Zoledronic acid combined with androgen-deprivation therapy may prolong time to castration-resistant prostate cancer in hormone-naïve metastatic prostate cancer patients-A propensity scoring approach
a Department of Urology, Graduate School of Medicine, Yamaguchi University, Japan;
b Department of Urology, Kinki University Faculty of Medicine, Japan;
c Department of Urology, Wakayama Medical University School of Medicine, Japan;
d Department of Urology, Sakai Hospital, Kinki University Faculty of Medicine, Japan;
e Department of Urology, Naga Hospital, Japan;
f Department of Urology, NTT Osaka Hospital, Japan;
g Department of Urology, National Hospital Organization Osaka Minami Medical Center, Japan;
h Department of Urology, Nara Hospital Kinki University Faculty of Medicine, Japan;
i Department of Urology, Tondabayashi Hospital, Japan;
j Department of Urology, Wakayama Rosai Hospital, Japan;
k Department of Urology, Kainan Municipal Hospital, Japan;
l Department of Urology, Izumiotsu Municipal Hospital, Japan
Zoledronic acid combined with androgen-deprivation therapy may prolong time to castration-resistant prostate cancer in hormone-naïve metastatic prostate cancer patients-A propensity scoring approach
a Department of Urology, Graduate School of Medicine, Yamaguchi University, Japan;
b Department of Urology, Kinki University Faculty of Medicine, Japan;
c Department of Urology, Wakayama Medical University School of Medicine, Japan;
d Department of Urology, Sakai Hospital, Kinki University Faculty of Medicine, Japan;
e Department of Urology, Naga Hospital, Japan;
f Department of Urology, NTT Osaka Hospital, Japan;
g Department of Urology, National Hospital Organization Osaka Minami Medical Center, Japan;
h Department of Urology, Nara Hospital Kinki University Faculty of Medicine, Japan;
i Department of Urology, Tondabayashi Hospital, Japan;
j Department of Urology, Wakayama Rosai Hospital, Japan;
k Department of Urology, Kainan Municipal Hospital, Japan;
l Department of Urology, Izumiotsu Municipal Hospital, Japan
摘要 Objective: To clarify the oncological benefit of zoledronic acid for hormone-naïve metastatic prostate cancer, patient outcome of androgen deprivation therapy with zoledronic acid (ADT + Z) and androgen deprivation therapy alone (ADT) was compared. Methods: Fifty-two patients with pathologically confirmed metastatic prostate cancer were prospectively enrolled and treated with combined androgen blockade (goserelin and bicalutamide) with zoledronic acid (4 mg every 4 weeks for 24 months). A propensity score-match with logistic regression analysis was applied to select 50 pair-matched cohorts (both from ADT + Z and from historical control cohorts who had undergone ADT alone), and patient outcomes were compared. Results: Patients with ADT + Z had significantly longer time to progression (TTP) than those with ADT (median TTP; 24.2 vs. 14.0 months, p = 0.0092), while no significant difference of overall survival between two groups (p = 0.1502). Multivariate analysis for biochemical recurrence revealed treatment with ADT was the sole independent prognostic factor (HR: 1.724, 95% CI: 1.06-2.86, p = 0.0297). Conclusion: Combination of zoledronic acid with ADT may prolong time to castration resistant prostate cancer.
Abstract: Objective: To clarify the oncological benefit of zoledronic acid for hormone-naïve metastatic prostate cancer, patient outcome of androgen deprivation therapy with zoledronic acid (ADT + Z) and androgen deprivation therapy alone (ADT) was compared. Methods: Fifty-two patients with pathologically confirmed metastatic prostate cancer were prospectively enrolled and treated with combined androgen blockade (goserelin and bicalutamide) with zoledronic acid (4 mg every 4 weeks for 24 months). A propensity score-match with logistic regression analysis was applied to select 50 pair-matched cohorts (both from ADT + Z and from historical control cohorts who had undergone ADT alone), and patient outcomes were compared. Results: Patients with ADT + Z had significantly longer time to progression (TTP) than those with ADT (median TTP; 24.2 vs. 14.0 months, p = 0.0092), while no significant difference of overall survival between two groups (p = 0.1502). Multivariate analysis for biochemical recurrence revealed treatment with ADT was the sole independent prognostic factor (HR: 1.724, 95% CI: 1.06-2.86, p = 0.0297). Conclusion: Combination of zoledronic acid with ADT may prolong time to castration resistant prostate cancer.
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