Effect of upfront intensive therapy on oncological outcomes in older patients with high tumor burden metastatic castration‐sensitive prostate cancer: A multicenter retrospective study
Background The effect of upfront intensive therapy on the prognosis of older patients with metastatic castration‐sensitive prostate cancer (mCSPC) remains unclear. Thus, we assessed the impact of older age (≥75 years) on oncological outcomes in mCSPC patients with a high tumor burden. Methods This m...
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| Veröffentlicht in: | The Prostate 2022-09, Vol.82 (13), p.1304-1312 |
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| creator | Miura, Yuki Hatakeyama, Shingo Narita, Shintaro Kimura, Takahiro Hata, Kenichi Yanagisawa, Takafumi Tanaka, Toshikazu Ishi, Noritaka Kawamura, Sadafumi Hoshi, Senji Ishidoya, Shigeto Mitsuzuka, Koji Ito, Akihiro Tsuchiya, Norihiko Egawa, Shin Habuchi, Tomonori Ohyama, Chikara |
| description | Background
The effect of upfront intensive therapy on the prognosis of older patients with metastatic castration‐sensitive prostate cancer (mCSPC) remains unclear. Thus, we assessed the impact of older age (≥75 years) on oncological outcomes in mCSPC patients with a high tumor burden.
Methods
This multicenter retrospective study included 252 patients aged ≥75 years treated with either upfront or conventional therapy between 2014 and 2021. We compared castration‐resistant prostate cancer (CRPC)‐free survival (FS) and overall survival (OS) between patients with androgen deprivation therapy (ADT) plus upfront intensive therapy (docetaxel [DTX] or abiraterone acetate [ABI] plus prednisolone) and conventional therapy (ADT monotherapy or ADT combined with bicalutamide). We evaluated the effect of upfront intensive therapy on prognosis by multivariable Cox regression analysis.
Results
The 231 patients enrolled in our study were classified in the conventional group (n = 148) or the upfront group (n = 104; DTX = 27 and ABI = 77). The upfront group had significantly prolonged CRPC‐FS and OS compared with the conventional group, and this was also the case in the background‐adjusted multivariable Cox regression analysis.
Conclusion
Patients aged ≥75 years who received upfront intensive therapy had significantly longer CRPC‐FS and OS compared with similar age patients treated with conventional therapy in real‐world practice. The oncological benefit may not diminish in this older population. |
| doi_str_mv | 10.1002/pros.24404 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2681043128</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2681043128</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3344-dc22da03704a96e56338dd8fba242f8dd676dbb70dd088c3bf7df2eef8408c23</originalsourceid><addsrcrecordid>eNp9kc9u1DAQxiMEEkvhwhNY4oKQUiaON8lyq6pSkCoVQe-WY4-7rhI7-E-rvfEIvA6v0ydhwnLigGTJn-TfzPd5pqpeN3DaAPD3SwzplAsB4km1aWDX1wBi-7TaAO-hFk3bP69epHQHQDjwTfXrwlrUmQXLymJj8Jk5n9End48s7zGq5cCCp6PDFG6dVhMLJeswYyKShclgZIvKDn1O7MHlPdu72z3LZQ6RjSUa9GzGrFImSDNNIpIK_vHHz7Qa5dVqDU4A0rvXGD-wMzaXiQqoLRlEzAQslHSFUy7m8LJ6ZtWU8NXf-6S6-Xhxc_6pvrq-_Hx-dlXrthWiNppzo6DtQahdh9uubQdjBjsqLrgl2fWdGccejIFh0O1oe2M5oh0EDJq3J9XbY1tK-L1gynJ2SeM0KY-hJMm7oQHRNnwg9M0_6F0o0VM4SdPnW9jybkfUuyOl6UcpopVLdLOKB9mAXJco11nIP0skuDnCD27Cw39I-eXr9bdjzW_r0abB</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2702505269</pqid></control><display><type>article</type><title>Effect of upfront intensive therapy on oncological outcomes in older patients with high tumor burden metastatic castration‐sensitive prostate cancer: A multicenter retrospective study</title><source>Wiley-Blackwell Full Collection</source><creator>Miura, Yuki ; Hatakeyama, Shingo ; Narita, Shintaro ; Kimura, Takahiro ; Hata, Kenichi ; Yanagisawa, Takafumi ; Tanaka, Toshikazu ; Ishi, Noritaka ; Kawamura, Sadafumi ; Hoshi, Senji ; Ishidoya, Shigeto ; Mitsuzuka, Koji ; Ito, Akihiro ; Tsuchiya, Norihiko ; Egawa, Shin ; Habuchi, Tomonori ; Ohyama, Chikara</creator><creatorcontrib>Miura, Yuki ; Hatakeyama, Shingo ; Narita, Shintaro ; Kimura, Takahiro ; Hata, Kenichi ; Yanagisawa, Takafumi ; Tanaka, Toshikazu ; Ishi, Noritaka ; Kawamura, Sadafumi ; Hoshi, Senji ; Ishidoya, Shigeto ; Mitsuzuka, Koji ; Ito, Akihiro ; Tsuchiya, Norihiko ; Egawa, Shin ; Habuchi, Tomonori ; Ohyama, Chikara</creatorcontrib><description>Background
The effect of upfront intensive therapy on the prognosis of older patients with metastatic castration‐sensitive prostate cancer (mCSPC) remains unclear. Thus, we assessed the impact of older age (≥75 years) on oncological outcomes in mCSPC patients with a high tumor burden.
