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Matsubara N, Uemura H, Nagamori S, Suzuki H, Uemura H, Kimura G. A Phase II, Randomized, Open-Label, Multi-arm Study of TAS-115 for Castration-Resistant Prostate Cancer Patients With Bone Metastases. Clin Genitourin Cancer 2021; 19:491-500. [PMID: 34493431 DOI: 10.1016/j.clgc.2021.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 07/05/2021] [Accepted: 07/25/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION TAS-115 is an oral multikinase inhibitor targeting the MET proto-oncogene, vascular endothelial growth factor receptor, and colony-stimulating factor 1 receptor. We evaluated the efficacy and safety of TAS-115 in castration-resistant prostate cancer (CRPC) patients with bone metastases. PATIENTS AND METHODS This phase II study, conducted in Japan, comprised 2 cohorts of CRPC patients. Cohort A included patients with bone metastasis and no history of docetaxel; TAS-115 200 to 400 mg/d was administered with abiraterone and prednisone. Cohort B included patients with symptomatic multiple bone metastases, post- or unfit for docetaxel, randomized 1:1 to receive TAS-115 400 or 600 mg/d orally, once daily, in a repeated weekly schedule of 5 days on/2 days off. The primary endpoint was bone scan index (BSI) response rate at Week 12 in each dose group. RESULTS Cohorts A and B included 24 and 26 patients, respectively. The 12-week BSI response rates for 200, 300, and 400 mg were 0%, 33.3%, and 16.7% in Cohort A, and for 400 and 600 mg were 7.1% and 25.0% in Cohort B. The best BSI response rates for 200, 300, and 400 mg were 0%, 66.7%, and 16.7% in Cohort A, and for 400 and 600 mg were 7.1% and 33.3% in Cohort B. A ≥ 30% reduction in BPI-SF score was shown in 57.7% of patients in Cohort B. The most frequent Grade ≥ 3 adverse drug reactions were hypophosphatemia (20.8%) in Cohort A and anemia (23.1%) in Cohort B. CONCLUSION TAS-115 appears to demonstrate anti-tumor activity and acceptable tolerability in CRPC patients with bone metastases.
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Affiliation(s)
- Nobuaki Matsubara
- Division of Breast and Medical Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
| | - Hirotsugu Uemura
- Department of Urology, Kindai University Faculty of Medicine, Osaka-sayama, Osaka, Japan
| | - Satoshi Nagamori
- Department of Urology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Hokkaido, Japan
| | - Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, Sakura City, Chiba, Japan
| | - Hiroji Uemura
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Go Kimura
- Department of Urology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
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Uemura H, Kobayashi K, Yokomizo A, Hinotsu S, Horie S, Kakehi Y, Naito S, Nonomura N, Ogawa O, Oya M, Suzuki K, Saito A, Uno S, Akaza H. Enzalutamide + androgen deprivation therapy (ADT) versus flutamide + ADT in Japanese men with castration‐resistant prostate cancer: AFTERCAB study. BJUI COMPASS 2021; 3:26-36. [PMID: 35475157 PMCID: PMC8988761 DOI: 10.1002/bco2.103] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/02/2021] [Accepted: 06/22/2021] [Indexed: 12/15/2022] Open
Abstract
Objectives The objective of the study is to compare the efficacy and safety of alternative androgen therapy (AAT) with enzalutamide + androgen deprivation therapy (ADT) and flutamide + ADT in the treatment of Japanese men with metastatic or nonmetastatic castration‐resistant prostate cancer (CRPC) who progressed despite combined androgen blockade (CAB) with bicalutamide + ADT. AAT treatment sequence was also investigated. Materials and methods The open‐label, Phase 4 AFTERCAB study (NCT02918968) was conducted from November 2016 to March 2020 in Japanese men aged ≥20 years with asymptomatic or mildly symptomatic CRPC. Patients were initially randomized to enzalutamide (160 mg/day) + ADT (enzalutamide first) or flutamide (375mg/day [125mg three times daily]) + ADT (flutamide first) as first‐line therapy. Following prostate‐specific antigen (PSA) progression, other disease progression, or discontinuation of first‐line therapy due to an adverse event (AE), patients switched to the other treatment as second‐line therapy. The primary endpoint was time to PSA progression with first‐line therapy (TTPP1). Secondary endpoints included TTPP2 (TTPP1 + time to PSA progression with second‐line therapy). AEs were monitored to assess safety. Results Overall, 206 men were randomized (enzalutamide first, n = 102; flutamide first, n = 104) and stratified by study site and disease stage; 133 patients transitioned to second‐line therapy (enzalutamide first, n = 48; flutamide first, n = 85). TTPP1 was significantly improved with enzalutamide first versus flutamide first (median 21.4 months vs. 5.8 months; hazard ratio [HR] 0.42; 95% confidence interval [CI] [0.29, 0.61]). TTPP2 was numerically improved with enzalutamide first versus flutamide first (median not reached vs. 21.2 months; HR 0.76; 95% CI [0.48, 1.19]). Both treatments were generally well tolerated, with AEs consistent with their known safety profiles. Conclusion First‐line AAT with enzalutamide + ADT provided a significant improvement in time to PSA progression versus flutamide + ADT. Enzalutamide + ADT may therefore be the preferred first‐line AAT option in Japanese men with metastatic or nonmetastatic CRPC who progress despite CAB with bicalutamide + ADT.
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Affiliation(s)
- Hiroji Uemura
- Yokohama City University Medical Center Yokohama Japan
| | | | | | | | - Shigeo Horie
- Graduate School of Medicine Juntendo University Tokyo Japan
| | - Yoshiyuki Kakehi
- Department of Urology National University Corporation Kagawa University Takamatsu Japan
| | | | - Norio Nonomura
- Graduate School of Medicine Osaka University Osaka Japan
| | - Osamu Ogawa
- Graduate School of Medicine Kyoto University Kyoto Japan
| | | | | | | | | | - Hideyuki Akaza
- Department of Strategic Investigation on Comprehensive Cancer Network, Research Center for Advanced Science and Technology The University of Tokyo Tokyo Japan
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Shinchi M, Horiguchi A, Ojima K, Hirano Y, Takahashi E, Kimura F, Ito K. Deep lateral transurethral incision for vesicourethral anastomotic stenosis after radical prostatectomy. Int J Urol 2021; 28:1120-1126. [PMID: 34382239 DOI: 10.1111/iju.14650] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 07/01/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To investigate the outcomes of deep lateral incision for vesicourethral anastomotic stenosis after radical prostatectomy and its impact on postoperative urinary incontinence. METHODS We retrospectively investigated 43 men who underwent deep lateral incision for non-obliterated vesicourethral anastomotic stenosis after radical prostatectomy between 2011 and 2020. The bladder neck was deeply incised through its circular fibers into the surrounding perivesical fat at 3 and 9 o'clock through electrocautery incision using needle-type electrodes. Successful deep lateral incision was defined as the absence of additional treatment, including self-dilatation. The postoperative urinary incontinence status was evaluated based on the number of pads used daily. RESULTS Deep lateral incision was successful in 35 (81.4%) patients, with a median follow-up period of 43 months (interquartile range 15-80 months). There was no significant association of age (P = 0.66), body mass index (P = 0.49) and history of diabetes mellitus (P = 0.39), radiation therapy (P = 0.89) or previous vesicourethral anastomotic stenosis treatment (P = 0.71) with the incision outcomes; however, there were significantly more unsuccessful cases in those with preoperative urinary retention (P = 0.04) or indwelling urinary catheters for >5 days post-incision (P = 0.01). A second incision was carried out in eight patients and a third incision in two patients, resulting in 42 (97.7%) successful incisions. A total of 37 (88.1%) patients had urinary incontinence and used at least one pad daily; seven (16.7%) underwent artificial urinary sphincter implantation after the last incision. CONCLUSIONS Deep lateral incision is highly effective for treating vesicourethral anastomotic stenosis after radical prostatectomy. Appropriate treatment is required for urinary incontinence, which occurs frequently after incision.
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Affiliation(s)
- Masayuki Shinchi
- Department of Urology, National Defense Medical College, Saitama, Japan.,Department of Urology, National Hospital Organization, Nishisaitama-Chuo Hospital, Saitama, Japan
| | - Akio Horiguchi
- Department of Urology, National Defense Medical College, Saitama, Japan
| | - Kenichiro Ojima
- Department of Urology, National Defense Medical College, Saitama, Japan
| | - Yusuke Hirano
- Department of Urology, National Defense Medical College, Saitama, Japan
| | - Eiji Takahashi
- Department of Urology, National Hospital Organization, Nishisaitama-Chuo Hospital, Saitama, Japan
| | - Fumihiro Kimura
- Department of Urology, National Hospital Organization, Nishisaitama-Chuo Hospital, Saitama, Japan
| | - Keiichi Ito
- Department of Urology, National Defense Medical College, Saitama, Japan
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Blas L, Onozawa M, Shiota M, Hinotsu S, Sakamoto S, Kitagawa Y, Kawai T, Eto M, Kume H, Akaza H. Long-term outcomes of androgen deprivation therapy in prostate cancer among Japanese men over 80 years old. Cancer Sci 2021; 112:3074-3082. [PMID: 34014592 PMCID: PMC8353900 DOI: 10.1111/cas.14974] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/04/2021] [Accepted: 05/10/2021] [Indexed: 12/12/2022] Open
Abstract
This study aimed to analyze the survival rate and to examine the risk of death from prostate cancer when accounting for competing risk of death, in men aged ≥80 y treated with primary androgen deprivation therapy (ADT). Data of patients with prostate cancer who had received ADT were extracted from a nationwide community‐based database established by the Japan Study Group for Prostate Cancer. Prognostic variables, including progression‐free survival, cancer‐specific survival, overall survival, and death rates were compared between men stratified by prostate cancer risk. Overall, 4760 patients older than 80 y were included. The proportion of low‐, intermediate‐, high‐, or very high‐risk, regional, and metastatic prostate cancer among super‐elderly men was 9.5%, 14.6%, 48.8%, 9.0%, 3.2%, and 24.9%, respectively. Survival rates decreased with increasing risk stratification. The cumulative 5‐y death rate by prostate cancer for low‐, intermediate‐, high‐, or very high‐risk, regional, and metastatic prostate cancer, was 0.92% (95% confidence interval [CI]: 0.2%‐3.6%), 1.6% (95% CI: 0.8%‐3.4%), 5.75% (95% CI: 4.25%‐7.75%), 15.6% (95% CI: 11.6%‐23.3%), 20.7% (95% CI: 13.1%‐31.7%), and 36.9% (95% CI: 32.8%‐41.4%), respectively. Our findings support that there is no need for immediate ADT for low‐ and intermediate‐risk groups. Conversely, in high‐ or very high‐risk, regional, and metastatic prostate cancer, more efforts for curative therapy and intensive therapy are needed in selected patients.
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Affiliation(s)
- Leandro Blas
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mizuki Onozawa
- Department of Urology, Narita Hospital, International University of Health and Welfare, Chiba, Japan
| | - Masaki Shiota
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shiro Hinotsu
- Department of Biostatistics and Clinical Epidemiology, Sapporo Medical University, Sapporo, Japan
| | - Shinichi Sakamoto
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | - Taketo Kawai
- Department of Urology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Masatoshi Eto
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Hideyuki Akaza
- Research Center for Advanced Science and Technology, University of Tokyo, Tokyo, Japan
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Fukagawa E, Yamamoto S, Ohde S, Yoshitomi KK, Hamada K, Yoneoka Y, Fujiwara M, Fujiwara R, Oguchi T, Komai Y, Numao N, Yuasa T, Fukui I, Yonese J. External validation of the Briganti 2019 nomogram to identify candidates for extended pelvic lymph node dissection among patients with high-risk clinically localized prostate cancer. Int J Clin Oncol 2021; 26:1736-1744. [PMID: 34117947 PMCID: PMC8364898 DOI: 10.1007/s10147-021-01954-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/27/2021] [Indexed: 01/14/2023]
Abstract
Background We aimed to establish an external validation of the Briganti 2019 nomogram in a Japanese cohort to preoperatively evaluate the probability of lymph node invasion in patients with high-risk, clinically localized prostate cancer. Methods The cohort consisted of 278 patients with prostate cancer diagnosed using magnetic resonance imaging-targeted biopsy who underwent radical prostatectomy and extended pelvic lymph node dissection from 2012 to 2020. Patients were rated using the Briganti 2019 nomogram, which evaluates the probability of lymph node invasion. We used the area under curve of the receiver operating characteristic analysis to quantify the accuracy of the nomogram. Results Nineteen (6.8%) patients had lymph node invasion. The median number of lymph nodes removed was 18. The area under the curve for the Briganti 2019 was 0.71. When the cutoff was set at 7%, 84 (30.2%) patients with extended pelvic lymph node dissection could be omitted, and only 1 (1.2%) patient with lymph node invasion would be missed. Sensitivity, specificity, and negative predictive values at the 7% cutoff were 94.7, 32.0, and 98.8%, respectively. Conclusion This external validation showed that the Briganti 2019 nomogram was accurate, although there may still be scope for individual adjustments.
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Affiliation(s)
- Eri Fukagawa
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Shinya Yamamoto
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - Sachiko Ohde
- Graduate School of Public Health, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan
| | - Kasumi Kaneko Yoshitomi
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Kosuke Hamada
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yusuke Yoneoka
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Motohiro Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Ryo Fujiwara
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Tomohiko Oguchi
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yoshinobu Komai
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Noboru Numao
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Takeshi Yuasa
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Iwao Fukui
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Junji Yonese
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
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Tohi Y, Kato T, Yokomizo A, Mitsuzuka K, Tomida R, Inokuchi J, Matsumoto R, Saito T, Sasaki H, Inoue K, Kinoshita H, Fukuhara H, Maruyama S, Sakamoto S, Tanikawa T, Egawa S, Ichikura H, Abe T, Nakamura M, Kakehi Y, Sugimoto M. Impact of health-related quality of life on repeat protocol biopsy compliance on active surveillance for favorable prostate cancer: results from a prospective cohort in the PRIAS-JAPAN study. Urol Oncol 2021; 40:56.e9-56.e15. [PMID: 34112576 DOI: 10.1016/j.urolonc.2021.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/25/2021] [Accepted: 05/02/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study aimed to evaluate how health-related quality of life (HRQOL) is related to repeat protocol biopsy compliance. MATERIALS AND METHODS We conducted a retrospective analysis using data from a prospective cohort in the Prostate Cancer Research International: Active Surveillance (PRIAS)-JAPAN study between January 2010 and August 2019. We used the Short Form 8 Health Survey (SF-8), as patient-reported outcomes, to assess HRQOL at AS enrollment and the first year of the protocol. The physical component summary (PCS) and mental component summary (MCS) were calculated from SF-8 questionnaires. The primary outcome was the evaluation of the association of HRQOL at enrollment on the first repeat biopsy compliance. The secondary outcome was the comparison of SF-8 scores during AS, stratified by repeat protocol biopsy compliance. RESULTS Of 805 patients who proceeded to the first year of the protocol, the non-compliance rate was 15% (121 patients). In the adjusted model, lower MCS at enrollment was significantly associated with the first repeat protocol biopsy non-compliance (odds ratio [OR], 2.134; 95% confidence interval [CI], 1.031-4.42; P = 0.041) but not in lower PCS (OR, 0.667; 95% CI, 0.294-1.514; P = 0.333). All subscales of SF-8 were lower in the non-compliance group than in the compliance group at any point. MCS in the non-compliance group improved over time from the time of AS enrollment (2.34 increased, P = 0.152). CONCLUSION Our data suggest that lower MCS at AS enrollment using patient-reported outcomes was negatively associated with the first repeat protocol biopsy compliance. Our study may support the availability of a simple questionnaire to extract non-compliance.
