Although patients with metastatic CRPC (mCRPC) are in the terminal stage of the disease, their median overall survival (OS) in real world data can reach 19–30 months under the continuous progress of treatment modalities. However, almost all patients acquired resistance to ADT after years of treatment, known as castration-resistant prostate cancer (CRPC). Further study is needed to determine if an early switch in therapy for those in whom neither is achieved may impact OS.Īndrogen deprivation therapy (ADT) has been the fundamental strategy for the treatment of metastatic prostate cancer. Patients with mCRPC who received first-line ARATs had better survival if they had a PSA nadir \(\leqq\)2 ng/mL or a TTN \(\geqq\)7 months. ![]() Patients with both of these poor prognostic factors had worse OS compared to those who had 0–1 factors (HR 9.21, p < 0.001). Multivariable analysis showed that PSA nadir > 2 ng/mL and TTN<7 months (HR 2.18, p = 0.012) were independently associated with shorter OS. OS was not different between the use of abiraterone and enzalutamide, though enzalutamide showed a higher rate of PSA decline ≧ 90% (56% versus 40%, p = 0.021) and longer TTN (5.5 versus 4.7 months, p = 0.019). The median OS was not reached in patients with first-line ARATs alone and was 38.8 months in those with subsequent chemotherapy after failure from ARATs. ResultsĪmong 202 patients, 164 patients were treated with first-line ARATs alone and 38 patients received second-line chemotherapy. Cox proportional hazards model with inversed probability of treatment weighing-adjustment was used to validate the effect of patient, disease, and treatment response factors on OS. Kaplan–Meier survival analyses were applied for depicting OS. The secondary endpoints were PSA decline, PSA nadir, and time to nadir (TTN) after ARATs. The primary endpoint was overall survival (OS) defined as the interval from the start of ARAT to death, loss to follow-up, or the end of the study period. ![]() ![]() This retrospective study obtained data from 202 patients who started abiraterone acetate or enzalutamide as first-line therapy for mCRPC between 20 from a single academic center. To investigate the survival outcomes of metastatic castration-resistant prostate cancer (mCRPC) patients receiving first-line novel androgen receptor axis-targeted therapies (ARATs) and prognostic factors for patient survival.
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