TY  - JOUR
A1  - Höh, Robert Benedikt
A1  - Würnschimmel, Christoph
A1  - Flammia, Rocco Simone
A1  - Horlemann, Benedikt
A1  - Sorce, Gabriele
A1  - Chierigo, Francesco
A1  - Tian, Zhe
A1  - Saad, Fred
A1  - Graefen, Markus
A1  - Gallucci, Michele
A1  - Briganti, Alberto
A1  - Terrone, Carlo
A1  - Shariat, Shahrokh F.
A1  - Tilki, Derya
A1  - Kluth, Luis
A1  - Mandel, Philipp
A1  - Chun, Felix
A1  - Karakiewicz, Pierre I.
T1  - Effect of chemotherapy on overall survival in contemporary metastatic prostate cancer patients
T2  - Frontiers in oncology
N2  - Introduction: Randomized clinical trials demonstrated improved overall survival in chemotherapy exposed metastatic prostate cancer patients. However, real-world data validating this effect with large scale epidemiological data sets are scarce and might not agree with trials. We tested this hypothesis.
Materials and Methods: We identified de novo metastatic prostate cancer patients within the Surveillance, Epidemiology, and End Results (SEER) database (2014-2015). Kaplan-Meier plots and Cox regression models tested for overall survival differences between chemotherapy-exposed patients vs chemotherapy-naïve patients. All analyses were repeated in propensity-score matched cohorts. Additionally, landmark analyses were applied to account for potential immortal time bias.
Results: Overall, 4295 de novo metastatic prostate cancer patients were identified. Of those, 905 (21.1%) patients received chemotherapy vs 3390 (78.9%) did not. Median overall survival was not reached at 30 months follow-up. Chemotherapy-exposed patients exhibited significantly better overall survival (61.6 vs 54.3%, multivariable HR:0.82, CI: 0.72-0.96, p=0.01) at 30 months compared to their chemotherapy-naïve counterparts. These findings were confirmed in propensity score matched analyses (multivariable HR: 0.77, CI:0.66-0.90, p<0.001). Results remained unchanged after landmark analyses were applied in propensity score matched population.
Conclusions: In this contemporary real-world population-based cohort, chemotherapy for metastatic prostate cancer patients was associated with better overall survival. However, the magnitude of overall survival benefit was not comparable to phase 3 trials.
KW  - chemotherapy
KW  - overall survival
KW  - metastatic prostate cancer
KW  - SEER
KW  - contemporary
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/62057
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-620579
SN  - 2234-943X
VL  - 11
IS  - art. 778858
SP  - 1
EP  - 7
PB  - Frontiers Media
CY  - Lausanne
ER  -