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Affiliation(s)
- Yoichiro Tohi
- Department of Urology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
| | - Takuma Kato
- Department of Urology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Akira Yokomizo
- Division of Urology, Harasanshin Hospital, Fukuoka, Japan
| | - Koji Mitsuzuka
- Department of Urology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Ryotaro Tomida
- Department of Urology, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Junichi Inokuchi
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryuji Matsumoto
- Department of Renal and Genito-Urinary Surgery, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Toshihiro Saito
- Department of Urology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Hiroshi Sasaki
- Department of Urology, Jikei University School of Medicine, Tokyo, Japan
| | - Koji Inoue
- Department of Urology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Hidefumi Kinoshita
- Department of Urology and Andrology, General Medical Center, Kansai Medical University, Osaka, Japan
| | - Hiroshi Fukuhara
- Department of Urology, Kyorin University School of Medicine, Tokyo, Japan
| | - Satoru Maruyama
- Department of Urology, Hokkaido Cancer Center, Sapporo, Japan
| | - Shinichi Sakamoto
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Toshiki Tanikawa
- Department of Urology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Shin Egawa
- Department of Urology, Jikei University School of Medicine, Tokyo, Japan
| | | | - Takashige Abe
- Department of Renal and Genito-Urinary Surgery, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Masaki Nakamura
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshiyuki Kakehi
- Department of Urology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Mikio Sugimoto
- Department of Urology, Faculty of Medicine, Kagawa University, Kagawa, Japan
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Matsumoto K, Niwa N, Kosaka T, Takeda T, Yasumizu Y, Tanaka N, Morita S, Mizuno R, Shinojima T, Asanuma H, Oya M. Negative impact of neoadjuvant hormonal therapy on detecting biochemical recurrence after radical prostatectomy. Int J Clin Oncol 2021; 26:1722-1728. [PMID: 34086109 PMCID: PMC8175233 DOI: 10.1007/s10147-021-01942-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/21/2021] [Indexed: 11/24/2022]
Abstract
Background Routine use of neoadjuvant hormonal therapy (NHT) before radical prostatectomy (RP) is not recommended, but it is sometimes performed to reduce the prostate size and tumor volume or to prevent tumor progression during the wait times for surgery in clinical practice. On the other hand, the impact of NHT on the pattern of biochemical recurrence (BCR) is unknown. Methods We retrospectively examined 1749 consecutive patients who underwent RP between 1996 and 2017. Among the patients who met the inclusion criteria, BCR developed in 240 of non-NHT patients and in 120 of NHT patients during the mean follow-up period of 6.9 years. We examined the impact of NHT on the PSA-doubling time (DT) following BCR at different times after RP. Results The median PSA-DTs in non-NHT patients who experienced BCR in the first year after surgery, between 1 and 2 years, between 2 and 3 years, between 3 and 4 years, between 4 and 5 years, and at > 5 years were 5.5, 8.8, 11.3, 17.7, 18.2, and 18.4 months, respectively. On the other hand, those in NHT patients were 1.4, 4.1, 9.1, 13.4, 27.2, and 19.3 months, respectively. The differences of PSA-DTs in the first year after surgery (p < 0.001) and between 1 and 2 years (p = 0.005) were significant between non-NHT and NHT patients. Conclusion Patients who received NHT had a higher risk of a rapid PSA increase when they experienced BCR, especially within 2 years after RP. In order to not miss the optimal timing of salvage treatment for BCR, intensive PSA follow-up is necessary. Supplementary Information The online version contains supplementary material available at 10.1007/s10147-021-01942-8.
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Affiliation(s)
- Kazuhiro Matsumoto
- Department of Urology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Naoya Niwa
- Department of Urology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takeo Kosaka
- Department of Urology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Toshikazu Takeda
- Department of Urology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yota Yasumizu
- Department of Urology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Nobuyuki Tanaka
- Department of Urology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shinya Morita
- Department of Urology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ryuichi Mizuno
- Department of Urology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Toshiaki Shinojima
- Department of Urology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hiroshi Asanuma
- Department of Urology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan
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Koroki Y, Imanaka K, Yasuda Y, Harada S, Fujino A. Safety and efficacy of abiraterone acetate plus prednisolone in patients with castration-resistant prostate cancer: a prospective, observational, post-marketing surveillance study. Jpn J Clin Oncol 2021; 51:1452-1461. [PMID: 34050660 PMCID: PMC8405844 DOI: 10.1093/jjco/hyab077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/03/2021] [Indexed: 12/24/2022] Open
Abstract
Background Abiraterone acetate plus prednisolone is approved to treat patients with castration-resistant prostate cancer. This study evaluated the safety and efficacy of abiraterone acetate plus prednisolone in castration-resistant prostate cancer patients with or without previous chemotherapy in a real-world setting in Japan. Methods This study was an observational, prospective, post-marketing surveillance. Castration-resistant prostate cancer patients, who initiated abiraterone acetate after its approval in Japan, were enrolled. Data were collected during an observation period of 12 months and a follow-up period of another 12 months. Adverse events and adverse drug reactions were evaluated for safety. Prostate-specific antigen levels and overall survival were evaluated for efficacy. Results From 141 participating institutions, 497 patients were registered: 492 patients including 180 chemotherapy-naïve, 311 chemotherapy-experienced and one off-label-use patient received abiraterone and were evaluated for safety. Adverse events were observed in 225/492 patients (45.7%), adverse drug reactions in 131/492 patients (26.6%) and serious adverse drug reactions in 61/492 patients (12.4%). The most commonly observed adverse drug reaction was abnormal hepatic function (6.5%), followed by hypokalemia (3.0%) and decreased appetite (2.0%). At week 12, 110/432 patients (25.5%) achieved ≥50% decrease from baseline in prostate-specific antigen, and the proportion was higher in chemotherapy-naïve patients (56/161 patients; 34.8%) compared with chemotherapy-experienced patients (54/271 patients; 19.9%, P < 0.001). Survival rates at 24 months were 68.3% (295/432 patients), 73.9% (119/161 chemotherapy-naïve patients) and 64.9% (176/271 chemotherapy-experienced patients). Conclusions This large-scale, real-world, post-marketing surveillance study confirmed the safety and efficacy of abiraterone acetate plus prednisolone in Japanese castration-resistant prostate cancer patients with or without previous chemotherapy.
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Affiliation(s)
- Yosuke Koroki
- Medical Affairs, Janssen Pharmaceutical K.K., Tokyo, Japan
| | | | - Yukiko Yasuda
- Japan Safety and Surveillance, Janssen Pharmaceutical K.K., Tokyo, Japan
| | - Sayuri Harada
- Japan Safety and Surveillance, Janssen Pharmaceutical K.K., Tokyo, Japan
| | - Akiko Fujino
- Japan Safety and Surveillance, Janssen Pharmaceutical K.K., Tokyo, Japan
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Abstract
Prostate cancer is a global health problem, but incidence varies considerably across different continents. Asia is traditionally considered a low-incidence area, but the incidence and mortality of prostate cancer have rapidly increased across the continent. Substantial differences in epidemiological features have been observed among different Asian regions, and incidence, as well as mortality-to-incidence ratio, is associated with the human development index. Prostate cancer mortality decreased in Japan and Israel from 2007 to 2016, but mortality has increased in Thailand, Kyrgyzstan and Uzbekistan over the same period. Genomic analyses have shown a low prevalence of ERG oncoprotein in the East Asian population, alongside a low rate of PTEN loss, high CHD1 enrichments and high FOXA1 alterations. Contributions from single-nucleotide polymorphisms to prostate cancer risk vary with ethnicity, but germline mutation rates of DNA damage repair genes in metastatic prostate cancer are comparable in Chinese and white patients from the USA and UK. Pharmacogenomic features of testosterone metabolism might contribute to disparities seen in the response to androgen deprivation between East Asian men and white American and European men. Overall, considerable diversity in epidemiology and genomics of prostate cancer across Asia defines disease characteristics in these populations, but studies in this area are under-represented in the literature. Taking into account this intracontinental and intercontinental heterogeneity, translational studies are required in order to develop ethnicity-specific treatment strategies.
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Kobayashi K, Okuno N, Arai G, Nakatsu H, Maniwa A, Kamiya N, Satoh T, Kikukawa H, Nasu Y, Uemura H, Nakashima T, Mikami K, Iinuma M, Tanabe K, Furukawa J, Kobayashi H. Efficacy and safety of abiraterone acetate plus prednisolone in patients with early metastatic castration-resistant prostate cancer who failed first-line androgen-deprivation therapy: a single-arm, phase 4 study. Jpn J Clin Oncol 2021; 51:544-551. [PMID: 33324967 PMCID: PMC8012350 DOI: 10.1093/jjco/hyaa225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/27/2020] [Indexed: 12/24/2022] Open
Abstract
Aim The aim was to evaluate the efficacy and safety of abiraterone acetate plus prednisolone in patients with chemotherapy-naïve early metastatic castration-resistant prostate cancer who failed first-line androgen deprivation therapy. Methods Patients with early metastatic castration-resistant prostate cancer with confirmed prostate-specific antigen progression within 1-year or prostate-specific antigen progression without having normal prostate-specific antigen level (<4.0 ng/mL) during first-line androgen deprivation therapy were enrolled and administered abiraterone acetate (1000 mg) plus prednisolone (10 mg). A minimum of 48 patients were required according to Simon’s minimax design. The primary endpoint was prostate-specific antigen response rate (≥50% prostate-specific antigen decline by 12 weeks), secondary endpoints included prostate-specific antigen progression-free survival and overall survival. Safety parameters were also assessed. Results For efficacy, 49/50 patients were evaluable. Median age was 73 (range: 55–86) years. The median duration of initial androgen deprivation therapy was 32.4 (range: 13.4–84.1) weeks and 48 patients experienced prostate-specific antigen progression within 1-year after initiation of androgen deprivation therapy. prostate-specific antigen response rate was 55.1% (95% confidence interval: 40.2%–69.3%), median prostate-specific antigen–progression-free survival was 24.1 weeks, and median overall survival was 102.9 weeks (95% confidence interval: 64.86 not estimable [NE]). Most common adverse event was nasopharyngitis (15/50 patients, 30.0%). The most common ≥grade 3 adverse event was alanine aminotransferase increased (6/50 patients, 12.0%). Conclusions Abiraterone acetate plus prednisolone demonstrated a high prostate-specific antigen response rate of 55.1%, suggesting tumor growth still depends on androgen synthesis in patients with early metastatic castration-resistant prostate cancer. However, prostate-specific antigen–progression-free survival was shorter than that reported in previous studies. Considering the benefit–risk profile, abiraterone acetate plus prednisolone would be a beneficial treatment option for patients with chemotherapy-naive metastatic prostate cancer who show early castration resistance.
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Affiliation(s)
- K Kobayashi
- Department of Urology, Federation of National Public Service Personnel Mutual Aid Associations Yokosuka Kyosai Hospital, Kanagawa, Japan
| | - N Okuno
- Department of Urology, Independent Administrative Institution National Hospital Organization Sagamihara Hospital, Kanagawa, Japan
| | - G Arai
- Department of Urology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - H Nakatsu
- Department of Urology, Asahi General Hospital, Chiba, Japan
| | - A Maniwa
- Department of Urology, Independent Administrative Institution National Hospital Organization Shizuoka Medical Center, Shizuoka, Japan
| | - N Kamiya
- Department of Urology, Toho University Sakura Medical Center, Chiba, Japan
| | - T Satoh
- Department of Urology, Kitasato University School of Medicine, Kanagawa, Japan
| | - H Kikukawa
- Department of Urology, Independent Administrative Institution National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Y Nasu
- Department of Urology, Japan Organization of Occupational Health and Safety Okayama Rosai Hospital, Okayama, Japan
| | - H Uemura
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Kanagawa, Japan
| | - T Nakashima
- Department of Urology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan
| | - K Mikami
- Department of Urology, Chibaken Saiseikai Narashino Hospital, Chiba, Japan
| | - M Iinuma
- Department of Urology, Independent Administrative Institution National Hospital Organization Mito Medical Center, Ibaraki, Japan
| | - K Tanabe
- Department of Urology, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - J Furukawa
- Department of Urology, National University Corporation Kobe University Hospital, Hyogo, Japan
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Hatakeyama S, Yoneyama T, Tobisawa Y, Yamamoto H, Ohyama C. Narrative review of urinary glycan biomarkers in prostate cancer. Transl Androl Urol 2021; 10:1850-1864. [PMID: 33968674 PMCID: PMC8100853 DOI: 10.21037/tau-20-964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Prostate cancer (PC) is the second most common cancer in men worldwide. The application of the prostate-specific antigen (PSA) test has improved the diagnosis and treatment of PC. However, the PSA test has become associated with overdiagnosis and overtreatment. Therefore, there is an unmet need for novel diagnostic, prognostic, and predictive biomarkers of PC. Urinary glycoproteins and exosomes are a potential source of PC glycan biomarkers. Urinary glycan profiling can provide noninvasive monitoring of tumor heterogeneity and aggressiveness throughout a treatment course. However, urinary glycan profiling is not popular due to technical disadvantages, such as complicated structural analysis that requires specialized expertise. The technological development of glycan analysis is a rapidly advancing field. A lectin-based microarray can detect aberrant glycoproteins in urine, including PSA glycoforms and exosomes. Glycan enrichment beads can enrich the concentration of N-linked glycans specifically. Capillary electrophoresis, liquid chromatography-tandem mass spectrometry, and matrix-assisted laser desorption/ionization-time of flight mass spectrometry can detect glycans directory. Many studies suggest potential of urinary glycoproteins, exosomes, and glycosyltransferases as a biomarker of PC. Although further technological challenges remain, urinary glycan analysis is one of the promising approaches for cancer biomarker discovery.
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Affiliation(s)
- Shingo Hatakeyama
- Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tohru Yoneyama
- Department of Glycotechnology, Center for Advanced Medical Research, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yuki Tobisawa
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hayato Yamamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Chikara Ohyama
- Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of Glycotechnology, Center for Advanced Medical Research, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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62
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Suzuki H, Castellano D, de Bono J, Sternberg CN, Fizazi K, Tombal B, Wülfing C, Foster MC, Ozatilgan A, Geffriaud-Ricouard C, de Wit R. Cabazitaxel versus abiraterone or enzalutamide in metastatic castration-resistant prostate cancer: post hoc analysis of the CARD study excluding chemohormonal therapy for castrate-naive disease. Jpn J Clin Oncol 2021; 51:1287-1297. [PMID: 33738495 PMCID: PMC8521736 DOI: 10.1093/jjco/hyab028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 02/16/2021] [Indexed: 11/12/2022] Open
Abstract
Background In the CARD study (NCT02485691), cabazitaxel significantly improved clinical outcomes versus abiraterone or enzalutamide in patients with metastatic castration-resistant prostate cancer previously treated with docetaxel and the alternative androgen-signalling-targeted inhibitor. However, some patients received docetaxel or the prior alternative androgen-signalling-targeted inhibitor in the metastatic hormone-sensitive (mHSPC) setting. Therefore, the CARD results cannot be directly translated to a Japanese population. Methods Patients (N = 255) received cabazitaxel (25 mg/m2 IV Q3W, prednisone, G-CSF) versus abiraterone (1000 mg PO, prednisone) or enzalutamide (160 mg PO) after prior docetaxel and progression ≤12 months on the alternative androgen-signalling-targeted inhibitor. Patients who received combination therapy for mHSPC were excluded (n = 33) as docetaxel is not approved in this setting in Japan. Results A total of 222 patients (median age 70 years) were included in this subanalysis. Median number of cycles was higher for cabazitaxel versus androgen-signalling-targeted inhibitors (7 versus 4). Clinical outcomes favoured cabazitaxel over abiraterone or enzalutamide including, radiographic progression-free survival (rPFS; median 8.2 versus 3.4 months; P < 0.0001), overall survival (OS; 13.9 versus 11.8 months; P = 0.0102), PFS (4.4 versus 2.7 months; P < 0.0001), confirmed prostate-specific antigen response (37.0 versus 14.4%; P = 0.0006) and objective tumour response (38.9 versus 11.4%; P = 0.0036). For cabazitaxel versus androgen-signalling-targeted inhibitor, grade ≥ 3 adverse events occurred in 55% versus 44% of patients, with adverse events leading to death on study in 2.7% versus 5.7%. Conclusions Cabazitaxel significantly improved outcomes including rPFS and OS versus abiraterone or enzalutamide and are reflective of the Japanese patient population. Cabazitaxel should be considered the preferred treatment option over abiraterone or enzalutamide in this setting.
