Comparison of Radiographic Progression-Free Survival and PSA Response on Sequential Treatment Using Abiraterone and Enzalutamide for Newly Diagnosed Castration-Resistant Prostate Cancer: A Propensity Score Matched Analysis from Multicenter Cohort
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
Abbreviations
rPFS | radiographic progression-free survival |
OS | overall survival |
CRPC | castration-resistant prostate cancer |
ASIs | androgen signaling inhibitors |
TTPP | time to PSA progression |
ADT | androgen deprivation therapy |
RCT | randomized control trial |
SCC | Spearman’s correlation coefficient |
References
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Variables | Total (n = 184) | Abi (n = 92) | Enz (n = 92) | p Value |
---|---|---|---|---|
Age (mean ± SD) | 73.5 + 7.8 | 74.0 + 8.0 | 73.0 + 7.6 | 0.355 |
SRE during follow-up | ||||
No (%) | 144 (78.3) | 72 (78.3) | 72 (78.3) | |
Yes (%) | 40 (21.7) | 20 (21.7) | 20 (21.7) | 1.000 |
Taxanes during follow-up | ||||
No (%) | 159 (86.4) | 80 (87.0) | 79 (85.9) | |
Yes (%) | 25 (13.6) | 12 (13.0) | 13 (14.1) | 0.809 |
ADT response duration | ||||
≥12months (%) | 136 (73.9) | 65 (70.6) | 71 (77.2) | |
<12 months (%) | 48 (26.1) | 27 (29.4) | 21 (22.8) | 0.809 |
Median PSA level at diagnosis (ng/mL) (quartile) | 124.0 (29.3, 395.6) | 124.3 (41.9, 327.1) | 93.8 (25.7, 574.8) | 0.685 |
Median PSA level at first line treatment (ng/mL) (quartile) | 6.8 (2.3, 30.1) | 6.8 (2.0, 30.4) | 6.8 (2.5, 30.1) | 0.918 |
Gleason sum score (%) | ||||
≤7 | 20 (10.9) | 9 (9.8) | 11 (12.0) | |
8 | 41 (22.3) | 20 (21.7) | 21 (22.8) | |
9 | 113 (61.4) | 56 (60.9) | 57 (62.0) | |
10 | 10 (5.4) | 7 (7.6) | 3 (3.3) | 0.598 |
Local treatment prior to ADT (%) | ||||
Non | 156 (84.8) | 77 (83.7) | 79 (85.9) | |
Prostatectomy | 16 (8.7) | 9 (9.8) | 7 (7.6) | |
Radiation | 8 (4.3) | 5 (5.4) | 3 (3.3) | |
Others | 4 (2.2) | 1 (1.1) | 3 (3.3) | 0.311 |
Initial ADT (%) | ||||
LHRH analog + NAs | 162 (88.0) | 78 (84.8) | 84 (91.3) | |
LHRH analog | 11 (6.0) | 7 (7.6) | 4 (4.3) | |
NAs | 7 (3.8) | 5 (5.4) | 2 (2.2) | |
Others | 4 (2.2) | 2 (2.2) | 2 (2.2) | 0.113 |
Mets at first line treatment (%) | ||||
M0 | 57 (31.0) | 27 (29.4) | 30 (32.6) | |
M1 | 127 (69.0) | 65 (70.7) | 62 (67.4) | 0.345 |
Visceral mets at first line treatment (%) | ||||
No | 165 (89.7) | 82 (89.1) | 83 (90.2) | |
Yes | 19 (10.3) | 10 (10.9) | 9 (9.8) | 0.809 |
LN mets at first line treatment (%) | ||||
Non | 117 (63.6) | 55 (59.8) | 62 (67.4) | |
Regional | 45 (24.5) | 23 (25.0) | 22 (23.9) | |
Non-regional | 22 (12.0) | 14 (15.2) | 8 (8.7) | 0.350 |
