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Real-world survival outcomes of adding docetaxel or abiraterone in patients with high-volume metastatic castration-sensitive prostate cancer: historically controlled, propensity score matched comparison with androgen deprivation therapy

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Abstract

Purpose

This study investigated the impact of treatment intensification with upfront docetaxel (DOC) or abiraterone (ABI) plus prednisolone on survival outcomes in patients with metastatic castration-sensitive prostate cancer (mCSPC) by comparing it with androgen deprivation therapy (ADT) monotherapy or combined androgen blockade (CAB) using propensity score matching (PSM).

Methods

Outcomes from 278 CHAARTED high-volume patients receiving upfront DOC (92 patients) or upfront ABI (186 patients) were compared to those from 354 patients receiving ADT or CAB. PSM was conducted to assess castration-resistant prostate cancer-free survival (CRPCFS) and overall survival (OS).

Results

After PSM, patient distributions between the three groups were well balanced. After 1:1 PSM, patients receiving upfront ABI had significantly better CRPCFS than those receiving ADT/CAB or upfront DOC [hazard ratio (HR) 0.39; 95% CI 0.27–0.56 vs. HR 0.50; 95% CI 0.30–0.82, respectively]. No significant difference in CRPCFS was observed between the upfront DOC and ADT/CAB groups (HR 0.75; 95% CI 0.50–1.12). Patients receiving upfront DOC and upfront ABI had significantly better OS than those receiving ADT/CAB (HR 0.54; 95% CI 0.0.30–0.98 vs. HR 0.49; 95% CI 0.29–0.84, respectively). However, no significant difference in OS was observed between upfront ABI and upfront DOC (hazard ratio 0.84; 95% CI 0.34–2.06).

Conclusion

The comparison of real-world retrospective cohorts showed that treatment intensification with upfront DOC or upfront ABI promoted better OS compared to ADT alone or CAB in patients with high-volume mCSPC after PSM. However, no difference in OS was observed between upfront DOC and upfront ABI.

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Acknowledgements

We express our appreciation to Yoko Mitobe, Yukiko Sugiyama, and Saeko Nakamura for their assistance in performing this study.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-profit sectors.

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Authors and Affiliations

  1. Department of Urology, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan

    Shintaro Narita, Hiromi Sato, Soki Kashima, Atsushi Koizumi, Ryohei Yamamoto & Tomonori Habuchi

  2. Department of Urology, The Jikei University School of Medicine, Tokyo, Japan

    Takahiro Kimura, Kenichi Hata, Takafumi Yanagisawa & Shin Egawa

  3. Department of Urology, Hirosaki University School of Medicine, Hirosaki, Japan

    Shingo Hatakeyama & Chikara Ohyama

  4. Department of Urology, Iwate Prefectural Isawa Hospital, Mizusawa, Japan

    Shinya Maita & Jiro Shimoda

  5. Department of Urology, Yuri Kumiai General Hospital, Honjo, Japan

    Shuji Chiba

  6. Department of Urology, Yokote City Hospital, Yokote, Japan

    Koichiro Takayama

  7. Department of Urology, Akita Kosei Medical Center, Akita, Japan

    Katsumi Okane

  8. Department of Urology, Akita City Hospital, Akita, Japan

    Toshiya Ishida

  9. Department of Urology, Akita Red Cross Hospital, Akita, Japan

    Yohei Horikawa

  10. Department of Urology, Omagari Kosei Medical Center, Daisen, Japan

    Teruaki Kumazawa

  11. Department of Urology, Hiraka General Hospital, Yokote, Japan

    Takehiro Suzuki

  12. Department of Public Health, Akita University School of Medicine, Akita, Japan

    Kyoko Nomura

Authors
  1. Shintaro Narita
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  2. Takahiro Kimura
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  3. Shingo Hatakeyama
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Contributions

SN: data collection, study design, statistical analysis, and manuscript writing. TK and SH: study design and data collection. KH, TY, SM, SC, HS, SK, AK, RY, KT, KO, TI, YH, TK, JS, and TS: data collection. KN: statistical analysis. CO and SE: supervision. TH: supervision and manuscript writing. All authors had read and approved the final manuscript.

Corresponding author

Correspondence to Shintaro Narita.

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Conflict of interest

Shintaro Narita received honoraria from Janssen Pharmaceutical K.K. Takahiro Kimura is a paid consultant/advisor of Astellas Pharma Inc., Bayer AG, Janssen Pharmaceutical K.K and Sanofi S.A. Shin Egawa is a paid consultant/advisor of Takeda, Astellas, AstraZeneca, Sanofi, Janssen, and Pfizer. Tomonori Habuchi also received honoraria from Janssen Pharmaceutical K.K., Takeda Pharmaceutical Company Ltd., Astellas Pharma Inc., Daiichi Sankyo Company, Ltd., AstraZeneca K.K., Sanofi S.A., and Bayer AG. The other authors have no disclosures.

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Narita, S., Kimura, T., Hatakeyama, S. et al. Real-world survival outcomes of adding docetaxel or abiraterone in patients with high-volume metastatic castration-sensitive prostate cancer: historically controlled, propensity score matched comparison with androgen deprivation therapy. World J Urol 40, 1135–1141 (2022). https://doi.org/10.1007/s00345-022-03963-y

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