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Affiliation(s)
- Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, Chiba, Japan
| | - Daniel Castellano
- Medical Oncology Department, 12 de Octubre University Hospital, Madrid, Spain
| | - Johann de Bono
- Drug Development Unit, The Institute of Cancer Research and the Royal Marsden Hospital, London, UK
| | - Cora N Sternberg
- Division of Hematology and Medical Oncology, Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Karim Fizazi
- Department of Cancer Medicine, Gustave Roussy Institute and Paris Sud University, Villejuif, France
| | - Bertrand Tombal
- Division of Urology, Université Catholique de Louvain, Louvain, Belgium
| | | | | | - Ayse Ozatilgan
- Global Medical Affairs Oncology, Sanofi, Cambridge, MA, USA
| | | | - Ronald de Wit
- Department Medical Oncology, Erasmus University Hospital, Rotterdam, the Netherlands
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Uemura H, Masumori N, Takahashi S, Hosono M, Kinuya S, Sunaya T, Horio T, Okayama Y, Kakehi Y. Real-world safety and effectiveness of radium-223 in Japanese patients with castration-resistant prostate cancer (CRPC) and bone metastasis: exploratory analysis, based on the results of post-marketing surveillance, according to prior chemotherapy status and in patients without concomitant use of second-generation androgen-receptor axis-targeted agents. Int J Clin Oncol 2021; 26:753-763. [PMID: 33575828 PMCID: PMC7979648 DOI: 10.1007/s10147-020-01850-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/04/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Based on results from Japanese post-marketing surveillance, exploratory analyses were performed to investigate real-world outcomes of radium-223 for metastatic CRPC (mCRPC) according to patient characteristics. METHODS This non-interventional, prospective study enrolled mCRPC patients selected for radium-223 treatment in clinical practice. Six-month safety and effectiveness were evaluated in subgroups who had/had not received prior chemotherapy (prior-chemo/no prior-chemo groups), and a subgroup who had not received concomitant androgen-receptor axis-targeted agents (ARATs). RESULTS In the overall population (n = 296), the prior-chemo group (n = 126) tended to have more bone metastases, more analgesic use, and higher prostate-specific antigen values than the no prior-chemo group (n = 170). Incidences of treatment-emergent adverse events (TEAEs), drug-related TEAEs, and ≥ grade 3 drug-related hematological TEAEs were 47% vs. 53%, 25% vs. 29%, and 4% vs. 7% in the no prior-chemo and prior-chemo groups, respectively. Incidences of TEAEs (61%), drug-related TEAEs (36%), and ≥ grade 3 drug-related hematological events (12%) were numerically higher in 33 patients who had received two lines of prior chemotherapy. Multivariate analysis showed that two lines of prior chemotherapy, and hemoglobin, platelet, and lactate dehydrogenase values were baseline factors significantly related to ≥ grade 2 platelet count decreased. Safety and effectiveness in patients without concomitant ARATs (n = 201) were similar to those in the overall population. CONCLUSION In a real-life setting, radium-223 was well tolerated irrespective of prior chemotherapy, but relatively higher incidences of TEAEs and hematotoxicities were suggested in patients with two lines of prior chemotherapy, possibly reflecting more advanced disease. Radium-223 safety and effectiveness in patients without concomitant ARATs were favorable.
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Affiliation(s)
- Hirotsugu Uemura
- Department of Urology, Faculty of Medicine, Kindai University, 337-2, Ono-higashi, Osaka Sayama-City, Osaka, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, 291, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, Japan
| | - Shunji Takahashi
- Department of Medical Oncology, The Cancer Institute Hospital of JFCR, 3-8-31Koto-ku, AriakeTokyo, Japan
| | - Makoto Hosono
- Department of Radiology, Faculty of Medicine, Kindai University, 337-2, Ono-higashi, Osaka Sayama-City, Osaka, Japan
| | - Seigo Kinuya
- Department of Nuclear Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Japan
| | - Toshiyuki Sunaya
- Data Sciences & Analytics, Research & Development Japan, Bayer Yakuhin, Ltd., 2-4-9 Kita-ku, Umeda, Osaka, Japan
| | - Tomoyo Horio
- Medical Affairs Oncology, Medical Affairs & Pharmacovigilance, Bayer Yakuhin, Ltd., 2-4-9 Kita-ku, Umeda, Osaka, Japan
| | - Yutaka Okayama
- Pharmacovigilance Monitoring & Governance PMS, Medical Affairs & Pharmacovigilance, Bayer Yakuhin, Ltd, 2-4-9 Kita-ku, Umeda, Osaka, Japan.
| | - Yoshiyuki Kakehi
- Department of Urology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, Japan
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Saad F, Bögemann M, Suzuki K, Shore N. Treatment of nonmetastatic castration-resistant prostate cancer: focus on second-generation androgen receptor inhibitors. Prostate Cancer Prostatic Dis 2021; 24:323-334. [PMID: 33558665 PMCID: PMC8134049 DOI: 10.1038/s41391-020-00310-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/27/2020] [Accepted: 12/04/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Nonmetastatic castration-resistant prostate cancer (nmCRPC) is defined as a rising prostate-specific antigen concentration, despite castrate levels of testosterone with ongoing androgen-deprivation therapy or orchiectomy, and no detectable metastases by conventional imaging. Patients with nmCRPC progress to metastatic disease and are at risk of developing cancer-related symptoms and morbidity, eventually dying of their disease. While patients with nmCRPC are generally asymptomatic from their disease, they are often older and have chronic comorbidities that require long-term concomitant medication. Therefore, careful consideration of the benefit-risk profile of potential treatments is required. METHODS In this review, we will discuss the rationale for early treatment of patients with nmCRPC to delay metastatic progression and prolong survival, as well as the factors influencing this treatment decision. We will focus on oral pharmacotherapy with the second-generation androgen receptor inhibitors, apalutamide, enzalutamide, and darolutamide, and the importance of balancing the clinical benefit they offer with potential adverse events and the consequential impact on quality of life, physical capacity, and cognitive function. RESULTS AND CONCLUSIONS While the definition of nmCRPC is well established, the advent of next-generation imaging techniques capable of detecting hitherto undetectable oligometastatic disease in patients with nmCRPC has fostered debate on the criteria that inform the management of these patients. However, despite these developments, published consensus statements have maintained that the absence of metastases on conventional imaging suffices to guide such therapeutic decisions. In addition, the prolonged metastasis-free survival and recently reported positive overall survival outcomes of the three second-generation androgen receptor inhibitors have provided further evidence for the early use of these agents in patients with nmCRPC in order to delay metastases and prolong survival. Here, we discuss the benefit-risk profiles of apalutamide, enzalutamide, and darolutamide based on the data available from their pivotal clinical trials in patients with nmCRPC.
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Affiliation(s)
- Fred Saad
- Department of Urology, Centre Hospitalier de l'Université de Montreal (CHUM), Montreal Cancer Institute/CRCHUM, Montreal, QC, Canada.
| | - Martin Bögemann
- Department of Urology, Münster University Medical Center, Münster, Germany
| | - Kazuhiro Suzuki
- Department of Urology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Neal Shore
- Carolina Urologic Research Center, Atlantic Urology Clinics, Myrtle Beach, SC, USA
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Rebello RJ, Oing C, Knudsen KE, Loeb S, Johnson DC, Reiter RE, Gillessen S, Van der Kwast T, Bristow RG. Prostate cancer. Nat Rev Dis Primers 2021. [PMID: 33542230 DOI: 10.1038/s41572-020-0024.3-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/27/2023]
Abstract
Prostate cancer is a complex disease that affects millions of men globally, predominantly in high human development index regions. Patients with localized disease at a low to intermediate risk of recurrence generally have a favourable outcome of 99% overall survival for 10 years if the disease is detected and treated at an early stage. Key genetic alterations include fusions of TMPRSS2 with ETS family genes, amplification of the MYC oncogene, deletion and/or mutation of PTEN and TP53 and, in advanced disease, amplification and/or mutation of the androgen receptor (AR). Prostate cancer is usually diagnosed by prostate biopsy prompted by a blood test to measure prostate-specific antigen levels and/or digital rectal examination. Treatment for localized disease includes active surveillance, radical prostatectomy or ablative radiotherapy as curative approaches. Men whose disease relapses after prostatectomy are treated with salvage radiotherapy and/or androgen deprivation therapy (ADT) for local relapse, or with ADT combined with chemotherapy or novel androgen signalling-targeted agents for systemic relapse. Advanced prostate cancer often progresses despite androgen ablation and is then considered castration-resistant and incurable. Current treatment options include AR-targeted agents, chemotherapy, radionuclides and the poly(ADP-ribose) inhibitor olaparib. Current research aims to improve prostate cancer detection, management and outcomes, including understanding the fundamental biology at all stages of the disease.
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Affiliation(s)
- Richard J Rebello
- Cancer Research UK Manchester Institute, University of Manchester, Manchester Cancer Research Centre, Manchester, UK
| | - Christoph Oing
- Cancer Research UK Manchester Institute, University of Manchester, Manchester Cancer Research Centre, Manchester, UK
- Department of Oncology, Haematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Centre Eppendorf, Hamburg, Germany
| | - Karen E Knudsen
- Sidney Kimmel Cancer Center at Jefferson Health and Thomas Jefferson University, Philadelphia, PA, USA
| | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, Manhattan, NY, USA
| | - David C Johnson
- Department of Urology, University of North Carolina, Chapel Hill, NC, USA
| | - Robert E Reiter
- Department of Urology, Jonssen Comprehensive Cancer Center UCLA, Los Angeles, CA, USA
| | | | - Theodorus Van der Kwast
- Laboratory Medicine Program, Princess Margaret Cancer Center, University Health Network, Toronto, Canada
| | - Robert G Bristow
- Cancer Research UK Manchester Institute, University of Manchester, Manchester Cancer Research Centre, Manchester, UK.
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Abstract
Prostate cancer is a complex disease that affects millions of men globally, predominantly in high human development index regions. Patients with localized disease at a low to intermediate risk of recurrence generally have a favourable outcome of 99% overall survival for 10 years if the disease is detected and treated at an early stage. Key genetic alterations include fusions of TMPRSS2 with ETS family genes, amplification of the MYC oncogene, deletion and/or mutation of PTEN and TP53 and, in advanced disease, amplification and/or mutation of the androgen receptor (AR). Prostate cancer is usually diagnosed by prostate biopsy prompted by a blood test to measure prostate-specific antigen levels and/or digital rectal examination. Treatment for localized disease includes active surveillance, radical prostatectomy or ablative radiotherapy as curative approaches. Men whose disease relapses after prostatectomy are treated with salvage radiotherapy and/or androgen deprivation therapy (ADT) for local relapse, or with ADT combined with chemotherapy or novel androgen signalling-targeted agents for systemic relapse. Advanced prostate cancer often progresses despite androgen ablation and is then considered castration-resistant and incurable. Current treatment options include AR-targeted agents, chemotherapy, radionuclides and the poly(ADP-ribose) inhibitor olaparib. Current research aims to improve prostate cancer detection, management and outcomes, including understanding the fundamental biology at all stages of the disease.
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67
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Takeshima Y, Suzuki M, Miyakawa J, Tsuru I, Yamada Y, Nakamura M, Sato Y, Kawai T, Yamada D, Morikawa T, Kume H. Latent prostate cancer among Japanese males: a bibliometric study of autopsy reports from 1980-2016. Jpn J Clin Oncol 2021; 51:156-159. [PMID: 32875336 DOI: 10.1093/jjco/hyaa161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 08/11/2020] [Indexed: 11/13/2022] Open
Abstract
Prostate cancer is one of the most common malignancies, but a substantial portion remains latent throughout the patients' lifetime. Analysis of temporal change in the latent prostate cancer pool would be beneficial for clinical decision-making, but longitudinal autopsy studies are rare. We conducted a hand-search of the Annual of Pathological Autopsy Cases in Japan from 1980 to 2016 for cases of latent prostate cancer. Of 570 997 males aged 30 or older, latent prostate cancer was detected in 12 562 patients (2.2%). Proportion of detected cases correlated strongly with 'aging rate', the percentage of population aged 65 or older (squared Pearson's correlation coefficient r2 = 0.972, P value <0.0001). Temporal increase in proportion was also seen in each age group as well. This continuous growth reinforces evidence from past Japanese reports on latent prostate cancer. The rapidly rising ageing rate of Japan may forecast further increase in the latent prostate cancer pool moving forward.
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Affiliation(s)
- Yuta Takeshima
- Division of Innovative Cancer Therapy, The Advanced Clinical Research Center, Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-Ku, Tokyo
| | - Motofumi Suzuki
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo
| | - Jimpei Miyakawa
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo
| | - Ibuki Tsuru
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo
| | - Yuta Yamada
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo
| | - Masaki Nakamura
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo
| | - Yusuke Sato
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo
| | - Taketo Kawai
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo
| | - Daisuke Yamada
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo
| | - Teppei Morikawa
- Department of Pathology, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, Japan
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo
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Influence of prostate cancer status on the prevalence of medication-related osteonecrosis of the jaw. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:312-318. [PMID: 33431343 DOI: 10.1016/j.oooo.2020.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/20/2020] [Accepted: 12/21/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the risk of osteonecrosis of the jaw (ONJ) in patients with prostate cancer, particularly the relationship between prostate cancer progression and ONJ development. STUDY DESIGN This single-center, retrospective, observational study included 113 patients who received zoledronic acid or denosumab for prostate cancer with bone metastasis between January 2012 and March 2020. The risk of ONJ was evaluated regarding age; antiresorptive drugs; duration of antiresorptive treatment; prostate cancer status, including castration-resistant prostate cancer (CRPC) and prostate-specific antigen level; chemotherapy; radium-223 treatment; corticosteroid treatment; diabetes mellitus; and dental extractions. RESULTS Overall, 28 patients had ONJ; 10 patients received zoledronic acid and 18 patients received denosumab. Multiple logistic regression analysis demonstrated that CRPC (odds ratio = 6.01; 95% confidence interval, 1.76-20.05; P = .004) and dental extractions (odds ratio = 12.40; 95% confidence interval, 3.42-44.70; P < .001) were significantly associated with ONJ. In addition, antiresorptive treatment lasting more than 1 year partially mediated between CRPC and development of ONJ. CONCLUSION CRPC and dental extraction are risk factors for developing ONJ, and antiresorptive treatment lasting more than 1 year is a partial mediator between CRPC and ONJ.