No. of bone mets at first line treatment (%) | ||||
0 | 83 (45.1) | 40 (43.5) | 43 (46.7) | |
1 | 23 (12.5) | 11 (12.0) | 12 (13.0) | |
2 | 15 (8.2) | 8 (8.7) | 7 (7.6) | |
>3 | 63 (34.2) | 33 (35.9) | 30 (32.6) | 0.948 |
ECOG-PS (%) | ||||
0 | 104 (56.5) | 51 (55.4) | 53 (57.6) | |
1 | 66 (35.9) | 35 (38.0) | 31 (33.7) | |
≥2 | 14 (7.6) | 6 (6.6) | 8 (8.7) | 0.684 |
Neutrophil-lymphocyte ratio at first line treatment (mean ± SD) | 2.99 ± 2.49 | 3.08 ± 2.93 | 2.84 ± 1.59 | 0.648 |
Hb at first line treatment (g/dL) (mean ± SD) | 12.2 ± 1.8 | 12.1 ± 1.8 | 12.3 ± 1.8 | 0.627 |
Platelet count at first line treatment (103/uL) (mean ± SD) | 213 ± 75 | 215 ± 80 | 210 ± 71 | 0.640 |
ALP at first line treatment (U/L) (quartile) | 248 (202, 350) | 252 (199, 370) | 246 (213, 344) | 0.884 |
LDH at first line treatment (U/L) (quartile) | 200 (182, 238) | 201 (177, 231) | 200 (185, 240) | 0.675 |
Albumin (g/dL) (quartile) | 4.1 (3.8, 4.4) | 4.1 (3.6, 4.3) | 4.2 (3.9, 4.4) | 0.126 |
CRP (mg/dL) (quartile) | 0.1 (0.05, 0.32) | 0.1 (0.05, 0.23) | 0.1 (0.05, 0.48) | 0.670 |
Variables | Total (n = 84) | Abi to Enz (n = 46) | Enz to Abi (n = 38) | p Value |
---|---|---|---|---|
Age (mean ± SD) | 73.0 + 7.9 | 71.8 + 7.3 | 74.4 + 8.4 | ns |
SRE during follow-up | ||||
No (%) | 63 (75.0) | 32 (69.6) | 31 (81.6) | |
Yes (%) | 21 (25.0) | 14 (30.4) | 7 (18.4) | ns |
Median PSA level at 2nd line treatment (ng/mL) (quartile) | 21.3 (3.8, 93.2) | 21.5 (8.1, 61.3) | 21.0 (3.4, 94.3) | ns |
Gleason sum score (%) | ||||
≤7 | 11 (13.1) | 8 (17.4) | 3 (7.9) | |
8 | 16 (19.0) | 6 (13.0) | 10 (26.3) | |
9 | 53 (63.1) | 30 (65.2) | 23 (60.5) | |
10 | 4 (4.8) | 2 (4.4) | 2 (5.3) | ns |
Mets at 2nd line treatment (%) | ||||
M0 | 16 (19.0) | 9 (19.6) | 7 (18.4) | |
M1 | 68 (81.0) | 37 (80.4) | 31 (81.6) | ns |
Visceral mets at 2nd line treatment (%) | ||||
No | 75 (88.2) | 39 (84.8) | 36 (94.7) | |
Yes | 9 (11.8) | 7 (15.2) | 2 (5.3) | ns |
LN mets at 2nd line treatment (%) | ||||
No | 59 (70.2) | 31 (67.4) | 28 (73.7) | |
Yes | 25 (29.8) | 15 (32.6) | 10 (26.3) | ns |
Bone mets at 2nd line treatment (%) | ||||
No | 25 (29.8) | 14 (30.4) | 11 (29.0) | |
Yes | 59 (70.2) | 32 (69.6) | 27 (71.1) | ns |
Taxanes during follow-up | ||||
No | 72 (85.7) | 41 (89.1) | 30 (79.0) | |
Yes | 12 (14.3) | 5 (10.9) | 8 (21.0) | ns |
ECOG-PS (%) | ||||
0 | 34 (40.5) | 17 (37.0) | 17 (44.7) | |
1 | 45 (53.6) | 27 (58.7) | 18 (47.4) | |
≥2 | 5 (5.9) | 2 (4.4) | 3 (7.9) | ns |
PSA decline ≥50% at first line treatment | ||||
No (%) | 43 (51.2) | 28 (60.9) | 15 (39.5) | |
Yes (%) | 41 (48.8) | 18 (39.1) | 23 (60.5) | 0.037 |
