomes of mHSPC treated with new-generation androgen receptor pathway inhibitors (ARSIs) and identified risk factors associated with the prognosis of mHSPC. METHODS We retrospectively reviewed 324 patients with mHSPC who were treated with ARSIs, including abiraterone acetate, enzalutamide, and apalutamide, between January 2018 and December 2022. In addition to assessing the prostate-specific antigen (PSA) response and overall survival (OS) during ARSI treatment, we investigated several potential risk factors for a poor OS in patients with mHSPC. RESULTS Patients with a ≥ 90% PSA reduction (hazard ratio [HR]: 0.24, 95% confidence interval [CI], 0.10-0.58; P = .002) and those whose PSA declined to ≤ 0.2 ng/mL (HR: 0.22, 95% CI, 0.08-0.63; P = .005) showed significantly better OS than other patients. Gleason grade group 5 (GG5), presence of liver metastasis, and an LDH ≥ 250 U/L were identified as prognostic factors significantly associated with a poor OS, with HRs of 2.31 (95% CI, 1.02-5.20; P = .044), 7.87 (95% CI, 2.61-23.8; P < .001) and 3.21 (95% CI, 1.43-7.23; P = .005). CONCLUSION We identified GG5, the presence of liver metastasis, and elevated LDH at the diagnosis as significant factors predicting the OS of mHSPC, but the choice of ARSIs did not affect the prognosis. The potential prognostic impact of these markers requires further investigation.
Collapse
Affiliation(s)
- Kotaro Suzuki
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Yusuke Shiraishi
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Junya Furukawa
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yasuyoshi Okamura
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yukari Bando
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takuto Hara
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Keisuke Okada
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoaki Terakawa
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoji Hyodo
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Koji Chiba
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Jun Teishima
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuzo Nakano
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hideaki Miyake
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| |
Collapse
|
2
|
Gil-Lianes J, Amat-Samaranch V, Giavedoni P, Vilaseca A, Córdoba Sánchez J, Alamon-Reig F, Castillo P, Garcia AP, Pascal M, Carrera C. Cutaneous Adverse Reactions to Apalutamide: Case Series with Clinical and Pathological Correlations. Acta Derm Venereol 2024; 104:adv40719. [PMID: 39233615 PMCID: PMC11382552 DOI: 10.2340/actadv.v104.40719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 08/06/2024] [Indexed: 09/06/2024] Open
Abstract
Abstract is missing (Short communication)
Collapse
Affiliation(s)
- Javier Gil-Lianes
- Department of Dermatology, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
| | - Victoria Amat-Samaranch
- Department of Dermatology, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain; Pharmacovigilance program, Hospital Clínic Barcelona, Barcelona, Spain
| | - Priscila Giavedoni
- Department of Dermatology, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
| | - Antoni Vilaseca
- Pharmacovigilance program, Hospital Clínic Barcelona, Barcelona, Spain; Department of Urology, Hospital Clínic Barcelona, Barcelona, Spain
| | | | - Francesc Alamon-Reig
- Department of Dermatology, Hospital Clínic Barcelona, University of Barcelona, Spain
| | - Paola Castillo
- Department of Pathology, Hospital Clínic Barcelona, Barcelona, Spain
| | - Adriana P Garcia
- Department of Pathology, Hospital Clínic Barcelona, Barcelona, Spain
| | - Mariona Pascal
- Pharmacovigilance program, Hospital Clínic Barcelona, Barcelona, Spain; Department of Immunology, Hospital Clínic Barcelona, Barcelona, Spain
| | - Cristina Carrera
- Department of Dermatology, Hospital Clínic Barcelona, University of Barcelona, Spain; Pharmacovigilance program, Hospital Clínic Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Raras CIBERER, Instituto Salud Carlos III, Spain.