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69
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Nakayama K, Osaka W, Matsubara N, Takeuchi T, Toyoda M, Ohtake N, Uemura H. Shared decision making, physicians' explanations, and treatment satisfaction: a cross-sectional survey of prostate cancer patients. BMC Med Inform Decis Mak 2020; 20:334. [PMID: 33317523 PMCID: PMC7734751 DOI: 10.1186/s12911-020-01355-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 11/30/2020] [Indexed: 11/16/2022] Open
Abstract
Background Hormone therapy is one option for some types of prostate cancer. Shared decision making (SDM) is important in the decision making process, but SDM between prostate cancer patients receiving hormone therapy and physicians is not fully understood. This study tested hypotheses: “Patients’ perception of SDM is associated with treatment satisfaction, mediated by satisfaction with physicians’ explanations and perceived effective decision making” and “The amount of information provided to patients by physicians on diseases and treatment is associated with treatment satisfaction mediated by patients’ perceived SDM and satisfaction with physicians’ explanations.” Methods This cross-sectional study was conducted using an online panel via a private research company in Japan. The participants in this study were patients registered with the panel who had received or were currently receiving hormone therapy for prostate cancer and physicians registered with the panel who were treating patients with prostate cancer. Measures used in this study included a nine-item Shared Decision Making Questionnaire, levels of satisfaction with physicians’ explanations and treatment satisfaction, and effective decision making for patients (feeling the choice is informed, value-based, likely to be implemented and expressing satisfaction with the choice), and a Shared Decision Making Questionnaire for Doctors. The hypotheses were examined using path analysis. Results In total, 124 patients and 150 physicians were included in the analyses. In keeping with our hypotheses, perceived SDM significantly correlated with the physicians’ explanations and perceived effective decision making for patients, and satisfaction with physicians’ explanations and perceived effective decision making for patients were both related to treatment satisfaction. Although the amount of information provided to patients was correlated with the perceived SDM, it was indirectly related to their satisfaction with physicians’ explanations. Conclusions When physicians encourage patients to be actively involved in making decisions about treatment through the SDM process while presenting a wide range of information at the start of hormone therapy, patients’ effective decision making and physicians’ explanations may be improved; consequently, the patients’ overall treatment satisfaction may be improved. Physicians who treat patients with prostate cancer may have underestimated the importance of SDM before starting hormone therapy, even greater extent than patients.
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Affiliation(s)
- Kazuhiro Nakayama
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan.
| | - Wakako Osaka
- Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan.,The Jikei University School of Medicine, School of Nursing, Tokyo, Japan
| | - Nobuaki Matsubara
- Department of Breast and Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | | | | | | | - Hiroji Uemura
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
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70
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Uemura H, Matsushima H, Kobayashi K, Mizusawa H, Nishimatsu H, Fizazi K, Smith M, Shore N, Tammela T, Tabata KI, Matsubara N, Iinuma M, Uemura H, Oya M, Momma T, Kawakita M, Fukasawa S, Kobayashi T, Kuss I, Le Berre MA, Snapir A, Sarapohja T, Suzuki K. Efficacy and safety of darolutamide in Japanese patients with nonmetastatic castration-resistant prostate cancer: a sub-group analysis of the phase III ARAMIS trial. Int J Clin Oncol 2020; 26:578-590. [PMID: 33226524 PMCID: PMC7895789 DOI: 10.1007/s10147-020-01824-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 10/21/2020] [Indexed: 12/24/2022]
Abstract
Background Darolutamide, an oral androgen receptor inhibitor, has been approved for treating nonmetastatic castration-resistant prostate cancer (nmCRPC), based on significant improvements in metastasis-free survival (MFS) in the ARAMIS clinical trial. Efficacy and safety of darolutamide in Japanese patients are reported here. Methods In this randomized, double-blind, placebo-controlled phase III trial, 1509 patients with nmCRPC and prostate-specific antigen (PSA) doubling time ≤ 10 months were randomized 2:1 to darolutamide 600 mg twice daily or matched placebo while continuing androgen deprivation therapy. The primary endpoint was MFS. Results In Japan, 95 patients were enrolled and randomized to darolutamide (n = 62) or placebo (n = 33). At the primary analysis (cut-off date: September 3, 2018), after 20 primary end-point events had occurred, median MFS was not reached with darolutamide vs. 18.2 months with placebo (HR 0.28, 95% CI 0.11–0.70). Median OS was not reached due to limited numbers of events in both groups but favored darolutamide in the Japanese subgroup. Time to pain progression, time to PSA progression, and PSA response also favored darolutamide. Among Japanese patients randomized to darolutamide vs. placebo, incidences of treatment-emergent adverse events (TEAEs) were 85.5 vs. 63.6%, and incidences of treatment discontinuation due to TEAEs were 8.1 vs. 6.1%. Conclusions Efficacy outcomes favored darolutamide in Japanese patients with nmCRPC, supporting the clinical benefit of darolutamide in this patient population. Darolutamide was well tolerated; however, due to the small sample size, it is impossible to conclude with certainty whether differences in the safety profile exist between Japanese and overall ARAMIS populations. Electronic supplementary material The online version of this article (10.1007/s10147-020-01824-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hiroji Uemura
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
| | - Hisashi Matsushima
- Department of Urology, Tokyo Metropolitan Police Hospital, 4-22-1 Nakano, Nakano-ku, 164-8541, Japan
| | - Kazuki Kobayashi
- Department of Urology, Yokosuka Kyosai Hospital, 1-16 Yonegahamadori, Yokosuka, 238-8558, Japan
| | - Hiroya Mizusawa
- Department of Urology, National Hospital Organization, Shinshu Ueda Medical Center, 1-27-21 Midorigaoka, Ueda, 386-8610, Japan
| | - Hiroaki Nishimatsu
- Department of Urology, The Fraternity Memorial Hospital, 2-1-11 Yokoami, Sumida-ku, 130-8587, Japan
| | - Karim Fizazi
- Institut Gustave Roussy, 39 Rue Camille Desmoulins, 94805, Villejuif Cedex, France
| | - Matthew Smith
- Massachusetts General Hospital Cancer Center, 55 Fruit Street, Boston, MA, 02114, USA
| | - Neal Shore
- Carolina Urologic Research Center, 823 82nd Parkway, Myrtle Beach, SC, 29572, USA
| | - Teuvo Tammela
- Tampere University Hospital, Urologian poliklinikka, PL 2000, Teiskontie 35, 33521, Tampere, Finland
| | - Ken-Ichi Tabata
- Department of Urology, Kitasato University Hospital, 1-15-1 Kitazato Minami-ku, Sagamihara, 252-0375, Japan
| | - Nobuaki Matsubara
- Department of Breast and Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Masahiro Iinuma
- Department of Urology, National Hospital Organization, Mito Medical Center, 280 Sakuranosato Ibarakimachi, Higashiibaraki, 311-3193, Japan
| | - Hirotsugu Uemura
- Department of Urology, Kindai University, 377-2, Onohigashi, Osakasayama, 589-8511, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University, 35 Shinano-machi, Shinjuku-ku, 160-8582, Japan
| | - Tetsuo Momma
- Department of Urology, National Hospital Organization, Saitama National Hospital, 2-1 Suwa, Wako, 351-0102, Japan
| | - Mutsushi Kawakita
- Department of Urology, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi Chuo-ku, Kobe, 650-0047, Japan
| | - Satoshi Fukasawa
- Division of Urology, Chiba Cancer Center, 666-2, Nitona-cho, Chuo-ku, Chiba, 260-8717, Japan
| | - Tadahiro Kobayashi
- Department of Urology, Fukui Prefectural Hospital, 2-8-1 Yotsui, Fukui, 910-8526, Japan
| | - Iris Kuss
- Clinical Statistics, Bayer AG, Building P300, B342, 13342, Berlin, Germany
| | | | - Amir Snapir
- Orion Corporation Orion Pharma, Orionintie 1, P.O. Box 65, FI-02101, Espoo, Finland.,PCI Biotech, Ullernchausseen 64, 0379, Oslo, Norway
| | - Toni Sarapohja
- Orion Corporation Orion Pharma, Orionintie 1, P.O. Box 65, FI-02101, Espoo, Finland
| | - Kazuhiro Suzuki
- Department of Urology, Gunma University, 3-39-15 Showa-machi, Maebashi, 371-8511, Japan
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71
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Nepal SP, Nakasato T, Ogawa Y, Naoe M, Shichijo T, Maeda Y, Morita J, Oshinomi K, Unoki T, Inoue T, Kato R, Omizu M. Prostate cancer detection rate and Gleason score in relation to prostate volume as assessed by magnetic resonance imaging cognitive biopsy and standard biopsy. Turk J Urol 2020; 46:449-454. [PMID: 33052831 PMCID: PMC7608531 DOI: 10.5152/tud.2020.20248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/20/2020] [Indexed: 08/27/2023]
Abstract
OBJECTIVE This study aimed to assess the relationship of the prostate cancer and Gleason scores (GSs) or ISUP Grade system with prostate volume (PV) as assessed by magnetic resonance imaging (MRI) cognitive biopsy and standard biopsy. MATERIAL AND METHODS Data were collected from 659 patients who underwent MRI cognitive biopsy and standard biopsy from January 2014 to January 2018. The biopsies were performed because of increased prostate-specific antigen (PSA) levels (>4 ng/mL) and/or abnormal digital rectal examination findings. Transrectal ultrasound was used to measure PV. RESULTS Prostate cancer detection rates in patients with increased PVs of ≤40 cc and >40 cc were 68.8% and 51.6% (p<0.001), respectively. ISUP Grade group ≥2 (Gleason score ≥3+4) detection rates for increased PVs of ≤40 cc and >40 cc were 68% and 73%, and 22.3% and 37.8%, respectively, for those with ISUP Grade group ≥4 (Gleason score ≥8) (p=0.003). Among the patients with PV>40 cc, univariate logistic regression showed a significant relationship between ISUP Grade group ≥2 and PSA, free/total PSA, PSA density, and MRI (p<0.05). On multivariable logistic regression, MRI (p=0.014) and PSA (p=0.039) predicted ISUP Grade group ≥2 in patients with PV>40 cc. CONCLUSION Although the detection rates of prostate cancer decreased as PV increased, the detection of prostate cancer aggressiveness increased as PV increased. This increase in high ISUP Grade lesions with the rise in PV is due to the use of MRI during prostate biopsy with standard biopsy.
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Affiliation(s)
- Sat Prasad Nepal
- Department of Urology, Showa University, School of Medicine, Tokyo, Japan
| | - Takehiko Nakasato
- Department of Urology, Showa University, School of Medicine, Tokyo, Japan
| | - Yoshio Ogawa
- Department of Urology, Showa University, School of Medicine, Tokyo, Japan
| | - Michio Naoe
- Department of Urology, Showa University, School of Medicine, Tokyo, Japan
| | - Takeshi Shichijo
- Department of Urology, Showa University, School of Medicine, Tokyo, Japan
| | - Yoshiko Maeda
- Department of Urology, Showa University, School of Medicine, Tokyo, Japan
| | - Jun Morita
- Department of Urology, Showa University, School of Medicine, Tokyo, Japan
| | - Kazuhiko Oshinomi
- Department of Urology, Showa University, School of Medicine, Tokyo, Japan
| | - Tsutomu Unoki
- Department of Urology, Showa University, School of Medicine, Tokyo, Japan
| | - Tatsuki Inoue
- Department of Urology, Showa University, School of Medicine, Tokyo, Japan
| | - Ryosuke Kato
- Department of Urology, Showa University, School of Medicine, Tokyo, Japan
| | - Madoka Omizu
- Department of Urology, Showa University, School of Medicine, Tokyo, Japan
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72
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Taguchi S, Shiraishi K, Fukuhara H. Updated evidence on oncological outcomes of surgery versus external beam radiotherapy for localized prostate cancer. Jpn J Clin Oncol 2020; 50:963-969. [PMID: 32580211 DOI: 10.1093/jjco/hyaa105] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 05/31/2020] [Indexed: 11/12/2022] Open
Abstract
Radical prostatectomy and external beam radiotherapy are recognized as comparable treatment options for localized prostate cancer. Previous studies of oncological outcomes of surgery versus radiotherapy have reported their comparability or possible superiority of surgery. However, the issue of which treatment is better remains controversial. Several factors make fair comparison of their outcomes difficult: different patient backgrounds caused by selection bias, different definitions of biochemical recurrence and different complication profiles between the treatment modalities. In 2016, the first large randomized controlled trial was published, which compared radical prostatectomy, external beam radiotherapy and active monitoring in localized prostate cancer. More recently, another study has reported comparative outcomes of robot-assisted radical prostatectomy and volumetric modulated arc therapy, as the leading surgery and radiotherapy techniques, respectively. Furthermore, there has been a trend toward combining external beam radiotherapy with brachytherapy boost, especially in patients with high-risk prostate cancer. This review summarizes the updated evidence on oncological outcomes of surgery versus external beam radiotherapy for localized prostate cancer.
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Affiliation(s)
- Satoru Taguchi
- Department of Urology, Kyorin University School of Medicine, Tokyo, Japan
| | - Kenshiro Shiraishi
- Department of Radiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Hiroshi Fukuhara
- Department of Urology, Kyorin University School of Medicine, Tokyo, Japan
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73
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The impact of complications after initial prostate biopsy on repeat protocol biopsy acceptance rate. Results from the Prostate Cancer Research International: Active Surveillance JAPAN study. Int J Clin Oncol 2020; 25:2107-2114. [PMID: 32770439 DOI: 10.1007/s10147-020-01761-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/29/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Patients with favorable-risk prostate cancer on active surveillance (AS) are strictly followed for safer execution. Repeat protocol biopsy is essential for evaluating cancer aggressiveness. However, the acceptance rate of repeat biopsy is not high enough because of the burdens of biopsy. We assessed the impact of complications after the initial biopsy on repeat protocol biopsy at 1 year using data from the Prostate Cancer Research International: Active Surveillance (PRIAS)-JAPAN study. METHODS We performed a retrospective analysis using a prospective cohort in the PRIAS-JAPAN study. Patients with favorable-risk prostate cancer (n = 856) who consented to participate in the PRIAS-JAPAN study from 2010 to 2018 were enrolled. Follow-up evaluations included regular prostate-specific antigen, digital rectal examination and biopsy. Rates of complications after biopsies and repeat protocol biopsy non-acceptance rate at 1 year were reported. Logistic regression analysis explored the association between the complications after the initial biopsy and repeat protocol biopsy non-acceptance. RESULTS Altogether, 759 patients (88.7%) actually proceeded to protocol at 1 year. Repeat protocol biopsy non-acceptance rate at 1 year was 14.9%. Regarding complications after the initial biopsy, hematuria (p = 0.028) and pain (p < 0.001) rates were significantly higher in the repeat biopsy non-acceptance group, but infection (p = 0.056) and hematospermia (p = 0.337) rates were not different. On multivariate logistic regression analysis, pain was a significant predictor for repeat protocol biopsy non-acceptance (odds ratio 4.68, 95% confidence interval 1.864-11.75; p = 0.001). CONCLUSIONS Pain at the initial biopsy negatively impacts patients' compliance with further protocol biopsies during AS.
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74
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Wang J, Lin H, Zhou M, Xiang Q, Deng Y, Luo L, Liu Y, Zhu Z, Zhao Z. The m6A methylation regulator-based signature for predicting the prognosis of prostate cancer. Future Oncol 2020; 16:2421-2432. [PMID: 32687727 DOI: 10.2217/fon-2020-0330] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Aim: To construct a survival prediction signature for prostate cancer (PC) based on the RNA N6-methyladenosine (m6A) methylation regulator. Materials & methods: This paper explores the interaction network of differentially expressed m6A RNA methylation regulators in PC by Pearson correlation analysis. Univariate Cox risk regression and LASSO regression analysis were used to construct a predictive signature of PC. Kaplan-Meier survival analysis compared the overall survival of the high- and low-risk groups. Results & Conclusion: We first constructed a prognostic two gene signature for PC based on the m6A RNA methylation regulators MRTTL14 and YTHDF2. The interaction network of m6A RNA methylation regulators in PC was also established.
