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Prognostic significance of third-line treatment for patients with metastatic castration-resistant prostate cancer: comparative assessments between cabazitaxel and other agents

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Abstract

Background

Cabazitaxel has played an important role in the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC); however, several types of sequential therapy against mCRPC have been performed in routine clinical practice. The objective of this study was to investigate the impact of third-line treatment on prognostic outcomes of mCRPC patients.

Methods

This study retrospectively analyzed the clinical outcomes of 166 patients who received 3 agents following the diagnosis of mCRPC, consisting of 81 sequentially treated with either abiraterone or enzalutamide and then docetaxel, followed by third-line cabazitaxel (group A) and 85 treated with 3 agents, including abiraterone, enzalutamide, and docetaxel (group B).

Results

There were no significant differences in major characteristics at the introduction of the third-line agent between these 2 groups. The proportion of patients with prostate-specific antigen (PSA) reduction > 50% by cabazitaxel in group A was significantly greater than that by either third-line agent in group B. Both PSA progression-free survival (PFS) and overall survival (OS) following third-line therapy in group A were significantly longer than those in group B. Furthermore, OS after the diagnosis of mCRPC in group A was significantly longer than that in group B. Multivariate analysis identified independent predictors of favorable prognostic outcomes after third-line therapy as follows: high-performance status (PS), low PSA level and third-line cabazitaxel for PSA PFS, and high PS, low lactate dehydrogenase level and third-line cabazitaxel for OS.

Conclusions

The introduction of cabazitaxel as a third-line agent could markedly improve the prognostic outcomes of mCRPC patients.

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Authors and Affiliations

  1. Department of Urology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, 431-3192, Japan

    Hideaki Miyake, Ryo Sato, Kyohei Watanabe, Yuto Matsushita, Hiromitsu Watanabe, Daisuke Motoyama, Toshiki Ito, Takayuki Sugiyama & Atsushi Otsuka

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  1. Hideaki Miyake
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  2. Ryo Sato
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  3. Kyohei Watanabe
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  4. Yuto Matsushita
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  5. Hiromitsu Watanabe
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  6. Daisuke Motoyama
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  7. Toshiki Ito
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  8. Takayuki Sugiyama
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  9. Atsushi Otsuka
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Corresponding author

Correspondence to Hideaki Miyake.

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Conflict of interest

H. Miyake, R. Sato, K. Watanabe, Y. Matsushita, H. Watanabe, D. Motoyama, T. Ito, T. Sugiyama and A. Otsuka declare that they have no conflict of interest.

Research involving human participants

All procedures performed in studies involving human participants were conducted in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was waived for individual participants included in the study given the retrospective nature of this work.

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Miyake, H., Sato, R., Watanabe, K. et al. Prognostic significance of third-line treatment for patients with metastatic castration-resistant prostate cancer: comparative assessments between cabazitaxel and other agents. Int J Clin Oncol 26, 1745–1751 (2021). https://doi.org/10.1007/s10147-021-01956-2

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  • DOI: https://doi.org/10.1007/s10147-021-01956-2

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