| |
Collapse
|
3
|
Urabe F, Muramoto K, Yanagisawa T, Fukuokaya W, Mori K, Tashiro K, Katsumi K, Takahashi H, Yoshihara K, Miyajima K, Imai Y, Iwatani K, Kayano S, Igarashi T, Murakami M, Tsuzuki S, Shimomura T, Yamada H, Miki J, Kimura T. Changes in the treatment landscape of metastatic hormone-sensitive prostate cancer following approval of upfront androgen receptor signaling inhibitors: A multicenter study. Int J Urol 2024. [PMID: 39031448 DOI: 10.1111/iju.15546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 07/10/2024] [Indexed: 07/22/2024]
Abstract
BACKGROUND A multicenter database was utilized to examine the current treatment landscape and clinical outcomes among patients with metastatic hormone-sensitive prostate cancer (mHSPC) following approval of upfront androgen receptor signaling inhibitors (ARSIs). METHODS We retrospectively analyzed patients with mHSPC who commenced treatment between February 2018 and June 2023. The Kaplan-Meier method was used to assess oncological outcomes, including time to castration-resistant prostate cancer (CRPC), progression-free survival 2 (PFS2, duration from initial treatment to tumor progression during second-line treatment), cancer-specific survival (CSS), and overall survival (OS). Cox regression analyses were performed to determine the impact of treatment choices on oncological outcomes. In addition, the incidence rate of adverse events was assessed. RESULTS In total, 829 patients were analyzed; 42.5% received ARSIs with androgen deprivation therapy (ADT), 44.0% received combined androgen blockade (CAB), and 13.5% received ADT alone. Kaplan-Meier curves and multivariate Cox regression analyses indicated higher rates of CRPC and shorter PFS2 in patients treated with CAB versus ARSIs with ADT. By contrast, CSS and OS were not significantly different between the ARSI with ADT group and the CAB group. Grades 3-4 adverse events occurred in 1.9% of patients receiving CAB and 6.0% of those receiving ARSIs with ADT. CONCLUSIONS Initial treatment with ARSIs in combination with ADT resulted in a longer time to CRPC and longer PFS2 compared to CAB. Although CAB and ADT alone were associated with fewer adverse events, ARSIs with ADT should be considered a first-line treatment option given its superior oncological outcomes.
Collapse
Affiliation(s)
- Fumihiko Urabe
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Katsuki Muramoto
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Takafumi Yanagisawa
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Wataru Fukuokaya
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Keiichiro Mori
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kojiro Tashiro
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
- Department of Urology, Jikei Katsushika Medical Center, Tokyo, Japan
| | - Kota Katsumi
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hidetsugu Takahashi
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kentaro Yoshihara
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
- Department of Urology, Jikei Katsushika Medical Center, Tokyo, Japan
| | - Keiichiro Miyajima
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yu Imai
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kosuke Iwatani
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
- Department of Urology, Jikei Kashiwa Hospital, Chiba, Japan
| | - Sotaro Kayano
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Taro Igarashi
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Masaya Murakami
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shunsuke Tsuzuki
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Tatsuya Shimomura
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroki Yamada
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
- Department of Urology, Jikei Katsushika Medical Center, Tokyo, Japan
| | - Jun Miki
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
- Department of Urology, Jikei Kashiwa Hospital, Chiba, Japan
| | - Takahiro Kimura
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|
4
|
Miyake H, Matsumoto R, Fujimoto K, Mizokami A, Uemura H, Kamoto T, Kawakami S, Nakamura K, Maekawa S, Shibayama K, Watanabe A, Ito M, Tajima Y, Matsuyama H, Uemura H. Clinical Outcomes of Patients with High-risk Metastatic Hormone-naïve Prostate Cancer: A 3-year Interim Analysis of the Observational J-ROCK Study. Eur Urol Oncol 2024; 7:625-632. [PMID: 38296736 DOI: 10.1016/j.euo.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/22/2023] [Accepted: 12/29/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Androgen deprivation therapy (ADT), administered alone, as combined androgen blockade (CAB) or as ADT plus androgen receptor signalling inhibitors (ARSIs) or ADT plus docetaxel, is the standard treatment for metastatic hormone-naïve prostate cancer (mHNPC) in Japanese real-world practice. OBJECTIVE To investigate treatment patterns and clinical outcomes in LATITUDE criteria high-risk mHNPC. DESIGN, SETTING, AND PARTICIPANTS The longitudinal, multicentre, J-ROCK registry study enrolled patients initiating ADT in Japan after May 2019, and categorised them as cohort 1 (ADT or CAB) or cohort 2 (ADT plus ARSIs or docetaxel). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Prostate-specific antigen (PSA) response, progression-free survival (PFS), time to castrate-resistant prostate cancer (CRPC), overall survival (OS), and safety were evaluated. PFS, time to CRPC, and OS were estimated via the Kaplan-Meier method and between-cohort comparisons via multivariate Cox regression models. RESULTS AND LIMITATIONS In total, 974 patients were included (cohort 1: 38.1%, cohort 2: 61.9%). CAB was preferred (67.4%) to ADT alone in cohort 1, and abiraterone acetate plus prednisolone was used most frequently in cohort 2 (59.4%). The proportion of patients with ≥50%/≥90% PSA decline or who achieved PSA ≤0.2/≤0.1 ng/ml tended to be higher in cohort 2. PFS (adjusted hazard ratio 0.42; 95% confidence interval [CI] 0.31-0.55), time to CRPC (0.28; 95% CI 0.23-0.36), and OS (0.54; 95% CI 0.35-0.82) were longer in cohort 2. In cohorts 1 and 2, adverse drug reactions of special interest (ADRSIs) occurred in 1.3% and 15.1%, and fatal adverse events occurred in 1.9% and 1.7%, respectively. Limitations included nonrandomised design, varying time since marketing authorisation for ARSIs, and limited safety assessments. CONCLUSIONS ADT plus ARSIs or docetaxel was used more frequently to treat high-risk mHNPC than standard ADT/CAB and was associated with more favourable clinical outcomes. Although ADRSIs were reported more in cohort 2, the safety profile was considered tolerable. PATIENT SUMMARY Although many treatment options are available for high-risk metastatic prostate cancer, there are limited reports on real-world clinical experience with different therapies outside of the clinical trial setting. In this study, we compared clinical and safety outcomes with different treatment regimens, using a large series of patients with high-risk metastatic hormone-naïve prostate cancer across Japan. We found that androgen deprivation therapy in combination with newer androgen receptor signalling inhibitors resulted in improved response compared with androgen deprivation therapy alone or in combination with a first-generation antiandrogen.