Methods
This multicenter retrospective study included 252 patients aged ≥75 years treated with either upfront or conventional therapy between 2014 and 2021. We compared castration‐resistant prostate cancer (CRPC)‐free survival (FS) and overall survival (OS) between patients with androgen deprivation therapy (ADT) plus upfront intensive therapy (docetaxel [DTX] or abiraterone acetate [ABI] plus prednisolone) and conventional therapy (ADT monotherapy or ADT combined with bicalutamide). We evaluated the effect of upfront intensive therapy on prognosis by multivariable Cox regression analysis.
Results
The 231 patients enrolled in our study were classified in the conventional group (n = 148) or the upfront group (n = 104; DTX = 27 and ABI = 77). The upfront group had significantly prolonged CRPC‐FS and OS compared with the conventional group, and this was also the case in the background‐adjusted multivariable Cox regression analysis.
Conclusion
Patients aged ≥75 years who received upfront intensive therapy had significantly longer CRPC‐FS and OS compared with similar age patients treated with conventional therapy in real‐world practice. The oncological benefit may not diminish in this older population.</description><identifier>ISSN: 0270-4137</identifier><identifier>EISSN: 1097-0045</identifier><identifier>DOI: 10.1002/pros.24404</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc</publisher><subject>Acetic acid ; Castration ; castration‐resistant prostate cancer ; castration‐sensitive prostate cancer ; Medical prognosis ; Metastases ; Metastasis ; older age ; Prednisolone ; Prognosis ; Prostate cancer ; Regression analysis ; Survival ; Tumors ; upfront intensive therapy</subject><ispartof>The Prostate, 2022-09, Vol.82 (13), p.1304-1312</ispartof><rights>2022 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3344-dc22da03704a96e56338dd8fba242f8dd676dbb70dd088c3bf7df2eef8408c23</citedby><cites>FETCH-LOGICAL-c3344-dc22da03704a96e56338dd8fba242f8dd676dbb70dd088c3bf7df2eef8408c23</cites><orcidid>0000-0002-0026-4079 ; 0000-0002-7410-0712</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fpros.24404$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fpros.24404$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27926,27927,45576,45577</link.rule.ids></links><search><creatorcontrib>Miura, Yuki</creatorcontrib><creatorcontrib>Hatakeyama, Shingo</creatorcontrib><creatorcontrib>Narita, Shintaro</creatorcontrib><creatorcontrib>Kimura, Takahiro</creatorcontrib><creatorcontrib>Hata, Kenichi</creatorcontrib><creatorcontrib>Yanagisawa, Takafumi</creatorcontrib><creatorcontrib>Tanaka, Toshikazu</creatorcontrib><creatorcontrib>Ishi, Noritaka</creatorcontrib><creatorcontrib>Kawamura, Sadafumi</creatorcontrib><creatorcontrib>Hoshi, Senji</creatorcontrib><creatorcontrib>Ishidoya, Shigeto</creatorcontrib><creatorcontrib>Mitsuzuka, Koji</creatorcontrib><creatorcontrib>Ito, Akihiro</creatorcontrib><creatorcontrib>Tsuchiya, Norihiko</creatorcontrib><creatorcontrib>Egawa, Shin</creatorcontrib><creatorcontrib>Habuchi, Tomonori</creatorcontrib><creatorcontrib>Ohyama, Chikara</creatorcontrib><title>Effect of upfront intensive therapy on oncological outcomes in older patients with high tumor burden metastatic castration‐sensitive prostate cancer: A multicenter retrospective study</title><title>The Prostate</title><description>Background
The effect of upfront intensive therapy on the prognosis of older patients with metastatic castration‐sensitive prostate cancer (mCSPC) remains unclear. Thus, we assessed the impact of older age (≥75 years) on oncological outcomes in mCSPC patients with a high tumor burden.
