Improved prognosis of de novo metastatic prostate cancer after an introduction of life-prolonging agents for castration-resistant prostate cancer.

In Japan, since 2014, new treatments such as androgen receptor signaling inhibitors and cabazitaxel have become applicable for metastatic castration-resistant prostate cancer (mCRPC), leading to dramatic changes in treatment options.

This study aims to evaluate the impact of recent advancements in treatment options on the overall survival (OS) of patients diagnosed with de novo metastatic castration-sensitive prostate cancer (mCSPC) in Japan.

A retrospective analysis was conducted on 2450 Japanese men diagnosed with de novo mCSPC between 2008 and 2018. Patients were stratified into two groups based on the period of diagnosis: an earlier period (2008-2013) and a later period (2014-2018). OS was compared between earlier and later periods using Kaplan-Meier analysis in total and propensity score matched subpopulation as well as risk-stratified subgroups.

Patients diagnosed in the later period exhibited significantly improved OS compared to those diagnosed in the earlier period. The risk score, calculated based on ISUP grade group, LDH levels, and ALP levels, was a poor prognostic factor. In the later period, compared to the earlier period, there was no improvement in OS in the favorable-risk group, but a significant improvement was observed in the poor-risk group.

It was suggested that the introduction of novel androgen receptor signaling inhibitors and chemotherapy treatment regimens since 2014 has led to improved survival outcomes for patients with de novo mCSPC, particularly those with poor-risk profiles. The findings highlight the impact of recent advancements in treatment on the prognosis of patients with metastatic prostate cancer in Japan.

International journal of clinical oncology. 2024 Dec 17 [Epub ahead of print]

Tokiyoshi Tanegashima, Masaki Shiota, Naoki Terada, Toshihiro Saito, Akira Yokomizo, Naoki Kohei, Takayuki Goto, Sadafumi Kawamura, Yasuhiro Hashimoto, Atsushi Takahashi, Takahiro Kimura, Ken-Ichi Tabata, Ryotaro Tomida, Kohei Hashimoto, Toshihiko Sakurai, Toru Shimazui, Shinichi Sakamoto, Manabu Kamiyama, Nobumichi Tanaka, Koji Mitsuzuka, Takuma Kato, Shintaro Narita, Hiroaki Yasumoto, Shogo Teraoka, Masashi Kato, Takahiro Osawa, Yoshiyuki Nagumo, Hiroaki Matsumoto, Hideki Enokida, Takayuki Sugiyama, Kentaro Kuroiwa, Hiroshi Kitamura, Toshiyuki Kamoto, Masatoshi Eto, Japanese Urological Oncology Group

Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan., Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan. ., Department of Urology, Miyazaki University, Miyazaki, Japan., Department of Urology, Niigata Cancer Center Hospital, Niigata, Japan., Department of Urology, Harasanshin Hospital, Fukuoka, Japan., Department of Urology, Shizuoka General Hospital, Shizuoka, Japan., Department of Urology, Kyoto University, Kyoto, Japan., Department of Urology, Miyagi Cancer Center, Natori, Japan., Department of Urology, Hirosaki University, Hirosaki, Japan., Department of Urology, Hakodate Goryoukaku Hospital, Hakodate, Japan., Department of Urology, Jikei University, Tokyo, Japan., Department of Urology, Kitasato University, Sagamihara, Japan., Department of Urology, Shikoku Cancer Center, Matsuyama, Japan., Department of Urology, Sapporo Medical University, Sapporo, Japan., Department of Urology, Yamagata University, Yamagata, Japan., Department of Urology, Ibaraki Prefectural Central Hospital, Ibaraki Cancer Center, Kasama, Japan., Department of Urology, Chiba University, Chiba, Japan., Department of Urology, University of Yamanashi Hospital, Chuo, Japan., Department of Urology, and Department of Prostate Brachytherapy, Nara Medical University, Kashihara, Japan., Department of Urology, Tohoku University, Sendai, Japan., Department of Urology, Kagawa University, Kagawa, Japan., Department of Urology, Akita University, Akita, Japan., Department of Urology, Shimane University, Izumo, Japan., Department of Urology, Tottori University, Yonago, Japan., Department of Urology, Nagoya University, Nagoya, Japan., Department of Renal and Genitourinary Surgery, Hokkaido University, Sapporo, Japan., Department of Urology, University of Tsukuba Hospital, Tsukuba, Japan., Department of Urology, Yamaguchi University, Ube, Japan., Department of Urology, Kagoshima University, Kagoshima, Japan., Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan., Department of Urology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan., Department of Urology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan.