Mp14-05 the Impact of Upfront Combination Therapy in Patients With McSPC on Os After McRpc: A Multicentre Retrospective Study

You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) II (MP14)1 May 2024MP14-05 THE IMPACT OF UPFRONT COMBINATION THERAPY IN PATIENTS WITH MCSPC ON OS AFTER MCRPC: A MULTICENTRE RETROSPECTIVE STUDY Toshikazu Tanaka, Ryuji Tabata, Daisuke Noro, Naoki Fujita, Takahiro Yoneyama, Yasuhiro Hashimoto, Satoshi Sato, Shintaro Narita, Tomonori Habuchi, Chikara Ohyama, and Shingo Hatakeyama Toshikazu TanakaToshikazu Tanaka , Ryuji TabataRyuji Tabata , Daisuke NoroDaisuke Noro , Naoki FujitaNaoki Fujita , Takahiro YoneyamaTakahiro Yoneyama , Yasuhiro HashimotoYasuhiro Hashimoto , Satoshi SatoSatoshi Sato , Shintaro NaritaShintaro Narita , Tomonori HabuchiTomonori Habuchi , Chikara OhyamaChikara Ohyama , and Shingo HatakeyamaShingo Hatakeyama View All Author Informationhttps://doi.org/10.1097/01.JU.0001009428.69695.82.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: While the ADT/CAB era emphasized the importance of Time to Castration Resistance (TTCR) for metastatic castration-sensitive prostate cancer (mCSPC) survival, recent guidelines advocate upfront treatment for mCSPC. This study investigates whether the Upfront era matches the survival outcomes observed in the ADT/CAB era. METHODS: Utilizing real-world data from the Akita, Hirosaki, and Ageo databases, We compared oncological outcomes in 458 patients treated with ADT/CAB and 310 with upfront therapy for high-tumor-burden mCSPC. Additionally, we compared the oncological outcome, including OS after CRPC, between 211 patients in the ADT/CAB group and 131 patients in the Upfront group who progressed to CRPC. We also analyzed the outcomes based on the specific drugs used. Ordinary treatments included Abiraterone, followed closely by docetaxel, apalutamide, and Enzalutamide in decreasing frequency. RESULTS: Upfront treatment demonstrated markedly superior outcomes, showing a CRPC-free survival rate with a hazard ratio (HR) of 0.49 and a significantly improved overall survival rate. In cases where cases advanced to CRPC rapidly during this study, especially for more severe cancer types, the CRPC-free survival in the Upfront ARSI group was comparable to that of the ADT/CAB group. However, the overall survival rate seemed slightly worse in the Upfront ARSI group. Intriguingly, the Upfront docetaxel group displayed a favorable trajectory in both CRPC-free survival and overall survival. When comparing survival rates post-mCRPC progression, outcomes from the Upfront ARSI arm were less promising when juxtaposed against the ADT/CAB and docetaxel groups. Drug-specific outcomes were also analyzed. Conclusively, it was inferred that while upfront treatments might extend the time to CRPC, leading to longer overall survival durations, the survival rate following CRPC progression could be suboptimal, underscoring the necessity for careful treatment deliberation. CONCLUSIONS: While Upfront treatment may protract TTCR, potentially culminating in a more extended overall survival, the survival rate post-CRPC progression remains a concern, necessitating a judicious therapeutic strategy. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e221 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Toshikazu Tanaka More articles by this author Ryuji Tabata More articles by this author Daisuke Noro More articles by this author Naoki Fujita More articles by this author Takahiro Yoneyama More articles by this author Yasuhiro Hashimoto More articles by this author Satoshi Sato More articles by this author Shintaro Narita More articles by this author Tomonori Habuchi More articles by this author Chikara Ohyama More articles by this author Shingo Hatakeyama More articles by this author Expand All Advertisement PDF downloadLoading ...