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Survival trends for patients with primary metastatic prostate cancer before and after the introduction of new antitumor drugs

Prostate Cancer and Prostatic Diseases volume 26, pages 53–58 (2023)Cite this article

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Abstract

Background

During the past two decades, new antitumor drugs (Abiraterone, Enzalutamide, Radium-223, Cabazitaxel, and Docetaxel) have been introduced for treatment of prostate cancer with distant metastases (mPCa). Each drug have demonstrated a survival gain in studies, but little is known about the impact in a general population of mPCa patients. In this study we assessed survival before and after introduction of the new drugs for Norwegian mPCa patients.

Methods

Survival was assessed in 5542 patients with primary mPCa. The patients were diagnosed between 2004 and 2018, identified in the Norwegian Cancer Registry. We also analyzed a subgroup of 2738 patients possibly eligible for treatment with new drugs (age <80 years, WHO performance status ≤2 and not dead within 3 months from diagnosis). We estimated overall (OS) and cause-specific survival (CSS) across three diagnostic time periods reflecting to the drugs’ introduction in Norway: Before (2004–2009), “in between” (2010–2014) and after the introduction (2015–2018). We used Kaplan-Meier survival analysis and multivariable Cox regression.

Results

Median OS increased from 2.3 years in 2004–2009 to 3.3 years in 2015–2018. 3-year OS improved from 41% in 2004–2009 to 51% in 2015–2018. An earlier diagnostic period, a more advanced T stage, higher ISUP grade group, lower WHO status and higher PSA levels were associated with a lower CSS. Similar results was found for the subgroup.

Conclusions

Median OS of mPCa has increased by one year since 2004 for mPCa patients in Norway. Survival improvement persisted after adjustment for recognized prognostic factors and may be related to the introduction of new drugs in Norway.

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Fig. 1: Kaplan Meier, overall survival and cancer-specific survival for all patients n = 5542.
Fig. 2: Overall survival and cancer specific survival for all patients split by time periods.

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Authors and Affiliations

  1. Department of Research, Cancer Registry of Norway, Oslo, Norway

    Anne Holck Storås, Sophie D. Fosså & Bettina Kulle Andreassen

  2. Department of Oncology, Oslo University Hospital, Oslo, Norway

    Anne Holck Storås & Sophie D. Fosså

  3. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway

    Sophie D. Fosså

  4. Cancer Registry of Norway, Oslo, Norway

    Giske Ursin

  5. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Giske Ursin

  6. Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway

    Giske Ursin

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  1. Anne Holck Storås
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  2. Sophie D. Fosså
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Contributions

Anne Holck Storås—original draft preparation, statistical analysis. Sophie D. Fosså—Conceptualization, writing-reviewing. Giske Ursin—Conceptualization, writing-reviewing. Bettina Kulle Andreassen—Conceptualization, writing-reviewing, statistical analysis.

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Correspondence to Anne Holck Storås.

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Storås, A.H., Fosså, S.D., Ursin, G. et al. Survival trends for patients with primary metastatic prostate cancer before and after the introduction of new antitumor drugs. Prostate Cancer Prostatic Dis 26, 53–58 (2023). https://doi.org/10.1038/s41391-021-00445-x

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