Anticancer Effect of Second-line Treatment for Castration-Resistant Prostate Cancer Following First-line Treatment...

Area of Science:

• Oncology
• Urology
• Medical Science

Background:

• Limited data exists on treatments for castration-resistant prostate cancer (CRPC) following first-line androgen receptor pathway inhibitors (ARPI).
• Comparing second-line therapies like ARPI, docetaxel (DTX), and radium-223 (Ra-223) is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the efficacy of different second-line treatments in patients with CRPC who have progressed on first-line ARPI therapy.
• To evaluate treatment outcomes including prostate-specific antigen (PSA) decrease, progression-free survival (PFS), and overall survival (OS).

Main Methods:

• Retrospective review of 88 CRPC patients who received first-line ARPI followed by second-line ARPI, DTX, or Ra-223.
• Comparison of clinicopathological characteristics and treatment outcomes between the second-line treatment groups.

Main Results:

• Docetaxel (DTX) treatment was associated with significantly better PFS compared to ARPI or Ra-223 (P=0.023).
• DTX was an independent prognostic factor for improved PFS (HR 0.44, P=0.006).
• Subgroup analyses indicated DTX benefits PFS in patients with Gleason score >8 and PSA decline >50% during first-line ARPI.

Conclusions:

• Second-line DTX demonstrates superior efficacy in terms of PFS for CRPC patients progressing on first-line ARPI compared to subsequent ARPI or Ra-223.
• While DTX improves PFS, no significant difference in overall survival was observed across the second-line treatment groups.