Japanese journal of clinical oncology · 2026
Screening for prognostic indicators in patients with metastatic castration-resistant prostate cancer after androgen receptor signaling inhibitor treatment for metastatic castration-sensitive prostate cancer.
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Hayakawa Keita, Ueda Takashi, Gabata Yusuke, Murashita Junki, Takahashi Hikaru, Saito Yumiko, Miyashita Masatsugu, Shiraishi Takumi, Fujihara Atsuko, Okumi Masayoshi, Hongo Fumiya, Ukimura Osamu
Аннотация
BACKGROUND: Androgen receptor signaling inhibitors (ARSI) and docetaxel (DTX) are standard treatments for metastatic castration-resistant prostate cancer (mCRPC). However, the differences in therapeutic efficacy between these treatments for mCRPC after upfront ARSI for metastatic castration-sensitive prostate cancer (mCSPC) remain unclear. In this study, we used real-world data to compare treatment efficacy and to identify prognostic indicators.
METHODS: We retrospectively analyzed 120 patients who progressed to mCRPC after receiving ARSI as a first-line therapy for mCSPC. Second-line progression-free survival (PFS) and second-line overall survival (OS) were compared between the DTX and non-DTX groups. Cox proportional hazards regression analysis was performed to identify the prognostic indicators of second-line OS in patients with mCRPC. Propensity score matching was used to adjust for differences in baseline clinical characteristics.
RESULTS: Among matched patients with mCRPC, no significant differences were observed in second-line PFS or OS between the non-DTX and DTX groups. Univariate and multivariate analyses demonstrated that pretreatment serum lactate dehydrogenase (LDH) levels (<220 vs. ≥220 U/l) and Gleason pattern 5 (GP5) status were significant prognostic indicators for second-line OS in patients with mCRPC.
CONCLUSIONS: Pretreatment LDH levels and GP5 status may be useful prognostic indicators for patients with mCRPC following upfront ARSI therapy for mCSPC.
METHODS: We retrospectively analyzed 120 patients who progressed to mCRPC after receiving ARSI as a first-line therapy for mCSPC. Second-line progression-free survival (PFS) and second-line overall survival (OS) were compared between the DTX and non-DTX groups. Cox proportional hazards regression analysis was performed to identify the prognostic indicators of second-line OS in patients with mCRPC. Propensity score matching was used to adjust for differences in baseline clinical characteristics.
RESULTS: Among matched patients with mCRPC, no significant differences were observed in second-line PFS or OS between the non-DTX and DTX groups. Univariate and multivariate analyses demonstrated that pretreatment serum lactate dehydrogenase (LDH) levels (<220 vs. ≥220 U/l) and Gleason pattern 5 (GP5) status were significant prognostic indicators for second-line OS in patients with mCRPC.
CONCLUSIONS: Pretreatment LDH levels and GP5 status may be useful prognostic indicators for patients with mCRPC following upfront ARSI therapy for mCSPC.