Comparative assessment of prognostic outcomes between first-generation antiandrogens and novel androgen-receptor-axis-targeted agents in patients with non-metastatic castration-resistant prostate cancer

  • Hideaki MiyakeEmail author
  • Yuto Matsushita
  • Hiromitsu Watanabe
  • Keita Tamura
  • Daisuke Motoyama
  • Toshiki Ito
  • Takayuki Sugiyama
  • Atsushi Otsuka
Original Article



To compare the prognostic outcomes between first-generation antiandrogen (FGA) and novel androgen-receptor-axis-targeted agent (ARATA) as first-line therapy in patients with non-metastatic castration-resistant prostate cancer (nmCRPC).


This study retrospectively included a total of 103 consecutive nmCRPC patients consisting of 47 (45.6%) and 56 (54.4%) who received FGA (bicalutamide or flutamide) and ARATA (abiraterone acetate or enzalutamide), respectively, as the first-line agent after the failure of primary androgen deprivation therapy (ADT).


There were no significant differences in the major clinicopathological parameters and previous therapeutic histories between the FGA and ARATA groups. During the observation period, 31 (66.0%) and 29 (51.8%) discontinued first-line therapy in the FGA and ARATA groups, respectively, and of these, 27 (87.1%) and 23 (79.3%) in the FGA and ARATA groups, respectively, were subsequently treated with approved agents as second-line therapy. The prostate-specific antigen (PSA) response rate in the FGA group was significantly lower than that in the ARATA group. Although no significant difference in overall survival was noted between the FGA and ARATA groups, there were significant differences in the PSA progression-free survival on first-line therapy and metastasis-free survival between the two groups, favoring the ARATA group compared with FGA group.


Collectively, these findings suggest that among nmCRPC patients who progressed following treatment with the primary ADT, the introduction of ARATA may result in the delay of disease progression compared with FGA.


Non-metastatic castration-resistant prostate cancer First-generation antiandrogen Androgen-receptor-axis-targeted agent Prognosis 


Compliance with ethical standards

Conflict of interest

All authors have declared no conflict of interest.


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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  • Hideaki Miyake
    • 1
    Email author
  • Yuto Matsushita
    • 1
  • Hiromitsu Watanabe
    • 1
  • Keita Tamura
    • 1
  • Daisuke Motoyama
    • 1
  • Toshiki Ito
    • 1
  • Takayuki Sugiyama
    • 1
  • Atsushi Otsuka
    • 1
  1. 1.Department of UrologyHamamatsu University School of MedicineHamamatsuJapan

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