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Affiliation(s)
- Jiamin Wang
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, PR China
| | - Han Lin
- Department of Gynecology of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, PR China
| | - Mingda Zhou
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, PR China
| | - Qian Xiang
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, PR China
| | - Yihan Deng
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, PR China
| | - Lianmin Luo
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, PR China
| | - Yangzhou Liu
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, PR China
| | - Zhiguo Zhu
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, PR China
| | - Zhigang Zhao
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, PR China
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75
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Matsuyama H, Matsubara N, Kazama H, Seto T, Tsukube S, Suzuki K. Real-world efficacy and safety of two doses of cabazitaxel (20 or 25 mg/m 2) in patients with castration-resistant prostate cancer: results of a Japanese post-marketing surveillance study. BMC Cancer 2020; 20:649. [PMID: 32660451 PMCID: PMC7359263 DOI: 10.1186/s12885-020-07131-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 07/02/2020] [Indexed: 11/10/2022] Open
Abstract
Background The recommended starting dose of cabazitaxel for castration-resistant prostate cancer (CRPC) is 25 mg/m2 in Japan and Europe. Although lower doses are established alternatives based on randomized controlled trials, the safety and efficacy of 25 and 20 mg/m2 in real-world settings are not well established. Therefore, we investigated the safety and efficacy of cabazitaxel at the recommended starting dose or a lower dose (20 mg/m2) in real-world clinical practice. Methods We compared the safety and efficacy of cabazitaxel between patients who received cabazitaxel at starting doses of 25 and 20 mg/m2 (C25 and C20, respectively) in a Japanese post-marketing surveillance study of 662 patients with docetaxel-refractory CRPC. Safety was assessed in terms of adverse drug reactions (ADRs). Prostate-specific antigen (PSA) response rate, overall survival (OS), and time-to-treatment failure (TTF) were compared between the C25 and C20 groups in unmatched patients and after applying propensity score matching. Results The C20 and C25 groups comprised 190 and 159 patients without matching and 112 patients per group after matching. In unmatched patients, any-grade (C25 vs C20: 89.3% vs 78.4%, Fisher’s p < 0.01) and grade ≥ 3 (81.1% vs 61.1%) ADRs were more frequent in the C25 group. Neutropenia (any grade: 61.6% vs 54.2%; grade ≥ 3: 55.3% vs 42.6%) and febrile neutropenia (grade ≥ 3: 30.2% vs 14.7%) were more frequent in the C25 group. In matched patients, the PSA response rate (reduction in PSA ≥30% from a baseline ≥5 ng/mL) was 26.4 and 32.0% in the C20 and C25 groups, respectively, median OS was 291 days (95% CI 230–not reached) versus not reached (hazard ratio 0.73, 95% CI 0.50–1.08), and TTF favored C25 (hazard ratio 0.75, 95% CI 0.57–0.99). Conclusions Clinicians should consider the patient’s risk of clinically significant ADRs and prophylactic granulocyte colony stimulating factor when selecting the starting dose of cabazitaxel for CRPC. Some patients at high risk of ADRs or unfit patients may benefit from a lower starting dose of 20 mg/m2, whereas fit patients may be candidates for a starting dose of 25 mg/m2. Trial registration Not applicable.
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Affiliation(s)
- Hideyasu Matsuyama
- Department of Urology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan.
| | - Nobuaki Matsubara
- Department of Breast and Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | | | | | - Shoko Tsukube
- Sanofi Genzyme Oncology Medical, Sanofi K.K., Tokyo, Japan.,Medical Affairs, Sanofi K.K., Tokyo, Japan
| | - Kazuhiro Suzuki
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan
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76
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Shimbo M, Endo F, Matsushita K, Hattori K. Impact of indocyanine green‐guided extended pelvic lymph node dissection during robot‐assisted radical prostatectomy. Int J Urol 2020; 27:845-850. [DOI: 10.1111/iju.14306] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 06/04/2020] [Indexed: 01/23/2023]
Affiliation(s)
- Masaki Shimbo
- Department of Urology St. Luke’s International Hospital Tokyo Japan
| | - Fumiyasu Endo
- Department of Urology St. Luke’s International Hospital Tokyo Japan
| | | | - Kazunori Hattori
- Department of Urology St. Luke’s International Hospital Tokyo Japan
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77
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Momota M, Hatakeyama S, Soma O, Tanaka T, Hamano I, Fujita N, Okamoto T, Yoneyama T, Yamamoto H, Imai A, Yoshikawa K, Yoneyama T, Hashimoto Y, Ohyama C. Geriatric 8 screening of frailty in patients with prostate cancer. Int J Urol 2020; 27:642-648. [PMID: 32500621 DOI: 10.1111/iju.14256] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 03/31/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To evaluate the association between the score of the Geriatric 8 screening tool and treatment by disease stages in patients with prostate cancer. METHODS Between January 2017 and June 2019, we prospectively evaluated the Geriatric 8 in 540 prostate cancer patients who were treated with robot-assisted radical prostatectomy, radiotherapy, androgen deprivation therapy alone and standard of care for metastatic hormone-naïve prostate cancer or castration-resistant prostate cancer. The primary purpose was the association between frailty (Geriatric 8 ≤14) and robot-assisted radical prostatectomy, radiotherapy, androgen deprivation therapy alone, and metastatic diseases. Secondary purposes included a comparison of the Geriatric 8 scores among the disease status and the influence of Geriatric 8 score on overall survival. RESULTS The median age was 75 years. Geriatric 8 scores ≤14 were seen in 36% of robot-assisted radical prostatectomy (n = 78/214), 57% of radiotherapy (n = 119/209), 91% of androgen deprivation therapy alone (n = 19/21) and 70% of metastatic diseases (n = 67/96). The median Geriatric 8 score in patients treated with robot-assisted radical prostatectomy, radiotherapy, androgen deprivation therapy alone and metastatic diseases was 15.0, 14.0, 12.0 and 12.8, respectively. The median Geriatric 8 score was significantly higher in the metastatic disease than that in localized disease (14.5 vs 12.8, respectively). Robot-assisted radical prostatectomy patients had a significantly higher Geriatric 8 score than radiotherapy patients, with the cut-off value of <14.5. The overall survival was significantly different between Geriatric 8 scores ≤13 and >13 in metastatic hormone-naïve prostate cancer patients, and between Geriatric 8 scores ≤12 and >12 in castration-resistant prostate cancer patients. CONCLUSION The Geriatric 8 score is significantly associated with treatment by disease stages in patients with prostate cancer.
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Affiliation(s)
- Masaki Momota
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shingo Hatakeyama
- Department of, Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Osamu Soma
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Toshikazu Tanaka
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Itsuto Hamano
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Naoki Fujita
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Teppei Okamoto
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tohru Yoneyama
- Department of, Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hayato Yamamoto
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Atsushi Imai
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | | | - Takahiro Yoneyama
- Department of, Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yasuhiro Hashimoto
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Chikara Ohyama
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of, Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of, Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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78
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Efficacy and safety of apalutamide in Japanese patients with nonmetastatic castration-resistant prostate cancer: a subgroup analysis of a randomized, double-blind, placebo-controlled, Phase-3 study. Prostate Int 2020; 8:190-197. [PMID: 33425798 PMCID: PMC7767934 DOI: 10.1016/j.prnil.2020.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/08/2020] [Accepted: 05/11/2020] [Indexed: 12/03/2022] Open
Abstract
Background In the global Phase-3 Selective Prostate Androgen Receptor Targeting with ARN-509 study, apalutamide plus ongoing androgen deprivation therapy (ADT) significantly increased metastasis-free survival (MFS) and improved other clinical outcomes in men with nonmetastatic castration-resistant prostate cancer (nm-CRPC) who were at high risk of developing metastases. In this subpopulation analysis of Selective Prostate Androgen Receptor Targeting with ARN-509 study, the efficacy and safety of apalutamide plus ADT were evaluated in Japanese patients with nm-CRPC. Methods The primary efficacy end point was MFS. Secondary efficacy end points were time to metastasis, progression-free survival, symptomatic progression, initiation of cytotoxic chemotherapy, and overall survival. Safety and pharmacokinetic parameters were also assessed. Results Fifty-five Japanese patients with ongoing ADT were randomized (apalutamide: n = 34, placebo: n = 21). Median treatment duration was 5.7 months in the apalutamide group and 11.0 months in the placebo group. Median MFS was not reached in the apalutamide group (95% confidence interval: 10.97, not estimable) and was 18.23 months (95% confidence interval: 11.04, 18.50) in the placebo group. Secondary end points were improved in the apalutamide group. The safety profile of apalutamide with ADT was comparable with the global population, and no new safety signals were identified in this Japanese subpopulation. Although, apalutamide exposure tended to be higher in the Japanese subpopulation compared with the non-Japanese population, this was likely to be explained by body weight and considered not clinically meaningful. Conclusion In the Japanese subpopulation, treatment with apalutamide with ADT resulted in favorable efficacy outcomes with comparable benefit-risk profile to the global population with nm-CRPC who are at high-risk of developing metastases.
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79
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Hatakeyama S, Narita S, Takahashi M, Sakurai T, Kawamura S, Hoshi S, Ishida M, Kawaguchi T, Ishidoya S, Shimoda J, Sato H, Hamano I, Okamoto T, Mitsuzuka K, Ito A, Tsuchiya N, Arai Y, Habuchi T, Ohyama C. Association of tumor burden with the eligibility of upfront intensification therapy in metastatic castration‐sensitive prostate cancer: A multicenter retrospective study. Int J Urol 2020; 27:610-617. [DOI: 10.1111/iju.14258] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 04/07/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Shingo Hatakeyama
- Department of Urology Hirosaki University School of Medicine Hirosaki Japan
| | - Shintaro Narita
- Department of Urology Akita University School of Medicine Akita Japan
| | | | - Toshihiko Sakurai
- Department of Urology Yamagata University School of Medicine Yamagata Japan
| | | | - Senji Hoshi
- Department of Urology Yamagata Prefectural Central Hospital Yamagata Japan
| | - Masanori Ishida
- Department of Urology Iwate Prefectural Isawa Hospital Isawa Japan
| | | | | | - Jiro Shimoda
- Department of Urology Iwate Prefectural Isawa Hospital Isawa Japan
| | - Hiromi Sato
- Department of Urology Akita University School of Medicine Akita Japan
| | - Itsuto Hamano
- Department of Urology Hirosaki University School of Medicine Hirosaki Japan
| | - Teppei Okamoto
- Department of Urology Hirosaki University School of Medicine Hirosaki Japan
| | - Koji Mitsuzuka
- Department of Urology Tohoku University School of Medicine Sendai Japan
| | - Akihiro Ito
- Department of Urology Tohoku University School of Medicine Sendai Japan
| | - Norihiko Tsuchiya
- Department of Urology Yamagata University School of Medicine Yamagata Japan
| | - Yoichi Arai
- Department of Urology Miyagi Cancer Center Natori Japan
| | - Tomonori Habuchi
- Department of Urology Akita University School of Medicine Akita Japan
| | - Chikara Ohyama
- Department of Urology Hirosaki University School of Medicine Hirosaki Japan
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Momota M, Hatakeyama S, Soma O, Hamano I, Fujita N, Okamoto T, Togashi K, Hamaya T, Yoneyama T, Yamamoto H, Yoneyama T, Hashimoto Y, Ohyama C. Frailty is a predictor of moderate to severe pain after robot‐assisted laparoscopic prostatectomy: A case‐control study (FRAP study). BJUI COMPASS 2020; 1:100-107. [PMID: 35474865 PMCID: PMC8988788 DOI: 10.1002/bco2.17] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/02/2020] [Accepted: 04/11/2020] [Indexed: 02/06/2023] Open
Abstract
Objective To investigate the association of pain with frailty in patients with localized prostate cancer (PC) who underwent robot‐assisted laparoscopic radical prostatectomy (RARP). Materials and Methods Between January 2017 and June 2019, we prospectively evaluated the geriatric 8 (G8) score, simplified frailty index (sFI), and numerical rating scale (NRS) of 154 patients with localized PC who underwent RARP at our institution. NRS was measured on preoperative day 0, postoperative days 1, 2, 3, and at discharge. Moderate to severe pain was defined as NRS ≥ 5, whereas frailty was defined as G8 ≤ 14. The primary objectives of this study were to investigate the effects of moderate to severe pain (NRS ≥ 5) on frailty, postoperative complications, and the use of analgesics after RARP. Our secondary objectives were the effect of frailty on postoperative complications and the use of analgesics. Results The median age of participants was 69 years. Of 154 patients, 37 (24%) and 61 (40%) were classified to have NRS ≥ 5 and G8 ≤ 14, respectively. Patients with NRS > 5 presented significantly association with G8 < 14, whereas they did not show the association with sFI, complication, or analgesics. Multivariate logistic regression analysis showed that G8 ≤ 14 was significantly associated with NRS ≥ 5. Frailty was not significantly associated with postoperative complications and analgesics. Conclusions Frailty was significantly associated with moderate to severe pain after RARP, and might be a potential predictor of postoperative pain. Frail patients require individual care to avoid painful experiences.
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Affiliation(s)
- Masaki Momota
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Shingo Hatakeyama
- Department of Advanced Blood Purification TherapyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Osamu Soma
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Itsuto Hamano
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Naoki Fujita
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Teppei Okamoto
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Kyo Togashi
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Tomoko Hamaya
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Tohru Yoneyama
- Department of Advanced Transplant and Regenerative MedicineHirosaki University Graduate School of MedicineHirosakiJapan
| | - Hayato Yamamoto
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Takahiro Yoneyama
- Department of Advanced Transplant and Regenerative MedicineHirosaki University Graduate School of MedicineHirosakiJapan
| | - Yasuhiro Hashimoto
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Chikara Ohyama
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
- Department of Advanced Blood Purification TherapyHirosaki University Graduate School of MedicineHirosakiJapan
- Department of Advanced Transplant and Regenerative MedicineHirosaki University Graduate School of MedicineHirosakiJapan
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Yanai Y, Matsumoto K, Kosaka T, Takeda T, Tanaka N, Morita S, Mizuno R, Shinojima T, Asanuma H, Oya M. External validation of the "optimal PSA follow-up schedule after radical prostatectomy" in a new cohort. Int J Clin Oncol 2020; 25:1393-1397. [PMID: 32285217 DOI: 10.1007/s10147-020-01676-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/03/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Biochemical recurrence (BCR) after radical prostatectomy (RP) is most commonly diagnosed by detecting an increase in asymptomatic prostate-specific antigen (PSA). We previously reported the "optimal PSA follow-up schedule after RP". The aim of this study was to confirm the usefulness and safety of that follow-up schedule in another cohort. METHODS We retrospectively reviewed the clinicopathological data of 798 consecutive patients who underwent radical prostatectomy between 2009 and 2017. We examined all PSA values measured during follow-up. Furthermore, we estimated the PSA value when we observed the "optimal PSA follow-up schedule" at each timing in the virtual follow-up. BCR was defined as an elevation of PSA to greater than 0.2 ng/ml, and the ideal PSA range for detection of BCR was regarded to be 0.2-0.4 ng/ml. RESULTS During the mean follow-up period of 5.8 years, BCR occurred in 115 (14.9%) patients and the frequency of virtual follow-up was significantly lower than the actual frequency. However, overlooking of BCR (detecting BCR when PSA exceeded 0.4 ng/ml) was observed in 17 patients, which is higher than the actual frequency of overlooking (12 patients). Therefore, we modified the follow-up schedule, which could achieve the lower follow-up frequency and a limited number of overlooking of BCR (7 patients). CONCLUSION This external validation study revealed that the "modified optimal PSA follow-up schedule after RP" can reduce the frequency of PSA measurement with a limited risk of overlooking BCR.
