We compared the real-world efficacy and medical costs for treatment with upfront docetaxel (DOC) and abiraterone acetate (ABI) up to progression-free survival 2 (PFS2) in patients with metastatic hormone-sensitive prostate cancer (mHSPC).
This multicenter retrospective study included 340 patients with mHSPC treated with either upfront DOC or upfront ABI between October 2015 and December 2021. We compared PFS2 and medical costs between the two treatment groups. PFS2 was defined as the time from first-line therapy to progression on second-line therapy. Medical costs were estimated using the National Health Insurance drug prices in 2022 in Japan.
The upfront DOC and ABI groups included 107 and 233 patients, respectively. The incidence of metastatic castration-resistant PC progression was significantly higher in the upfront DOC group compared with the incidence in the upfront ABI group. However, no significant differences in PFS2 were observed between the two treatment groups. Monthly medical costs per patient were significantly higher in the upfront ABI group ($3453) compared with the costs in the upfront DOC group ($1239, P < 0.001). The cost differences were significantly influenced by differences in the length of androgen deprivation therapy monotherapy (DOC group, 13.4 months vs. ABI group, 0.0 months).
We observed a significant cost benefit in the upfront DOC group in Japanese real-world practice, while the PFS2 rates were similar between the groups. Upfront DOC was a more cost-effective option for men with mHSPC who were eligible for toxic chemotherapy.
World journal of urology. 2022 Dec 15 [Epub ahead of print]
Kai Ozaki, Shingo Hatakeyama, Shintaro Narita, Kenichi Hata, Takafumi Yanagisawa, Toshikazu Tanaka, Kyo Togashi, Tomoko Hamaya, Teppei Okamoto, Hayato Yamamoto, Takahiro Yoneyama, Yasuhiro Hashimoto, Takahiro Kimura, Tomonori Habuchi, Chikara Ohyama
Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, 036-8562, Japan., Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, 036-8562, Japan. ., Department of Urology, Akita University School of Medicine, Akita, 010-8543, Japan., Department of Urology, the Jikei University School of Medicine, Tokyo, 105-8461, Japan., Department of Urology, Aomori Prefectural Central Hospital, Aomori, 030-8553, Japan., Department of Advanced Transplant and Regenerative Medicine, Hirosaki University School of Medicine, Hirosaki, 036-8562, Japan.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/36520204