Collapse
Affiliation(s)
- Hideaki Miyake
- Department of Urology, Hamamatsu University Hospital, Shizuoka, Japan
| | - Rikiya Matsumoto
- Department of Urology, Chutoen General Medical Center, Shizuoka, Japan
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University Hospital, Nara, Japan
| | - Atsushi Mizokami
- Department of Urology, Kanazawa University Hospital, Ishikawa, Japan
| | | | - Toshiyuki Kamoto
- Department of Urology, University of Miyazaki Hospital, Miyazaki, Japan
| | - Satoru Kawakami
- Department of Urology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | | | | | - Kazuhiro Shibayama
- Statistics & Decision Sciences Japan, Janssen Pharmaceutical K.K., Tokyo, Japan
| | - Aki Watanabe
- Medical Affairs Operations, Global Development, Janssen R&D, Tokyo, Japan
| | - Miku Ito
- Department of Medical Affairs, Janssen Pharmaceutical K.K., Tokyo, Japan
| | - Yohei Tajima
- Department of Medical Affairs, Janssen Pharmaceutical K.K., Tokyo, Japan
| | | | - Hiroji Uemura
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Kanagawa, Japan
| |
Collapse
|
5
|
Tohi Y, Kato T, Kobayashi K, Daizumoto K, Fukuhara H, Ohira S, Katayama S, Shimizu R, Takamoto A, Nishimura K, Ikeda K, Nagami T, Hayashida Y, Hirama H, Naito H, Tomida R, Sasaki Y, Yamamoto S, Shimizu S, Sugimoto M. Real-world prostate-specific antigen response and progression to castration-resistant prostate cancer among men with metastatic castration-sensitive prostate cancer treated with apalutamide: a multi-institutional study in the Chu-shikoku Japan Urological Consortium. Jpn J Clin Oncol 2024; 54:167-174. [PMID: 37840362 DOI: 10.1093/jjco/hyad143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND Japanese men receiving apalutamide often experience skin-adverse events (AEs), possibly requiring treatment interruption or dose reduction. However, concerns have arisen regarding the impact of these adjustments on the efficacy of apalutamide. Our study evaluated the efficacy, safety, and persistence of apalutamide in men with metastatic castration-sensitive prostate cancer (mCSPC). METHODS We retrospectively reviewed the medical records of 108 men with mCSPC from 14 Japanese institutions. The primary outcomes were the efficacy of apalutamide: prostate-specific antigen (PSA) response (50%, 90% and < 0.2 decline) and progression to castration-resistant prostate cancer (CRPC). The secondary outcomes were the skin-AE and compliance of apalutamide. RESULTS PSA50%, PSA90% and PSA < 0.2 declines were observed in 89.8, 84.3 and 65.7%, and the median time to CRPC progression was not reached. PSA < 0.2 decline and an initial full dose of apalutamide were significantly associated with a longer time to CRPC. The most common AE was skin-AE (50.9%), and there was no association between the occurrence of skin-AE and the time to CRPC (P = 0.72). The median apalutamide persistence was 29 months, which was longer in the initial full dose recipients than in the reduced dose recipients. The dosage is reduced in about 60% of patients within the first year of treatment in the initial full dose recipients. CONCLUSIONS Our findings indicate the effectiveness of apalutamide in Japanese men with mCSPC, despite a substantial portion requiring dose reduction within a year among the initial full dose recipients.