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Affiliation(s)
- Yoshinori Yanai
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuhiro Matsumoto
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Takeo Kosaka
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Toshikazu Takeda
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Nobuyuki Tanaka
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shinya Morita
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ryuichi Mizuno
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Toshiaki Shinojima
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hiroshi Asanuma
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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Matsubara N, Suzuki K, Kazama H, Tsukube S, Seto T, Matsuyama H. Cabazitaxel in patients aged ≥80 years with castration-resistant prostate cancer: Results of a post-marketing surveillance study in Japan. J Geriatr Oncol 2020; 11:1067-1073. [PMID: 32198082 DOI: 10.1016/j.jgo.2020.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/23/2020] [Accepted: 02/26/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Data on the safety and efficacy of cabazitaxel in patients aged ≥80 years with castration-resistant prostate cancer (CRPC) are limited. We report the safety (adverse drug reactions [ADRs]) and efficacy (overall survival [OS], time to treatment failure [TTF], and prostate-specific antigen [PSA] response rates) in patients aged <80 or ≥80 years treated with cabazitaxel for CRPC in clinical practice. MATERIALS AND METHODS We performed post-hoc subgroup analyses of a Japanese post-marketing surveillance study involving 662 patients with CRPC treated with cabazitaxel between September 2014 and June 2016. RESULTS In patients aged <80 (n = 610) and ≥80 years (n = 49), median PSA at baseline was 168.7 and 109.0 ng/mL, and 86.7% and 83.7% of patients were previously treated with enzalutamide and/or abiraterone. ADRs (all grade) occurred in 77.2% and 79.6% of patients aged <80 and ≥80 years, with grade three/worse ADRs in 61.8% and 63.3% of patients. Hematologic toxicities were the most common grade three/worse ADRs, including neutropenia, febrile neutropenia, and anemia in both subgroups. No specific ADRs were observed in patients aged ≥80 years. The PSA response and median OS and TTF were 28.3%, 292 days, and 116 days in patients aged ≥80 years, and 29.7%, 319 days, and 125 days in patients aged <80 years. CONCLUSION Cabazitaxel could be a treatment option for CRPC in patients aged ≥80 years based on its safety and efficacy profiles. This is the first report to investigate the safety and efficacy of cabazitaxel in patients aged ≥80 years with CRPC.
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Affiliation(s)
- Nobuaki Matsubara
- Department of Breast and Medical Oncology, National Cancer Center Hospital East, Chiba, Japan.
| | - Kazuhiro Suzuki
- Department of Urology, Graduate School of Medicine, Gunma University, Gunma, Japan
| | | | | | | | - Hideyasu Matsuyama
- Department of Urology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
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83
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Kato T, Sugimoto M. Quality of life in active surveillance for early prostate cancer. Int J Urol 2020; 27:296-306. [PMID: 32141110 DOI: 10.1111/iju.14202] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 01/20/2020] [Indexed: 01/06/2023]
Abstract
Recently, the prevalence of the prostate-specific antigen screening test for early-stage prostate cancer has increased, but this has also resulted in an increase in insignificant cancers. The treatment outcome of early-stage prostate cancer is excellent, but such a radical treatment also leaves the patient with undesired adverse consequences. To resolve such problems, attention should be paid to active surveillance as a modern treatment option. This study aimed to systematically review the literature about quality of life in prostate cancer patients undergoing active surveillance. Evidence was acquired from PubMed databases in March 2019 using quality of life, prostate cancer, well-being, anxiety, depression, stress, outcomes, active surveillance, radiation therapy and radical prostatectomy as keywords. Five clinical active surveillance studies measured health-related quality of life and related psychological factors, and seven compared active surveillance with other treatments (radical therapy and hormone therapy). Active surveillance was superior to radical therapy for urinary and sexual function. Furthermore, most patients who opted for active surveillance showed lower anxiety and fear of progression, whereas health-related quality of life was maintained. Although active surveillance has the advantage of being non-invasive, its diagnosis and follow-up protocols are unreliable. Because such uncertainty can affect patients' quality of life, utilization of imaging modalities, such as magnetic resonance imaging, and the development of new biomarkers are required.
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Affiliation(s)
- Takuma Kato
- Department of Urology, Faculty of Medicine, Kagawa University, Kita-gun, Kagawa, Japan
| | - Mikio Sugimoto
- Department of Urology, Faculty of Medicine, Kagawa University, Kita-gun, Kagawa, Japan
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84
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Suzuki K, Matsubara N, Kazama H, Seto T, Tsukube S, Matsuyama H. Safety and efficacy of cabazitaxel in 660 patients with metastatic castration-resistant prostate cancer in real-world settings: results of a Japanese post-marketing surveillance study. Jpn J Clin Oncol 2020; 49:1157-1163. [PMID: 31361807 PMCID: PMC6933873 DOI: 10.1093/jjco/hyz108] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/24/2019] [Accepted: 06/26/2019] [Indexed: 01/04/2023] Open
Abstract
Objective To evaluate the real-world safety and efficacy of cabazitaxel in Japanese patients with metastatic castration-resistant prostate cancer (mCRPC) previously treated with a docetaxel-containing regimen. Methods This prospective multicenter observational study registered all patients with mCRPC treated with cabazitaxel following its launch in Japan in September 2014. Patient enrollment continued until at least 500 patients were enrolled. Adverse drug reactions (ADRs) were evaluated according to CTCAE ver. 4.0. Efficacy endpoints were assessed for up to 1 year, and included prostate specific antigen (PSA) response rates (defined as a decrease of ≥30% or ≥50% from baseline), overall survival (OS), and time to treatment failure (TTF). Results A total of 660 mCRPC patients were enrolled across 316 centers by June 2016. Frequent ADRs (any grade) were neutropenia (49.1%), febrile neutropenia (18.0%) and anemia (15.0%). Most ADRs occurred in cycle 1. Neutropenia and febrile neutropenia were significantly less frequent in patients who received prophylactic granulocyte colony-stimulating factor. The PSA response rates for decrease of ≥30% or ≥50% from baseline were 28.1% and 17.5%, respectively, in patients with baseline PSA of ≥5 ng/ml. Median OS and TTF were 319 days (95% confidence interval: 293.0–361.0) and 116 days (95% confidence interval: 108.0–135.0), respectively. Conclusions This study of cabazitaxel in 660 Japanese patients treated in real-world settings, the largest study of cabazitaxel to date, demonstrated a safety profile that was generally consistent with those of pivotal clinical studies. Cabazitaxel was also effective in terms of the PSA response, OS, and TTF.
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Affiliation(s)
| | - Nobuaki Matsubara
- Department of Breast and Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
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85
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Miyoshi Y, Morizane S, Honda M, Hikita K, Iwamoto H, Yumioka T, Kimura Y, Yoshioka SI, Takenaka A. Health Related Quality of Life in Japanese Patients with Localized Prostate Cancer: Comparative Retrospective Study of Robot-Assisted Laparoscopic Radical Prostatectomy Versus Radiation Therapy. Yonago Acta Med 2020; 63:55-62. [PMID: 32158334 DOI: 10.33160/yam.2020.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 01/17/2020] [Indexed: 11/05/2022]
Abstract
Background Radical prostatectomy and radiotherapy are standard treatments for localized prostate cancer. When making decisions about treatment, it is important to not only consider medical information such as the patient's age, performance status, and complications, but also the impact on quality of life (QOL) after treatment. Our purpose was to compare health related quality of life (HRQOL) after robot-assisted laparoscopic radical prostatectomy (RARP) versus radiation therapy in Japanese patients with localized prostate cancer retrospectively. Methods Patients with localized prostate cancer receiving RARP or radiotherapy at Tottori University Hospital between October 2010 and December 2014 were enrolled in a retrospective observational study with follow-up for 24 months to December 2016. The Medical Outcome Study 8-Item Short-Form Health Survey was performed before treatment and 1, 3, 6, 12, and 24 months post-treatment. Results Complete responses to the questionnaire were obtained from 154/227 patients receiving RARP, 41/67 patients receiving intensity-modulated radiation therapy, 35/82 patients receiving low dose rate brachytherapy, and 18/28 patients given low dose rate brachytherapy plus external beam radiation therapy. The median physical component summary score of the Medical Outcome Study 8-Item Short-Form Health Survey was significantly lower at 1 month after prostatectomy than radiotherapy, but was similar for both treatments at 3 months, and was significantly higher at 6, 12 and 24 months after prostatectomy. The median mental component summary score was also significantly lower in the prostatectomy group at 1 month, but not from 3 months onwards. Conclusion Our study suggested that HRQOL was inferior at 1 month after RARP, however, recovered at 3 months after RARP and was better than after radiotherapy at 6, 12, and 24 months.
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Affiliation(s)
- Yoko Miyoshi
- Department of Adult and Elderly Nursing, School of Health Science, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | - Shuichi Morizane
- Department of Urology, Tottori University Hospital, Yonago 683-8504, Japan
| | - Masashi Honda
- Division of Urology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | - Katsuya Hikita
- Department of Urology, Tottori University Hospital, Yonago 683-8504, Japan
| | - Hideto Iwamoto
- Division of Urology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | - Tetsuya Yumioka
- Department of Urology, Matsue City Hospital, Matsue 690-8509, Japan
| | - Yusuke Kimura
- Division of Urology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | - Shin-Ichi Yoshioka
- Department of Nursing Care Environment and Mental Health, School of Health Science, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | - Atsushi Takenaka
- Division of Urology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
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86
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Suzuki H, Jinnouchi S, Kaji Y, Kishida T, Kinoshita H, Yamaguchi S, Tobe T, Okamura T, Kawakita M, Furukawa J, Otaka A, Kakehi Y. Diagnostic performance of 18F-fluciclovine PET/CT for regional lymph node metastases in patients with primary prostate cancer: a multicenter phase II clinical trial. Jpn J Clin Oncol 2019; 49:803-811. [PMID: 31095314 DOI: 10.1093/jjco/hyz072] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 03/25/2019] [Accepted: 04/25/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE This multicenter, phase II clinical trial evaluated the diagnostic performance of 18F-fluciclovine, a novel amino acid for positron-emission tomography (PET), for detection of small lymph node metastases with short-axis diameters of 5-10 mm in patients with prostate cancer. METHODS Patients with prostate cancer were eligible after screening of laboratory tests and pelvic contrast-enhanced computed tomography (CT). Pelvic region 18F-fluciclovine PET/CT was then acquired within 28 days and dissection of regional lymph nodes was performed within 60 days of pelvic contrast-enhanced CT. Diagnostic performance of 18F-fluciclovine-PET/CT was evaluated by comparison with standard histopathology of lymph nodes. RESULTS In a total of 28 patients, 40 regional lymph nodes with short-axis diameters of 5-10 mm were eligible for efficacy evaluation; seven of these showed metastases confirmed by histopathology. The sensitivity of 18F-fluciclovine PET/CT was 57.1% (4/7). All four true positive lymph nodes detected by 18F-fluciclovine PET/CT had a metastatic lesion with a long-axis diameter of ≥7 mm and a high proportion of cancer volume (60-100%) according to pathology evaluation. The specificity, diagnostic accuracy, positive predictive value, and negative predictive value of 18F-fluciclovine PET/CT in lymph node-based analysis were 84.8% (28/33), 80.0% (32/40), 44.4% (4/9), and 90.3% (28/31), respectively. No clinically significant adverse events occurred. CONCLUSIONS 18F-fluciclovine PET/CT detected small lymph node metastases; however it also showed positive findings in benign lymph nodes. Refinement of the image assessment criteria may improve the diagnostic performance of 18F-fluciclovine PET/CT for small lymph node metastases in patients with prostate cancer.
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Affiliation(s)
- Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, Sakura, Japan
| | | | - Yasushi Kaji
- Department of Radiology, Dokkyo Medical University, Shimotuga-gun, Japan
| | - Takeshi Kishida
- Department of Urology, Kanagawa Cancer Center, Yokohama, Japan
| | - Hidefumi Kinoshita
- Department of Urology and Andrology, Kansai Medical University, Hirakata, Japan
| | - Seiji Yamaguchi
- Department of Urology, Osaka General Medical Center, Osaka, Japan
| | - Toyofusa Tobe
- Department of Urology, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan
| | | | - Mutsushi Kawakita
- Department of Urology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Junya Furukawa
- Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akiharu Otaka
- Clinical Development Department, Nihon Medi-Physics Co., Ltd, Koto-ku, Japan
| | - Yoshiyuki Kakehi
- Department of Urology, Kagawa University Faculty of Medicine, Kita-gun, Kagawa, Japan
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87
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A randomized, double-blind, comparison of radium-223 and placebo, in combination with abiraterone acetate and prednisolone, in castration-resistant metastatic prostate cancer: subgroup analysis of Japanese patients in the ERA 223 study. Int J Clin Oncol 2019; 25:720-731. [DOI: 10.1007/s10147-019-01589-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 11/24/2019] [Indexed: 01/08/2023]
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88
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Shah R, Botteman M, Waldeck R. Treatment characteristics for nonmetastatic castration-resistant prostate cancer in the United States, Europe and Japan. Future Oncol 2019; 15:4069-4081. [DOI: 10.2217/fon-2019-0563] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: We conducted this study to describe nonmetastatic castration-resistant prostate cancer (nmCRPC) patient characteristics and treatment patterns in the US, Europe and Japan. Materials & methods: Descriptive analyses were conducted using the 2015–2017 Ipsos Global Oncology Monitor Database. Results: A total of 2065 (442 in the US, 509 in Europe and 1114 in Japan) patients (median age: 74–80 years; stage III at diagnosis : 38.5%; Eastern Cooperative Oncology Group [ECOG] score ≤1: 79.4%; treated by urologist : 88.4%) were included in the analytic cohort. Luteinizing hormone-releasing hormone agonists and antiandrogens were the most commonly used first regimen treatments. With subsequent nmCRPC regimens their use decreased, while the use of chemotherapy, corticosteroids, androgen synthesis inhibitors and second-generation androgen receptor inhibitors increased. Conclusion: These data represent real-world treatment patterns in nmCRPC.
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89
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Taguchi S, Shiraishi K, Fujimura T, Naito A, Kawai T, Nakagawa K, Abe O, Kume H, Fukuhara H. Robot-assisted radical prostatectomy versus volumetric modulated arc therapy: Comparison of front-line therapies for localized prostate cancer. Radiother Oncol 2019; 140:62-67. [DOI: 10.1016/j.radonc.2019.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 05/11/2019] [Accepted: 05/13/2019] [Indexed: 11/17/2022]
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90
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Okamoto T, Hatakeyama S, Narita S, Arai Y, Habuchi T, Ohyama C. Validation and development of the CHAARTED criteria in patients with hormone-naïve metastatic prostate cancer: A multi-institutional retrospective study in Japan. Int J Urol 2019; 27:90-91. [PMID: 31617248 DOI: 10.1111/iju.14136] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Teppei Okamoto
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan
| | - Shintaro Narita
- Department of Urology, Akita University School of Medicine, Akita, Japan
| | - Yoichi Arai
- Department of Urology, Miyagi Cancer Center, Natori, Miyagi, Japan
| | - Tomonori Habuchi
- Department of Urology, Akita University School of Medicine, Akita, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan
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91
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Factors contributing to the ceiling effect of the EQ-5D-5L: an analysis of patients with prostate cancer judged "no-problems". Qual Life Res 2019; 29:755-763. [PMID: 31583618 PMCID: PMC7028791 DOI: 10.1007/s11136-019-02316-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2019] [Indexed: 11/22/2022]
Abstract
Purpose The goal of the present study was to determine factors related to a ceiling effect (CE) on the EQ-5D-5L among Japanese patients with prostate cancer (PC). Methods An existent cross-sectional observational study dataset was used. Patients were ≥ 20 years of age and diagnosed with PC. For CE determinants on the EQ-5D-5L, we excluded possible “full-health” patients flagged by the EQ-VAS (score = 100) and/or FACT-P (score = 156) instruments. We then divided them into binary variables: A CE group (EQ-5D-5L score = 1) and others (< 1). The associations between CE, sociodemographic and medical characteristics, and FACT-P subscale scores were examined using a multivariate LASSO selection followed by a binomial logistic regression analysis performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results A total of 362 patients were analyzed. The LASSO selection variables, including all obtained variables, were as follows: age, palliative treatment, FACT-P physical well-being, and PC subscale score. Statistically significant variables predicting CE were palliative treatment (OR 0.23; 95% CI 0.09–0.60), physical well-being (OR 1.54; 95% CI 1.34–1.76), and PC subscale (OR 1.08; 95% CI 1.03–1.14). Conclusions This study revealed that palliative treatment and two FACT-P physical well-being and PC subscale scores were positively related to CE on the EQ-5D-5L. To our knowledge, this is the first study to examine predictors of CE on the EQ-5D-5L. The present results may be helpful for facilitating the consideration of “bolt-on” studies from the standpoint of PC patients.