Methods
This multicenter retrospective study included 252 patients aged ≥75 years treated with either upfront or conventional therapy between 2014 and 2021. We compared castration‐resistant prostate cancer (CRPC)‐free survival (FS) and overall survival (OS) between patients with androgen deprivation therapy (ADT) plus upfront intensive therapy (docetaxel [DTX] or abiraterone acetate [ABI] plus prednisolone) and conventional therapy (ADT monotherapy or ADT combined with bicalutamide). We evaluated the effect of upfront intensive therapy on prognosis by multivariable Cox regression analysis.
Results
The 231 patients enrolled in our study were classified in the conventional group (n = 148) or the upfront group (n = 104; DTX = 27 and ABI = 77). The upfront group had significantly prolonged CRPC‐FS and OS compared with the conventional group, and this was also the case in the background‐adjusted multivariable Cox regression analysis.
Conclusion
Patients aged ≥75 years who received upfront intensive therapy had significantly longer CRPC‐FS and OS compared with similar age patients treated with conventional therapy in real‐world practice. The oncological benefit may not diminish in this older population.</description><subject>Acetic acid</subject><subject>Castration</subject><subject>castration‐resistant prostate cancer</subject><subject>castration‐sensitive prostate cancer</subject><subject>Medical prognosis</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>older age</subject><subject>Prednisolone</subject><subject>Prognosis</subject><subject>Prostate cancer</subject><subject>Regression analysis</subject><subject>Survival</subject><subject>Tumors</subject><subject>upfront intensive therapy</subject><issn>0270-4137</issn><issn>1097-0045</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kc9u1DAQxiMEEkvhwhNY4oKQUiaON8lyq6pSkCoVQe-WY4-7rhI7-E-rvfEIvA6v0ydhwnLigGTJn-TfzPd5pqpeN3DaAPD3SwzplAsB4km1aWDX1wBi-7TaAO-hFk3bP69epHQHQDjwTfXrwlrUmQXLymJj8Jk5n9End48s7zGq5cCCp6PDFG6dVhMLJeswYyKShclgZIvKDn1O7MHlPdu72z3LZQ6RjSUa9GzGrFImSDNNIpIK_vHHz7Qa5dVqDU4A0rvXGD-wMzaXiQqoLRlEzAQslHSFUy7m8LJ6ZtWU8NXf-6S6-Xhxc_6pvrq-_Hx-dlXrthWiNppzo6DtQahdh9uubQdjBjsqLrgl2fWdGccejIFh0O1oe2M5oh0EDJq3J9XbY1tK-L1gynJ2SeM0KY-hJMm7oQHRNnwg9M0_6F0o0VM4SdPnW9jybkfUuyOl6UcpopVLdLOKB9mAXJco11nIP0skuDnCD27Cw39I-eXr9bdjzW_r0abB</recordid><startdate>20220901</startdate><enddate>20220901</enddate><creator>Miura, Yuki</creator><creator>Hatakeyama, Shingo</creator><creator>Narita, Shintaro</creator><creator>Kimura, Takahiro</creator><creator>Hata, Kenichi</creator><creator>Yanagisawa, Takafumi</creator><creator>Tanaka, Toshikazu</creator><creator>Ishi, Noritaka</creator><creator>Kawamura, Sadafumi</creator><creator>Hoshi, Senji</creator><creator>Ishidoya, Shigeto</creator><creator>Mitsuzuka, Koji</creator><creator>Ito, Akihiro</creator><creator>Tsuchiya, Norihiko</creator><creator>Egawa, Shin</creator><creator>Habuchi, Tomonori</creator><creator>Ohyama, Chikara</creator><general>Wiley Subscription Services, Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TO</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0026-4079</orcidid><orcidid>https://orcid.org/0000-0002-7410-0712</orcidid></search><sort><creationdate>20220901</creationdate><title>Effect of upfront intensive therapy on oncological outcomes in older patients with high tumor burden metastatic castration‐sensitive prostate cancer: A multicenter retrospective study</title><author>Miura, Yuki ; Hatakeyama, Shingo ; Narita, Shintaro ; Kimura, Takahiro ; Hata, Kenichi ; Yanagisawa, Takafumi ; Tanaka, Toshikazu ; Ishi, Noritaka ; Kawamura, Sadafumi ; Hoshi, Senji ; Ishidoya, Shigeto ; Mitsuzuka, Koji ; Ito, Akihiro ; Tsuchiya, Norihiko ; Egawa, Shin ; Habuchi, Tomonori ; Ohyama, Chikara</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3344-dc22da03704a96e56338dd8fba242f8dd676dbb70dd088c3bf7df2eef8408c23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Acetic acid</topic><topic>Castration</topic><topic>castration‐resistant prostate cancer</topic><topic>castration‐sensitive prostate cancer</topic><topic>Medical prognosis</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>older age</topic><topic>Prednisolone</topic><topic>Prognosis</topic><topic>Prostate cancer</topic><topic>Regression analysis</topic><topic>Survival</topic><topic>Tumors</topic><topic>upfront