Mp60-10 Comparison of Upfront Arat Therapy and Cab Therapy for Metastatic Hormone-Sensitive Prostate Cancer: A Retrospective Multicenter Study

You have accessJournal of UrologyProstate Cancer: Advanced (Including Drug Therapy) III (MP60)1 May 2024MP60-10 COMPARISON OF UPFRONT ARAT THERAPY AND CAB THERAPY FOR METASTATIC HORMONE-SENSITIVE PROSTATE CANCER: A RETROSPECTIVE MULTICENTER STUDY Yusuke Shiraishi, Taisuke Tobe, Hideto Ueki, Kotaro Suzuki, Takuto Hara, Tomoaki Terakawa, Jun Teishima, Yuzo Nakano, Hideaki Miyake, and Masato Fujisawa Yusuke ShiraishiYusuke Shiraishi , Taisuke TobeTaisuke Tobe , Hideto UekiHideto Ueki , Kotaro SuzukiKotaro Suzuki , Takuto HaraTakuto Hara , Tomoaki TerakawaTomoaki Terakawa , Jun TeishimaJun Teishima , Yuzo NakanoYuzo Nakano , Hideaki MiyakeHideaki Miyake , and Masato FujisawaMasato Fujisawa View All Author Informationhttps://doi.org/10.1097/01.JU.0001008804.84010.ec.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The improvement in overall survival (OS) and Progression-Free Survival (PFS) with upfront Androgen Receptor-Axis-Targeted (ARAT) agents in metastatic hormone-sensitive prostate cancer (mHSPC) has been reported in Phase III clinical trials. However, previous reports have included cases that underwent prior treatments like radical prostatectomy or cases where docetaxel was administered concurrently. Additionally, some studies compared ADT alone rather than combined androgen deprivation therapy (CAB). We conducted a comparative analysis of the outcomes between conventional CAB and Upfront ARAT as primary treatments for untreated mHSPC. METHODS: A total of 756 mHSPC patients received conventional CAB (Vintage group) or up front ARAT (Upfront group) between January 2018 and December 2022 at Kobe University Hospital and related institutions. Kaplan-Meir curves were used to retrospectively analyze OS and PFS. Multivariate Cox regression analyses identified potential prognostic factors for OS and PFS. RESULTS: The Vintage group included 432 patients, and the Upfront group included 324 patients. The median follow-up duration was 25.1 months (range: 0.9-64.9) for the Vintage group and 17.5 months (range: 0.9-64.9) for the Upfront group. In the Vintage group, 224 patients (51.9%) had high-volume mHSPC in CHAARTED trial, while the Upfront group had 234 patients (72.2%). In the Vintage group and Upfront group, 204 patients (53.0%) and 223 patients (70.6%), respectively, achieved a ≥90% reduction in PSA levels at 4 months. Propensity score matching (PSM) analyses were conducted to compare OS and PFS between the two matched groups. Following PSM, the median OS for the Vintage group and Upfront group was not reached and 52.3 months, respectively, with no significant difference. The median PFS for the Vintage group was 28.0 months, while the Upfront group had a median PFS of 33.4 months, demonstrating a significantly longer PFS in the Upfront group (p<0.001).Multivariate analysis for OS identified BMI, Grade group, CRP, high volume in CHAARTED, and a ≥90% PSA reduction at 3 months as factors associated with OS. The multivariate analysis for PFS revealed that Grade group, CRP, symptoms, high volume in CHAARTED, and the type of treatment were associated with PFS. CONCLUSIONS: The upfront group did not display a statistically significant disparity in OS compared to the vintage group. However, it notably outperformed the vintage group in achieving a significant reduction in PSA levels and a prolonged period of PFS. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1003 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Yusuke Shiraishi More articles by this author Taisuke Tobe More articles by this author Hideto Ueki More articles by this author Kotaro Suzuki More articles by this author Takuto Hara More articles by this author Tomoaki Terakawa More articles by this author Jun Teishima More articles by this author Yuzo Nakano More articles by this author Hideaki Miyake More articles by this author Masato Fujisawa More articles by this author Expand All Advertisement PDF downloadLoading ...