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92
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Iguchi T, Tamada S, Kato M, Yasuda S, Machida Y, Ohmachi T, Ishii K, Iwata H, Yamamoto S, Kanamaru T, Morimoto K, Hase T, Tashiro K, Harimoto K, Deguchi T, Adachi T, Iwamoto K, Takegaki Y, Nakatani T. Enzalutamide versus flutamide for castration-resistant prostate cancer after combined androgen blockade therapy with bicalutamide: the OCUU-CRPC study. Int J Clin Oncol 2019; 25:486-494. [PMID: 31564004 DOI: 10.1007/s10147-019-01554-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 09/20/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Before the androgen target therapy era, flutamide was widely used for castration-resistant prostate cancer in Japan. Enzalutamide is currently the recommended treatment; however, the efficacy and safety of enzalutamide and flutamide after combined androgen blockade therapy with bicalutamide, has not been compared. METHODS Patients with castration-resistant prostate cancer who received combined androgen blockade therapy with bicalutamide were randomly assigned to receive either enzalutamide or flutamide. The primary endpoint for efficacy was the 3-month prostate-specific antigen response rate. This trial is registered with ClinicalTrials.gov (NCT02346578) and the University hospital Medical Information Network (UMIN000016301). RESULTS Overall, 103 patients were enrolled. The 3- (80.8% vs. 35.3%; p < 0.001) and 6-month (73.1% vs. 31.4%; p < 0.001) prostate-specific antigen response rates were higher in the enzalutamide than in the flutamide group. The 3-month disease progression rates (radiographic or prostate-specific antigen progression) were 6.4% and 38.8% in the enzalutamide and flutamide groups, respectively [hazard ratio (HR): 0.16; 95% confidence interval (CI): 0.05-0.47; p < 0.001]; the 6-month rates were 11.4% and 51.1%, respectively (HR 0.22; 95% CI 0.09-0.50; p < 0.001). Enzalutamide provided superior prostate-specific antigen progression-free survival compared with flutamide (HR 0.29; 95% CI 0.15-0.54; p < 0.001). Median time to prostate-specific antigen progression-free survival was not reached and was 6.6 months in the enzalutamide and flutamide groups, respectively. CONCLUSIONS As an alternative anti-androgen therapy in patients with castration-resistant prostate cancer who fail bicalutamide-combined androgen blockade therapy, enzalutamide provides superior clinical outcomes compared with flutamide. Enzalutamide should be preferred over flutamide in these patients.
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Affiliation(s)
- Taro Iguchi
- Department of Urology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
| | - Satoshi Tamada
- Department of Urology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Minoru Kato
- Department of Urology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Sayaka Yasuda
- Department of Urology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Yuichi Machida
- Department of Urology, Yao Municipal Hospital, Yao, Japan
| | - Tetsuji Ohmachi
- Department of Urology, Bell-land General Hospital, Sakai, Japan
| | - Keiichi Ishii
- Department of Urology, Osaka City General Hospital, Osaka, Japan
| | - Hiroyuki Iwata
- Department of Urology, Itami City Hospital, Itami, Japan
| | - Shinji Yamamoto
- Department of Urology, Ikuwakai Memorial Hospital, Osaka, Japan
| | | | - Kazuya Morimoto
- Department of Urology, Osaka General Hospital of West Japan Railway Company, Osaka, Japan
| | - Taro Hase
- Department of Urology, Suita Municipal Hospital, Suita, Japan
| | | | | | | | - Takahisa Adachi
- Department of Urology, Osaka City Juso Hospital, Osaka, Japan
| | - Katsuki Iwamoto
- Department of Urology, Ishikiriseiki Hospital, Higashiosaka, Japan
| | | | - Tatsuya Nakatani
- Department of Urology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
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93
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Okita K, Hatakeyama S, Narita S, Takahashi M, Sakurai T, Kawamura S, Hoshi S, Ishida M, Kawaguchi T, Ishidoya S, Shimoda J, Sato H, Mitsuzuka K, Ito A, Tsuchiya N, Arai Y, Habuchi T, Ohyama C. The Effect of Treatment Sequence on Overall Survival for Men With Metastatic Castration-resistant Prostate Cancer: A Multicenter Retrospective Study. Clin Genitourin Cancer 2019; 18:e103-e111. [PMID: 31810867 DOI: 10.1016/j.clgc.2019.09.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 08/29/2019] [Accepted: 09/10/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION We aimed to evaluate the treatment sequence for patients with metastatic castration-resistant prostate cancer (mCRPC) in real-world practice and compare overall survival in each sequential therapy. PATIENTS AND METHODS We retrospectively evaluated 146 patients with mCRPC who were initially treated with androgen deprivation therapy as metastatic hormone-naive prostate cancer in 14 hospitals between January 2010 and March 2019. The agents for the sequential therapy included new androgen receptor-targeted agents (ART: abiraterone acetate or enzalutamide), docetaxel, and/or cabazitaxel. We evaluated the treatment sequence for mCRPC and the effect of sequence patterns on overall survival. RESULTS The median age was 71 years. A total of 35 patients received ART-ART, 33 received ART-docetaxel, 68 received docetaxel-ART, and 10 received docetaxel-cabazitaxel sequences. The most prescribed treatment sequence was docetaxel-ART (47%), followed by ART-ART (24%). Overall survival calculated from the initial diagnosis reached 83, 57, 79, and 37 months in the ART-ART, ART-docetaxel, docetaxel-ART, and docetaxel-cabazitaxel, respectively. Multivariate Cox regression analyses showed no significant difference in overall survival between the first-line ART (n = 68) and first-line docetaxel (n = 78) therapies (hazard ratio [HR], 0.84; P = .530), between the ART-ART (n = 35) and docetaxel-mixed (n = 111) sequences (HR, 0.82; P = .650), and between the first-line abiraterone (n = 32) and first-line enzalutamide (n = 36) sequences (HR, 1.58; P = .384). CONCLUSION The most prescribed treatment sequence was docetaxel followed by ART. No significant difference was observed in overall survival among the treatment sequences in real-world practice.
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Affiliation(s)
- Kazutaka Okita
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan.
| | - Shintaro Narita
- Department of Urology, Akita University School of Medicine, Hondo, Akita, Japan
| | - Masahiro Takahashi
- Department of Urology, Tohoku University School of Medicine, Aoba-ku, Sendai, Miyagi, Japan
| | - Toshihiko Sakurai
- Department of Urology, Yamagata University School of Medicine, Yamagata, Yamagata, Japan
| | - Sadafumi Kawamura
- Department of Urology, Miyagi Cancer Center, Shiote, Aijima, Natori, Miyagi, Japan
| | - Senji Hoshi
- Department of Urology, Yamagata Prefectural Central Hospital, Aoyanagi, Yamagata, Japan
| | - Masanori Ishida
- Department of Urology, Iwate Prefectural Isawa Hospital, Ryugabaab, Mizusawa-ku, Oshu, Iwate, Japan
| | - Toshiaki Kawaguchi
- Department of Urology, Aomori Prefectural Central Hospital, Higashi-tsukurimichi, Aomori, Aomori, Japan
| | - Shigeto Ishidoya
- Department of Urology, Sendai City Hospital, Nagamachi, Asuto, Taihaku-ku, Sendai, Miyagi, Japan
| | - Jiro Shimoda
- Department of Urology, Iwate Prefectural Isawa Hospital, Ryugabaab, Mizusawa-ku, Oshu, Iwate, Japan
| | - Hiromi Sato
- Department of Urology, Akita University School of Medicine, Hondo, Akita, Japan
| | - Koji Mitsuzuka
- Department of Urology, Tohoku University School of Medicine, Aoba-ku, Sendai, Miyagi, Japan
| | - Akihiro Ito
- Department of Urology, Tohoku University School of Medicine, Aoba-ku, Sendai, Miyagi, Japan
| | - Norihiko Tsuchiya
- Department of Urology, Yamagata University School of Medicine, Yamagata, Yamagata, Japan
| | - Yoichi Arai
- Department of Urology, Miyagi Cancer Center, Shiote, Aijima, Natori, Miyagi, Japan
| | - Tomonori Habuchi
- Department of Urology, Akita University School of Medicine, Hondo, Akita, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan
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94
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Kodama H, Hatakeyama S, Narita S, Takahashi M, Sakurai T, Kawamura S, Hoshi S, Ishida M, Kawaguchi T, Ishidoya S, Shimoda J, Narita T, Sato H, Mitsuzuka K, Tochigi T, Tsuchiya N, Arai Y, Habuchi T, Ohyama C. Clinical Characterization of Low Prostate-specific Antigen on Prognosis in Patients With Metastatic Castration-naive Prostate Cancer. Clin Genitourin Cancer 2019; 17:e1091-e1098. [PMID: 31575477 DOI: 10.1016/j.clgc.2019.05.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/19/2019] [Accepted: 05/20/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION This study aimed to investigate the effect of low prostate-specific antigen (PSA) on prognosis, as the association of initial PSA level with prognosis in patients with metastatic castration-naive prostate cancer (mCNPC) remains unclear. PATIENTS AND METHODS We evaluated 575 patients with mCNPC from 10 hospitals. Patients were stratified into 2 groups according to their initial PSA: PSA < 100 and PSA ≥ 100 groups. We compared castration-resistant prostate cancer (CRPC)-free survival, overall survival (OS), and OS from the CRPC diagnosis between the groups. Multivariate Cox regression analysis was performed to evaluate the effect of initial PSA level on prognosis. RESULTS Of the 575 patients, 196 (34%) patients belonged to the PSA < 100 group. No significant difference was found in patients' backgrounds except for PSA, the extent of disease, and high tumor burden between the groups. CRPC-free survival was significantly shorter in the PSA ≥ 100 group than in the PSA < 100 group. However, the OS after CRPC diagnosis was significantly shorter in the PSA < 100 group than that of the PSA ≥ 100 group. Multivariate analyses showed that PSA < 100 ng/mL was an independent factor for OS after CRPC, whereas no significant association was observed in the CRPC-free survival and OS. CONCLUSIONS A significant effect of initial PSA < 100 ng/mL on OS after CRPC was observed. PSA < 100 ng/mL might be a poor prognostic factor in patients with mCNPC after CRPC.
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Affiliation(s)
- Hirotake Kodama
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan.
| | - Shintaro Narita
- Department of Urology, Akita University School of Medicine, Akita, Japan
| | - Masahiro Takahashi
- Department of Urology, Tohoku University School of Medicine, Aoba-ku, Sendai, Miyagi, Japan
| | - Toshihiko Sakurai
- Department of Urology, Yamagata University School of Medicine, Yamagata, Yamagata, Japan
| | - Sadafumi Kawamura
- Department of Urology, Miyagi Cancer Center, Shiote, Aijima, Natori, Miyagi, Japan
| | - Senji Hoshi
- Department of Urology, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Masanori Ishida
- Department of Urology, Iwate Prefectural Isawa Hospital, Mizusawa-ku, Oshu, Iwate, Japan
| | - Toshiaki Kawaguchi
- Department of Urology, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Shigeto Ishidoya
- Department of Urology, Sendai City Hospital, Asuto, Taihaku-ku, Sendai, Miyagi, Japan
| | - Jiro Shimoda
- Department of Urology, Iwate Prefectural Isawa Hospital, Mizusawa-ku, Oshu, Iwate, Japan
| | - Takuma Narita
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan
| | - Hiromi Sato
- Department of Urology, Akita University School of Medicine, Akita, Japan
| | - Koji Mitsuzuka
- Department of Urology, Tohoku University School of Medicine, Aoba-ku, Sendai, Miyagi, Japan
| | - Tatsuo Tochigi
- Department of Urology, Miyagi Cancer Center, Shiote, Aijima, Natori, Miyagi, Japan
| | - Norihiko Tsuchiya
- Department of Urology, Yamagata University School of Medicine, Yamagata, Yamagata, Japan
| | - Yoichi Arai
- Department of Urology, Miyagi Cancer Center, Shiote, Aijima, Natori, Miyagi, Japan
| | - Tomonori Habuchi
- Department of Urology, Akita University School of Medicine, Akita, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan
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95
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Suzuki H, Uemura H, Mizokami A, Hayashi N, Miyoshi Y, Nagamori S, Enomoto Y, Akaza H, Asato T, Kitagawa T, Suzuki K. Phase I trial of TAK-385 in hormone treatment-naïve Japanese patients with nonmetastatic prostate cancer. Cancer Med 2019; 8:5891-5902. [PMID: 31429205 PMCID: PMC6792482 DOI: 10.1002/cam4.2442] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/12/2019] [Accepted: 07/12/2019] [Indexed: 01/24/2023] Open
Abstract
This open‐label, phase I dose‐finding study evaluated the gonadotropin‐releasing hormone antagonist, TAK‐385, in Japanese patients with nonmetastatic prostate cancer. In a two‐part design, patients received daily oral TAK‐385 at doses of 320 (loading, day 1)/80 (maintenance, day 2 and thereafter), 320/120, 320/160, or 360/120 mg for 28 days in a dose‐escalation phase (part A, n = 13), and at 320/80 or 320/120 mg for up to 96 weeks in a randomized expansion phase (part B, n = 30). Primary endpoint in both parts was safety, including dose‐limiting toxicity in part A. Secondary endpoints included pharmacokinetics, pharmacodynamics, and prostate‐specific antigen concentration. Ten (77%) patients in part A and all patients in part B experienced an adverse event; hot flush (part A, n = 4; part B, n = 15), viral upper respiratory tract infection (part A, n = 1; part B, n = 10), and diarrhea (part B, n = 8) were most frequent. No dose‐limiting toxicities were observed (part A). In 12 evaluable patients (part A), TAK‐385 was rapidly absorbed after a single loading dose; on day 28 (maintenance dose), median steady‐state Tmax was ~1‐2 hours and mean t1/2z was 67‐79 hours. All doses rapidly reduced testosterone concentrations to castration levels within 1 week. Durable reductions in prostate‐specific antigen of >90% from baseline were observed through 96 weeks. TAK‐385 appeared tolerable and resulted in sustained reductions in testosterone to castration levels at all doses. The lowest loading/maintenance dose required for a clinical effect was 320/80 mg. http://ClinicalTrials.gov: NCT02141659.