Collapse
Affiliation(s)
- Yoichiro Tohi
- Department of Urology, Faculty of Medicine, Kagawa University, Kita-gun, Kagawa
| | - Takuma Kato
- Department of Urology, Faculty of Medicine, Kagawa University, Kita-gun, Kagawa
| | - Keita Kobayashi
- Department of Urology, Graduate School of Medicine, Yamaguchi University, Yamaguchi
| | - Kei Daizumoto
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima
| | - Hideo Fukuhara
- Department of Urology, Kochi Medical School, Nankoku, Kochi
| | - Shin Ohira
- Department of Urology, Kawasaki Medical School, Okayama
| | - Satoshi Katayama
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama
| | - Ryutaro Shimizu
- Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Tottori
| | | | | | - Kenichiro Ikeda
- Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima
| | - Taichi Nagami
- Department of Urology, Shimane University, Faculty of Medicine, Izumo, Shimane
| | - Yushi Hayashida
- Department of Urology, Sakaide City Hospital, Sakaide, Kagawa
| | - Hiromi Hirama
- Department of Urology, KKR Takamatsu Hospital, Takamatsu, Kagawa, Japan
| | - Hirohito Naito
- Department of Urology, Faculty of Medicine, Kagawa University, Kita-gun, Kagawa
| | - Ryotaro Tomida
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima
| | - Yutaro Sasaki
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima
| | | | | | - Mikio Sugimoto
- Department of Urology, Faculty of Medicine, Kagawa University, Kita-gun, Kagawa
| |
Collapse
|
6
|
Shah MJ, Sharma AP, Hameed BMZ, Jain R, Patil A, Karthickeyan N, Singh A. Oligometastatic carcinoma prostate - An overview of the last decade. Indian J Urol 2023; 39:195-201. [PMID: 37575157 PMCID: PMC10419768 DOI: 10.4103/iju.iju_60_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 04/11/2023] [Accepted: 05/15/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Oligometastatic prostate cancer (OMPC) has gained profound interest lately due to its different tumor biology and our ability to use multimodality therapy for cure or prolonged survival. Selecting the appropriate patient for treatment has become the aim of treating urologists, medical oncologists, and radiation oncologists. Through this review, we try to highlight the management of OMPC in light of recent literature. Methods Literature search was performed on Pubmed, Scopus and Embase using keywords "Oligometastatic", " Prostate Cancer" using operators such as "And" & "Or". Relevant articles were screened and all the latest articles on this emerging entity were included in this review. Results All trials relevant to oligometastatic prostate cancer defining the role of surgery, radiotherapy and systemic therapy were included and appropriate inferences were drawn. Relevant studies were compiled in tabular form for this article. Conclusion The current standard of care of management for OMPC remains systemic therapy on the lines of hormone-sensitive metastatic prostate cancer. The evolving role of surgery, and radiotherapy along with systemic therapy is highlighted in this article.
Collapse
Affiliation(s)
| | | | | | - Ravi Jain
- Uro Health Clinic, Ahmedabad, Gujarat, India
| | | | | | | |
Collapse
|
7
|
Oishi T, Hatakeyama S, Tabata R, Fujimori D, Kawashima Y, Tanaka R, Ishii N, Miura H, Tanaka T, Okamoto T, Yamamoto H, Yoneyama T, Hashimoto Y, Sato S, Ohyama C. Effects of apalutamide dose reduction on skin-related adverse events in patients with advanced prostate cancer: A multicenter retrospective study. Prostate 2023; 83:198-203. [PMID: 36314250 DOI: 10.1002/pros.24453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/30/2022] [Accepted: 10/14/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND We aimed to evaluate the effects of apalutamide dose reduction on skin-related adverse events (AEs) and castration-resistant prostate cancer (CRPC)-free survival in patients with advanced prostate cancer (PC). METHODS We retrospectively evaluated 35 patients with nonmetastatic CRPC and 72 patients with treatment-naïve metastatic castration-sensitive PC (mCSPC) who were treated with apalutamide. The primary outcome was the effect of apalutamide dose reduction on skin-related AEs. The secondary outcomes were the effect of apalutamide dose reduction on skin-related AEs in patients with small body size, postskin AE apalutamide discontinuation rate, and CRPC-free survival in patients with mCSPC treated with upfront apalutamide plus androgen deprivation therapy. RESULTS Of the 107 patients, 65 (60.7%) and 42 (39.3%) were treated with full and reduced doses of apalutamide, respectively. The skin-related AE rate was not significantly different between the groups (55% vs. 43%, p = 0.761). In the group receiving reduced apalutamide dose, the incidence of skin-related AEs was significantly lower in patients with small body sizes (body weight <67 kg and body mass index <24 kg/m2 ) than in those with other body sizes. The postskin AE apalutamide discontinuation rate was significantly differed between patients receiving the full (50%) and reduced (16.7%) doses. In the 72 patients with mCSPC, CRPC-free survival was not significantly different between the full and reduced dose groups. CONCLUSION Apalutamide dose reduction was not significantly associated with the incidence of skin-related AEs. However, dose reduction in patients with small body sizes may alleviate skin-related AEs without sacrificing oncological outcomes.