TTPP at 2nd Line | Radiographic PFS | |||||||
---|---|---|---|---|---|---|---|---|
Variables | HR | 95%CI | p Value | HR | 95%CI | p Value | ||
Treatment sequence | ||||||||
Abi to Enz | Ref | Ref | ||||||
Enz to Abi | 1.791 | 1.091 | 3.163 | 0.043 | 1.538 | 0.855 | 3.019 | 0.219 |
Visceral mets at 2nd line treatment | ||||||||
No | ||||||||
Yes | 3.647 | 1.003 | 23.634 | 0.049 | 3.647 | 1.182 | 19.278 | 0.032 |
LN mets at 2nd line treatment | ||||||||
No | Ref | Ref | ||||||
Yes | 1.663 | 0.847 | 3.406 | 0.141 | 1.233 | 0.784 | 2.392 | 0.221 |
Bone mets at 2nd line treatment | ||||||||
No | Ref | Ref | ||||||
Yes | 1.946 | 0.972 | 4.071 | 0.06 | 1.392 | 0.872 | 4.281 | 0.099 |
PSA decline ≥50% at first line | ||||||||
No | Ref | Ref | ||||||
Yes | 0.641 | 0.401 | 0.933 | 0.038 | 0.865 | 0.431 | 1.283 | 0.492 |
ECOG-PS | ||||||||
0 | Ref | Ref | ||||||
>1 | 2.154 | 1.163 | 4.154 | 0.014 | 1.538 | 0.699 | 2.193 | 0.293 |
Variables | Spearman’s Correlation Coefficient (SCC) (95%CI) | p Value |
---|---|---|
rPFS | 0.601 (0.411–0.722) | <0.001 |
TTPP | 0.468 (0.275–0.625) | <0.001 |
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Komura, K.; Fujiwara, Y.; Uchimoto, T.; Saito, K.; Tanda, N.; Matsunaga, T.; Ichihashi, A.; Tsutsumi, T.; Tsujino, T.; Yoshikawa, Y.; et al. Comparison of Radiographic Progression-Free Survival and PSA Response on Sequential Treatment Using Abiraterone and Enzalutamide for Newly Diagnosed Castration-Resistant Prostate Cancer: A Propensity Score Matched Analysis from Multicenter Cohort. J. Clin. Med. 2019, 8, 1251. https://doi.org/10.3390/jcm8081251
Komura K, Fujiwara Y, Uchimoto T, Saito K, Tanda N, Matsunaga T, Ichihashi A, Tsutsumi T, Tsujino T, Yoshikawa Y, et al. Comparison of Radiographic Progression-Free Survival and PSA Response on Sequential Treatment Using Abiraterone and Enzalutamide for Newly Diagnosed Castration-Resistant Prostate Cancer: A Propensity Score Matched Analysis from Multicenter Cohort. Journal of Clinical Medicine. 2019; 8(8):1251. https://doi.org/10.3390/jcm8081251
Chicago/Turabian StyleKomura, Kazumasa, Yuya Fujiwara, Taizo Uchimoto, Kenkichi Saito, Naoki Tanda, Tomohisa Matsunaga, Atsushi Ichihashi, Takeshi Tsutsumi, Takuya Tsujino, Yuki Yoshikawa, and et al. 2019. "Comparison of Radiographic Progression-Free Survival and PSA Response on Sequential Treatment Using Abiraterone and Enzalutamide for Newly Diagnosed Castration-Resistant Prostate Cancer: A Propensity Score Matched Analysis from Multicenter Cohort" Journal of Clinical Medicine 8, no. 8: 1251. https://doi.org/10.3390/jcm8081251