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Affiliation(s)
- Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, Chiba, Japan
| | - Hiroji Uemura
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Atsushi Mizokami
- Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Narihiko Hayashi
- Department of Urology, Public University Corporation Yokohama City University Hospital, Yokohama, Japan
| | - Yasuhide Miyoshi
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Satoshi Nagamori
- Department of Urology, Incorporated Administrative Agency National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | - Yutaka Enomoto
- Department of Urology, Mitsui Memorial Hospital, Tokyo, Japan
| | - Hideyuki Akaza
- Department of Strategic Investigation on Comprehensive Cancer Network, Interfaculty Initiative in Information Studies/Graduate School of Interdisciplinary Information Studies, The University of Tokyo, Tokyo, Japan
| | - Takayuki Asato
- Oncology Clinical Research Department, Oncology Therapeutic Area Unit for Japan and Asia, Takeda Pharmaceutical Company Limited, Osaka, Japan
| | - Tadayuki Kitagawa
- Japan Development Center, Takeda Pharmaceutical Company Limited, Osaka, Japan
| | - Kazuhiro Suzuki
- Department of Urology, Graduate School of Medicine, National University Corporation Gunma University, Maebashi, Japan
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96
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Lee HY, Kim DK, Doo SW, Yang WJ, Song YS, Lee B, Kim JH. Time Trends for Prostate Cancer Incidence from 2003 to 2013 in South Korea: An Age-Period-Cohort Analysis. Cancer Res Treat 2019; 52:301-308. [PMID: 31401823 PMCID: PMC6962480 DOI: 10.4143/crt.2019.194] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/28/2019] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Prostate cancer (PCa) incidence is affected by aging phenomenon and performance of screening test. In United States, PCa incidence is affected by period effect of U.S. Preventive Services Task Force (USPSTF) recommendation. However, no study has reported the effect of USPSTF recommendation or aging phenomenon on PCa incidence in South Korea. Thus, the objective of this study was to investigate effects of age, period, and birth cohort on PCa incidence using age-period-cohort analysis. Materials and Methods Annual report of cancer statistics between 2003 and 2013 from National Health Insurance Service (NHIS) in South Korea for the number of PCa patients and Korean Statistical Information Service (KOSIS) data between 2003 and 2013 from national statistics in South Korea for the number of Korean male population were used. Age-period-cohort models were used to investigate effects of age, period, and birth cohort on PCa incidence. RESULTS Overall PCa incidence in South Korea was increased 8.8% in annual percentage (95% confidential interval, 6.5 to 11.2; p < 0.001). It showed an increasing pattern from 2003 to 2011 but a decreasing pattern from 2011 to 2013. Age increased the risk of PCa incidence. However, the speed of increase was slower with increasing age. PCa incidence was increased 1.4 times in 2008 compared to that in 2003 or 2013. Regarding cohort effect, the risk of PCa incidence started to increase from 1958 cohort. CONCLUSION PCa incidence was affected by period of specific year. There was a positive cohort effect on PCa incidence associated with age structural change.
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Affiliation(s)
- Hyun Young Lee
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Do Kyoung Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Bora Lee
- Department of Statistics, Graduate School of Chung-Ang University, Seoul, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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97
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Ito K, Oki R, Sekine Y, Arai S, Miyazawa Y, Shibata Y, Suzuki K, Kurosawa I. Screening for prostate cancer: History, evidence, controversies and future perspectives toward individualized screening. Int J Urol 2019; 26:956-970. [PMID: 31183923 DOI: 10.1111/iju.14039] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 05/15/2019] [Indexed: 12/12/2022]
Abstract
Differences in the incidence and mortality rate of prostate cancer between the USA and Japan have been decreasing over time, and were only twofold in 2017. Therefore, countermeasures against prostate cancer could be very important not only in Western countries, but also in developed Asian countries. Screening for prostate cancer in the general population using transrectal ultrasonography, digital rectal examination and/or prostate acid phosphatase began in Japan in the early 1980s, and screening with prostate-specific antigen and digital rectal examination has been widespread in the USA since the late 1980s. Large- and mid-scale randomized controlled trials on screening for prostate cancer began around 1990 in the USA, Canada and Europe. However, most of these studies failed as randomized controlled trials because of high contamination in the control arm, low compliance in the screening arm or insufficient screening setting about screening frequency and/or biopsy indication. The best available level 1 evidence is data from the European Randomized Study of Screening for Prostate Cancer and the Göteborg screening study. However, several non-urological organizations and lay media around the world have mischaracterized the efficacy of prostate-specific antigen screening. To avoid long-term confusion about screening for prostate cancer, leading professional urological organizations, including the Japanese Urological Association, are moving toward the establishment of an optimal screening system that minimizes the drawbacks of overdetection, overtreatment and loss of quality of life due to treatment, and maximizes reductions in the risk of death as a result of prostate cancer and the development of metastatic prostate cancer.
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Affiliation(s)
- Kazuto Ito
- Institute for Preventive Medicine, Kurosawa Hospital, Takasaki, Gunma, Japan.,Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Ryo Oki
- Institute for Preventive Medicine, Kurosawa Hospital, Takasaki, Gunma, Japan
| | - Yoshitaka Sekine
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Seiji Arai
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Yoshiyuki Miyazawa
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Yasuhiro Shibata
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Kazuhiro Suzuki
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Isao Kurosawa
- Institute for Preventive Medicine, Kurosawa Hospital, Takasaki, Gunma, Japan
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98
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Min K, Chung JW, Ha YS, Lee JN, Kim BS, Kim HT, Kim TH, Yoo ES, Kwon TG, Chung SK, Tanaka M, Egawa S, Kimura T, Choi SH. Efficacy of Androgen Deprivation Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer Receiving Docetaxel-Based Chemotherapy. World J Mens Health 2019; 38:226-235. [PMID: 31190487 PMCID: PMC7076308 DOI: 10.5534/wjmh.190029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 05/03/2019] [Accepted: 05/13/2019] [Indexed: 12/16/2022] Open
Abstract
PURPOSE The purpose of this study was to determine the comparative effectiveness of androgen deprivation therapy (ADT) combined with docetaxel (DTX)-based chemotherapy in Korean and Japanese castration-resistant prostate cancer (CRPC) patient cohorts. MATERIALS AND METHODS Metastatic CRPC patients who underwent more than three DTX-based chemotherapy cycles in Korea and Japan between 2002 and 2017 were retrospectively analyzed and divided into the DTX-only (DTX, n=30) and combination (DTX+ADT, n=46) groups. Progression-free survival (PFS) was calculated as the time from the start of chemotherapy to the occurrence of either disease progression (prostate-specific antigen [PSA] progression or radiographic progression) or death. The primary end point was PFS and the secondary end point was overall survival (OS). RESULTS In the DTX and DTX+ADT groups, the median PFS was 6.0 and 11.0 months (log-rank p=0.053). The multivariate Cox regression analysis revealed that the significant predicting factors of PFS were ADT administration (hazard ratio [HR], 0.478; 95% confidence interval [CI], 0.284-0.804; p=0.005) and number of DTX-based chemotherapy cycles (HR, 0.934; 95% CI, 0.899-0.970; p<0.001). In the DTX and DTX+ADT groups, the median OS was 16.0 and 19.5 months (log-rank p=0.825). Through multiple Cox regression analysis, we found that the significant predicting factors of OS were the PSA nadir level (HR, 1.001; 95% CI, 1.000-1.002; p<0.001) and number of DTX-based chemotherapy cycles (HR, 0.932; 95% CI, 0.876-0.991; p=0.024). CONCLUSIONS Concurrent DTX-based chemotherapy and ADT may be beneficial compared with DTX-based chemotherapy alone in chemotherapy-naïve metastatic CRPC patients in terms of the PFS, but not the OS.
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Affiliation(s)
- Kyungchan Min
- Department of Urology, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Jae Wook Chung
- Department of Urology, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Yun Sok Ha
- Department of Urology, Kyungpook National University Hospital, Daegu, Korea
| | - Jun Nyung Lee
- Department of Urology, Kyungpook National University Chilgok Hospital, Daegu, Korea.,Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Bum Soo Kim
- Department of Urology, Kyungpook National University Hospital, Daegu, Korea.,Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyun Tae Kim
- Department of Urology, Kyungpook National University Chilgok Hospital, Daegu, Korea.,Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Tae Hwan Kim
- Department of Urology, Kyungpook National University Chilgok Hospital, Daegu, Korea.,Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Eun Sang Yoo
- Department of Urology, Kyungpook National University Hospital, Daegu, Korea.,Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Tae Gyun Kwon
- Department of Urology, Kyungpook National University Chilgok Hospital, Daegu, Korea.,Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sung Kwang Chung
- Department of Urology, Kyungpook National University Hospital, Daegu, Korea.,Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Masatoshi Tanaka
- Department of Urology, Jikei University School of Medicine, Tokyo, Japan
| | - Shin Egawa
- Department of Urology, Jikei University School of Medicine, Tokyo, Japan
| | - Takahiro Kimura
- Department of Urology, Jikei University School of Medicine, Tokyo, Japan
| | - Seock Hwan Choi
- Department of Urology, Kyungpook National University Hospital, Daegu, Korea.,Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea.
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99
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Murasawa H, Sugiyama T, Matsuoka Y, Okabe T, Hino A, Tanaka N, Sugimoto M, Oyama M, Fujimoto K, Horie S, Noto S, Shimozuma K. Health utility and health-related quality of life of Japanese prostate cancer patients according to progression status measured using EQ-5D-5L and FACT-P. Qual Life Res 2019; 28:2383-2391. [PMID: 31025290 DOI: 10.1007/s11136-019-02184-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2019] [Indexed: 01/22/2023]
Abstract
PURPOSE To obtain health utility data to allow for cost-effectiveness analysis in groups stratified by disease progression along with health-related quality of life (HRQoL) information in Japanese prostate cancer (PC) patients. METHODS In this cross-sectional observational study, EuroQol-5 Dimension- 5 Level (EQ-5D-5L), EuroQol Visual Analog Scale (EQ-VAS), and Functional Assessment of Cancer Therapy-Prostate (FACT-P) measures were used to examine utility, VAS scores, and disease-specific HRQoL, respectively. Scores obtained were statistically examined for the correlation among measures and domains. Parameter estimates of statistically significant factors were assessed using generalized linear models (GLM). RESULTS A total of 380 patients stratified by their disease progression status were analyzed. The numbers (%) of patients in groups stratified as having localized (L), localized progression (LP), distant metastatic (DM), and DM-castration-resistant PC (CRPC) were 275 (72.4), 40 (10.5), 27 (7.1), and 38 (10.0), respectively. EQ-5D-5L mean (standard deviation, SD) scores of L, LP, DM, and DM-CRPC in study participants were 0.87 (0.15), 0.86 (0.15), 0.85 (0.18), and 0.84 (0.17), respectively. The mean (SD) scores assessed by EQ-5D-5L, EQ-VAS, and FACT-P instruments were 0.86 (0.16), 74.6 (16.8), and 110.8 (19.6), respectively. Utility scores correlated well with FACT-P scores. Eastern Cooperative Oncology Group performance status had significant influences on all instruments' scores. CONCLUSIONS We obtained health utility and HRQoL scores of Japanese PC patients stratified by disease progression in detail. Our results will be useful for establishing cost-effectiveness analyses in Japanese PC settings.
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Affiliation(s)
- Hideki Murasawa
- Department of Life Sciences, Ritsumeikan University, Kusatsu, Japan.
| | - Takayuki Sugiyama
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yuki Matsuoka
- Department of Urology, Faculty of medicine, Kagawa University, Kagawa, Japan
| | - Takashi Okabe
- Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Amiko Hino
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | | | - Mikio Sugimoto
- Department of Urology, Faculty of medicine, Kagawa University, Kagawa, Japan
| | - Masafumi Oyama
- Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | | | - Shigeo Horie
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Shinichi Noto
- Department of Health Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Kojiro Shimozuma
- Department of Life Sciences, Ritsumeikan University, Kusatsu, Japan
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Uemura H, Uemura H, Nagamori S, Wakumoto Y, Kimura G, Kikukawa H, Yokomizo A, Mizokami A, Kosaka T, Masumori N, Kawasaki Y, Yonese J, Nasu Y, Fukasawa S, Sugiyama T, Kinuya S, Hosono M, Yamaguchi I, Akagawa T, Matsubara N. Three-year follow-up of a phase II study of radium-223 dichloride in Japanese patients with symptomatic castration-resistant prostate cancer and bone metastases. Int J Clin Oncol 2019; 24:557-566. [PMID: 30875000 PMCID: PMC6469691 DOI: 10.1007/s10147-018-01389-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 12/24/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Radium-223 is a first-in-class targeted alpha therapy to prolong overall survival (OS) in castration-resistant prostate cancer with bone metastases (mCRPC). The aim of the present analysis was to assess the long-term safety with radium-223 in Japanese patients with mCRPC. METHODS Patients with symptomatic mCRPC, ≥ 2 bone metastases and no known visceral metastases received up to 6 injections of radium-223 (55 kBq/kg), one every 4 weeks. Adverse events (AEs) considered to be related to radium-223 were reported until 3 years after the first injection. Pre-specified conditions, such as acute myelogenous leukemia, myelodysplastic syndrome, aplastic anemia, primary bone cancer, or other primary malignancies, were reported regardless of causality. RESULTS Of the 49 patients enrolled in the study, 44 (89.8%) entered the survival follow-up period and 33 (67.3%) died. Throughout the entire study, there were no reports of second primary malignancy or other pre-specified conditions. Eight patients (16.3%) experienced post-treatment drug-related AEs, which were all hematological (anemia and decreased lymphocyte, platelet, and white blood cell counts). No serious post-treatment drug-related AEs were reported. Updated median OS was 19.3 months (95% CI: 14.2, 28.5). CONCLUSIONS In Japanese patients with symptomatic mCRPC and bone metastases, radium-223 had a favorable long-term safety profile with no second primary malignancies reported. Taken together with median OS, which was comparable to that in the pivotal phase III ALSYMPCA study, these results support continued benefit from radium-223 in Japanese patients with mCRPC.
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Affiliation(s)
- Hirotsugu Uemura
- Department of Urology, Kindai University Faculty of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
| | - Hiroji Uemura
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, 4-57, Urafune-cho, Minami-ku, Yokohama, Japan
| | - Satsohi Nagamori
- Department of Urology, National Hospital Organization Hokkaido Cancer Center, 2-3-54 Kikusui 4 Jo, Shiroishi-ku, Sapporo, Japan
| | - Yoshiaki Wakumoto
- Department of Urology, Juntendo University, 2-2-1 Hongo Bunkyo-ku, Tokyo, Japan
| | - Go Kimura
- Department of Urology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, Japan
| | - Hiroaki Kikukawa
- Department of Urology, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, Japan
| | - Akira Yokomizo
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan
| | - Atsushi Mizokami
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
| | - Takeo Kosaka
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, Japan
| | - Yoshihide Kawasaki
- Department of Urology, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Japan
| | - Junji Yonese
- Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, Japan
| | - Yasutomo Nasu
- Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1, Shikata, Okayama, Japan
| | - Satoshi Fukasawa
- Prostate Center, Division of Urology, Chiba Cancer Center, 666-2, Nitona-cho, Chuo-ku, Chiba, Japan
| | - Takayuki Sugiyama
- Department of Urology, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-ku, Hamamatsu, Japan
| | - Seigo Kinuya
- The Japanese Society of Nuclear Medicine, 2-28-45, Honkomagome, Bunkyo-ku, Tokyo, Japan
| | - Makoto Hosono
- The Japanese Society of Nuclear Medicine, 2-28-45, Honkomagome, Bunkyo-ku, Tokyo, Japan
| | - Iku Yamaguchi
- Clinical Statistics, Bayer Yakuhin, Ltd, 2-4-9, Umeda, Kita-ku, Osaka, Japan
| | - Takashi Akagawa
- Oncology Clinical Development, Bayer Yakuhin, Ltd, 2-4-9, Umeda, Kita-ku, Osaka, Japan
| | - Nobuaki Matsubara
- Division of Breast and Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, Japan
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