Screening for prognostic indicators in patients with metastatic castration-resistant prostate cancer after androgen receptor signaling inhibitor treatment for metastatic castration-sensitive prostate cancer

Abstract Background Androgen receptor signaling inhibitors (ARSI) and docetaxel (DTX) are standard treatments for metastatic castration-resistant prostate cancer (mCRPC). However, the differences in therapeutic efficacy between these treatments for mCRPC after upfront ARSI for metastatic castration-sensitive prostate cancer (mCSPC) remain unclear. In this study, we used real-world data to compare treatment efficacy and to identify prognostic indicators. Methods We retrospectively analyzed 120 patients who progressed to mCRPC after receiving ARSI as a first-line therapy for mCSPC. Second-line progression-free survival (PFS) and second-line overall survival (OS) were compared between the DTX and non-DTX groups. Cox proportional hazards regression analysis was performed to identify the prognostic indicators of second-line OS in patients with mCRPC. Propensity score matching was used to adjust for differences in baseline clinical characteristics. Results Among matched patients with mCRPC, no significant differences were observed in second-line PFS or OS between the non-DTX and DTX groups. Univariate and multivariate analyses demonstrated that pretreatment serum lactate dehydrogenase (LDH) levels ( Conclusions Pretreatment LDH levels and GP5 status may be useful prognostic indicators for patients with mCRPC following upfront ARSI therapy for mCSPC.