Risk stratification for the prediction of overall survival could assist treatment decision-making at diagnosis of castration-resistant prostate cancer: a multicentre collaborative study in Japan.


Journal

BJU international
ISSN: 1464-410X
Titre abrégé: BJU Int
Pays: England
ID NLM: 100886721

Informations de publication

Date de publication:
02 2021
Historique:
pubmed: 24 7 2020
medline: 27 4 2021
entrez: 24 7 2020
Statut: ppublish

Résumé

To assess whether a new risk stratification system according to predictors for overall survival (OS) at the diagnosis of metastatic castration-resistant prostate cancer (mCRPC) could determine treatment outcomes and assist in treatment decision-making. Two independent clinical cohorts of patients, treated with androgen signalling inhibitors (ASIs: abiraterone and enzalutamide) or docetaxel as a first-line treatment for mCRPC, were used in this study: a derivation cohort (196 patients with mCRPC) and an external validation cohort (211 patients with mCRPC). Three independent predictors for OS, including duration of initial androgen deprivation therapy <12 months before mCRPC diagnosis, alkaline phosphatase level >350 U/dL and haemoglobin level <11 g/dL at the diagnosis of mCRPC, were defined as risk factors. Patients with zero, one and multiple risk factors were assigned to a favourable-, intermediate- and poor-risk group, respectively. The median OS values in each risk group were well separated in the derivation cohort (P < 0.001) as well as in the validation cohort (P < 0.001). Of a total of 407 patients with mCRPC, 84 were assigned to the poor-risk group with the median OS of 12 months. In this group, a trend towards longer OS favouring docetaxel compared to ASIs as the first-line treatment (medians of 17 and 12 months, respectively) was observed. The new risk group stratification system could predict patient survival at the diagnosis of mCRPC. Given the convenience of these risk definitions, physicians may be encouraged to consider these risk groups in daily practice.

Identifiants

pubmed: 32701219
doi: 10.1111/bju.15187
doi:

Substances chimiques

Antineoplastic Agents 0

Types de publication

Comparative Study Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

212-221

Subventions

Organisme : Japan Society for the Promotion of Science: JSPS
ID : 19K18624
Organisme : Uehara Memorial Foundation
Organisme : NOVARTIS Foundation
Organisme : Japan Research Foundation for Clinical Pharmacology
Organisme : Yamaguchi Endocrine Disease Research Foundation
Organisme : Takeda Science Foundation

Informations de copyright

© 2020 The Authors BJU International © 2020 BJU International Published by John Wiley & Sons Ltd.

Références

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Auteurs

Taizo Uchimoto (T)

Department of Urology, Osaka Medical College, Osaka, Japan.

Kazumasa Komura (K)

Department of Urology, Osaka Medical College, Osaka, Japan.
Translational Research Program, Osaka Medical College, Osaka, Japan.

Wataru Fukuokaya (W)

Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.

Takahiro Kimura (T)

Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.

Kazuhiro Takahashi (K)

Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.

Yuya Fujiwara (Y)

Department of Urology, Osaka Medical College, Osaka, Japan.

Tomohisa Matsunaga (T)

Department of Urology, Osaka Medical College, Osaka, Japan.

Takeshi Tsutsumi (T)

Department of Urology, Osaka Medical College, Osaka, Japan.

Takuya Tsujino (T)

Department of Urology, Osaka Medical College, Osaka, Japan.

Ryoichi Maenosono (R)

Department of Urology, Osaka Medical College, Osaka, Japan.

Yuki Yoshikawa (Y)

Department of Urology, Osaka Medical College, Osaka, Japan.

Kohei Taniguchi (K)

Translational Research Program, Osaka Medical College, Osaka, Japan.

Tomohito Tanaka (T)

Translational Research Program, Osaka Medical College, Osaka, Japan.

Hirofumi Uehara (H)

Department of Urology, Osaka Medical College, Osaka, Japan.

Naokazu Ibuki (N)

Department of Urology, Osaka Medical College, Osaka, Japan.

Hajime Hirano (H)

Department of Urology, Osaka Medical College, Osaka, Japan.

Hayahito Nomi (H)

Department of Urology, Osaka Medical College, Osaka, Japan.

Kiyoshi Takahara (K)

Department of Urology, Fujita-Health University School of Medicine, Nagoya, Japan.

Teruo Inamoto (T)

Department of Urology, Osaka Medical College, Osaka, Japan.

Shin Egawa (S)

Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.

Haruhito Azuma (H)

Department of Urology, Osaka Medical College, Osaka, Japan.

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