A retrospective study of prognostic factors and prostate-specific antigen dynamics in Japanese patients with metastatic hormone-sensitive prostate cancer who received combined androgen blockade therapy with bicalutamide

Yu Tashiro ^1,2, Shusuke Akamatsu ^3,4, Kentaro Ueno ⁵

¹Department of Urology, Japanese Red Cross Otsu Hospital, 1 Chome-1-35 Nagara, Otsu, Shiga, 520-0046, Japan. unity.tashiro@gmail.com.
²Department of Urology, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. unity.tashiro@gmail.com.
³Department of Urology, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
⁴Department of Urology, Nagoya University Graduate School of Medicine, 2 Chome-1-10 Kitachikusa, Chikusa Ward, Nagoya, Aichi, 464-0083, Japan.
⁵Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Yoshidakonoecho, Sakyo Ward, Kyoto, 606-8303, Japan.
⁶Department of Urology, University of Miyazaki, Kihara-5200 Kiyotakecho, Miyazaki, 889-1601, Japan.
⁷Department of Urology, University of Fukui, 3 Chome-9-1 Bunkyo, Fukui, 910-0017, Japan.
⁸Department of Urology, Graduate School of Medical Sciences, Kumamoto University, 2 Chome-40-1 Kurokami, Chuo Ward, Kumamoto, 860-0862, Japan.
⁹Astellas Pharma Inc, 2-5-1, Nihonbashi-Honcho, Chuo-Ku, Tokyo, 103-8411, Japan.

⁰Department of Urology, Japanese Red Cross Otsu Hospital, 1 Chome-1-35 Nagara, Otsu, Shiga, 520-0046, Japan. unity.tashiro@gmail.com.

International Journal of Clinical Oncology +

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August 17, 2024

View abstract on PubMed

Summary

Combined androgen blockade with bicalutamide (Bic-CAB) shows promise for initial treatment of metastatic hormone-sensitive prostate cancer (mHSPC). Low-risk patients experienced excellent survival, suggesting Bic-CAB is a viable option.

Area Of Science

Oncology
Urology
Clinical Research

Background

Investigating the efficacy of combined androgen blockade (CAB) using bicalutamide (Bic-CAB) as an initial therapy for metastatic hormone-sensitive prostate cancer (mHSPC).
Focus on the Japanese patient population and treatment patterns between 2007 and 2017.

Purpose Of The Study

To evaluate the therapeutic potential of Bic-CAB as an initial treatment for mHSPC.
To assess treatment outcomes including time to prostate-specific antigen (PSA) progression and overall survival (OS).

Main Methods

Retrospective analysis of electronic health records from 159 mHSPC patients across three Japanese institutions.
Assessment of PSA progression, duration of Bic-CAB treatment, and OS using various PSA progression definitions.
Multivariate Cox proportional hazards modeling to identify predictors of treatment end and OS.

Main Results

Median observation period of 46.4 months in patients with a median age of 71 years.
46.5% of patients experienced PSA progression, with a median survival of 29 months.
Low-risk patients (low initial PSA, small PSA change) demonstrated 100% 5-year OS and 75% 10-year OS.

Conclusions

Bic-CAB demonstrates potential therapeutic effects in mHSPC patients, particularly those at low risk of disease progression.
Initial Bic-CAB treatment combined with early adjustments based on PSA dynamics may represent a suitable treatment strategy.

Keywords:

Bicalutamide Combined androgen blockage Japan Metastatic hormone-sensitive prostate cancer

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