intensive therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Miura, Yuki</creatorcontrib><creatorcontrib>Hatakeyama, Shingo</creatorcontrib><creatorcontrib>Narita, Shintaro</creatorcontrib><creatorcontrib>Kimura, Takahiro</creatorcontrib><creatorcontrib>Hata, Kenichi</creatorcontrib><creatorcontrib>Yanagisawa, Takafumi</creatorcontrib><creatorcontrib>Tanaka, Toshikazu</creatorcontrib><creatorcontrib>Ishi, Noritaka</creatorcontrib><creatorcontrib>Kawamura, Sadafumi</creatorcontrib><creatorcontrib>Hoshi, Senji</creatorcontrib><creatorcontrib>Ishidoya, Shigeto</creatorcontrib><creatorcontrib>Mitsuzuka, Koji</creatorcontrib><creatorcontrib>Ito, Akihiro</creatorcontrib><creatorcontrib>Tsuchiya, Norihiko</creatorcontrib><creatorcontrib>Egawa, Shin</creatorcontrib><creatorcontrib>Habuchi, Tomonori</creatorcontrib><creatorcontrib>Ohyama, Chikara</creatorcontrib><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The Prostate</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Miura, Yuki</au><au>Hatakeyama, Shingo</au><au>Narita, Shintaro</au><au>Kimura, Takahiro</au><au>Hata, Kenichi</au><au>Yanagisawa, Takafumi</au><au>Tanaka, Toshikazu</au><au>Ishi, Noritaka</au><au>Kawamura, Sadafumi</au><au>Hoshi, Senji</au><au>Ishidoya, Shigeto</au><au>Mitsuzuka, Koji</au><au>Ito, Akihiro</au><au>Tsuchiya, Norihiko</au><au>Egawa, Shin</au><au>Habuchi, Tomonori</au><au>Ohyama, Chikara</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of upfront intensive therapy on oncological outcomes in older patients with high tumor burden metastatic castration‐sensitive prostate cancer: A multicenter retrospective study</atitle><jtitle>The Prostate</jtitle><date>2022-09-01</date><risdate>2022</risdate><volume>82</volume><issue>13</issue><spage>1304</spage><epage>1312</epage><pages>1304-1312</pages><issn>0270-4137</issn><eissn>1097-0045</eissn><abstract>Background
The effect of upfront intensive therapy on the prognosis of older patients with metastatic castration‐sensitive prostate cancer (mCSPC) remains unclear. Thus, we assessed the impact of older age (≥75 years) on oncological outcomes in mCSPC patients with a high tumor burden.
Methods
This multicenter retrospective study included 252 patients aged ≥75 years treated with either upfront or conventional therapy between 2014 and 2021. We compared castration‐resistant prostate cancer (CRPC)‐free survival (FS) and overall survival (OS) between patients with androgen deprivation therapy (ADT) plus upfront intensive therapy (docetaxel [DTX] or abiraterone acetate [ABI] plus prednisolone) and conventional therapy (ADT monotherapy or ADT combined with bicalutamide). We evaluated the effect of upfront intensive therapy on prognosis by multivariable Cox regression analysis.
Results
The 231 patients enrolled in our study were classified in the conventional group (n = 148) or the upfront group (n = 104; DTX = 27 and ABI = 77). The upfront group had significantly prolonged CRPC‐FS and OS compared with the conventional group, and this was also the case in the background‐adjusted multivariable Cox regression analysis.
Conclusion
Patients aged ≥75 years who received upfront intensive therapy had significantly longer CRPC‐FS and OS compared with similar age patients treated with conventional therapy in real‐world practice. The oncological benefit may not diminish in this older population.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1002/pros.24404</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-0026-4079</orcidid><orcidid>https://orcid.org/0000-0002-7410-0712</orcidid></addata></record> |
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| ispartof | The Prostate, 2022-09, Vol.82 (13), p.1304-1312 |
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| language | eng |
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| subjects | Acetic acid Castration castration‐resistant prostate cancer castration‐sensitive prostate cancer Medical prognosis Metastases Metastasis older age Prednisolone Prognosis Prostate cancer Regression analysis Survival Tumors upfront intensive therapy |
| title | Effect of upfront intensive therapy on oncological outcomes in older patients with high tumor burden metastatic castration‐sensitive prostate cancer: A multicenter retrospective study |
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