Collapse
Affiliation(s)
- Takuya Oishi
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shingo Hatakeyama
- Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Ryuji Tabata
- Department of Urology, Ageo Central General Hospital, Ageo, Japan
| | - Daiji Fujimori
- Department of Urology, Ageo Central General Hospital, Ageo, Japan
| | - Yohei Kawashima
- Department of Urology, Ageo Central General Hospital, Ageo, Japan
| | - Ryuma Tanaka
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Noritaka Ishii
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hikari Miura
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Toshikazu Tanaka
- Department of Urology, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Teppei Okamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hayato Yamamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takahiro Yoneyama
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yasuhiro Hashimoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Satoshi Sato
- Department of Urology, Ageo Central General Hospital, Ageo, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
- Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| |
Collapse
|
8
|
Sathianathen NJ, Pan HY, Lawrentschuk N, Siva S, Azad AA, Tran B, Bolton D, Murphy DG. Emergence of triplet therapy for metastatic castration-sensitive prostate cancer: An updated systematic review and network meta-analysis. Urol Oncol 2022; 41:233-239. [PMID: 36411180 DOI: 10.1016/j.urolonc.2022.10.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/04/2022] [Accepted: 10/13/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION There have been a growing number of treatment options available for men with metastatic castration-sensitive prostate cancer. Not only have newer agents entered the clinical landscape, there is a trend toward treatment intensification by combining multiple agents simultaneously. We aim to assess the best contemporary treatment option for men with mCSPC. MATERIALS AND METHODS We perform an updated systematic review and network meta-analysis of randomized control trials that evaluated systemic therapies in men with castration-sensitive prostate cancer. We searched multiple databases up to April 2022. We included all randomized trials assessing the effect of systemic agents. We performed subgroup analyses based on disease volume and timing of presentation. Statistical analysis was performed with Bayesian methods. RESULTS We found 10 eligible trials with 10,065 patients who were included in this analysis. Triplet therapy with darolutamide or abiraterone with docetaxel and ADT improved overall survival. In the sensitivity analysis, the respective hazard ratios for triplet therapy was HR 0.70 (95%CI 0.61-0.80) compared to docetaxel+ADT and 0.77 (95%CI 0.65-0.91) compared to androgen receptor pathway inhibitors+ADT combinations. It was estimated that there was 96% chance that one of the triplet therapy combinations were the best treatment option from an OS perspective. Triplet therapy also improved progression-free survival. These benefits were pronounced in men with high-volume disease burden and those with de novo metastatic disease. CONCLUSION The finding suggest that triplet therapy is likely the most efficacious available option in men with metastatic, castration-sensitive prostate cancer, especially in those with high-volume disease burden.
Collapse
|
9
|
Kato M. Editorial Comments to Patient-reported outcomes of a phase II neoadjuvant Apalutamide (ARN-509) and radical prostatectomy in treatment of intermediate- to high-risk prostate cancer (NEAR) trial. Int J Urol 2022; 29:1330. [PMID: 36001637 DOI: 10.1111/iju.15013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Manabu Kato
- Department of Urology, Aichi Cancer Center Hospital, Nagoya, Japan
| |
Collapse
|
10
|
Zang Z, Wang Z, Chiong E. Editorial Comment to Safety and efficacy of apalutamide in Japanese patients with metastatic castration-sensitive prostate cancer receiving androgen deprivation therapy: Final report for the Japanese subpopulation analysis of the randomized, placebo-controlled, phase III TITAN study. Int J Urol 2022; 29:541. [PMID: 35384091 PMCID: PMC9324806 DOI: 10.1111/iju.14891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Zhijiang Zang
- Department of Urology, National University Hospital, Singapore
| | - Ziting Wang
- Department of Urology, National University Hospital, Singapore
| | - Edmund Chiong
- Department of Urology, National University Hospital, Singapore.,Department of Surgery, National University of Singapore, Singapore
| |
Collapse
|