Recent trend of androgen deprivation therapy in newly diagnosed prostate cancer patients: Comparing between high‐ and middle‐income Asian countries

The number of newly diagnosed prostate cancer cases varies across Asia, with higher mortality‐to‐incidence ratio reported in developing nations. Androgen deprivation therapy (ADT), alone or in combination, remains the mainstay of first‐line treatment for advanced prostate cancer. Key findings of ext...

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Bibliographic Details
Published in:Cancer science 2021-06, Vol.112 (6), p.2071-2080
Main Authors: Lim, Jasmine, Onozawa, Mizuki, Saad, Marniza, Ong, Teng Aik, Malek, Rohan, Akaza, Hideyuki
Format: Article
Language:English
Subjects:
abiraterone acetate
adjuvant ADT
Agonists
Androgen receptors
Androgens
A‐CaP Study
Cancer
Cancer patients
Cancer therapies
Care and treatment
Castration
chemohormonal therapy
Clinical trials
Developing countries
Evidence-based medicine
Gonadotropin-releasing hormone
Metastases
Metastasis
metastatic prostate cancer
Mortality
Oncology, Experimental
Patients
Pituitary (anterior)
Pituitary hormones
Prostate cancer
Radiation therapy
Radiotherapy
Review
Trends
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Summary:The number of newly diagnosed prostate cancer cases varies across Asia, with higher mortality‐to‐incidence ratio reported in developing nations. Androgen deprivation therapy (ADT), alone or in combination, remains the mainstay of first‐line treatment for advanced prostate cancer. Key findings of extensive research and randomized controlled trials have shaped current clinical practice and influenced clinical guideline recommendations. We describe here the recent trend of ADT in newly diagnosed prostate cancer for Asia focusing on Japan (high‐income country) and Malaysia (middle‐income country) based on the Asian Prostate Cancer (A‐CaP) Study. The combination of radiotherapy and ADT or ADT alone was common in patients with intermediate‐to‐high risk localized and locally advanced disease. For metastatic prostate cancer, maximum androgen blockade (gonadotrophin‐releasing hormone [GnRH] agonist/antagonist plus antiandrogen) was prevalent among the Japanese patients while primary ADT alone with GnRH agonist/antagonist was widely practiced in the Malaysian cohort. Upfront combined therapy (ADT plus docetaxel or androgen receptor pathway inhibitor) has significantly improved the outcomes of patients with metastatic castration‐naïve prostate cancer. Its application, however, remains low in our cohorts due to patients’ financial capacity and national health insurance coverage. Early detection remains the cornerstone in prostate cancer control to improve treatment outcome and patient survival. The A‐ Asian Prostate Cancer Study revealed a high proportion of metastatic prostate cancer was reported in Asia, particularly in developing nations. Androgen deprivation therapy, alone or in combination, remains the mainstay of first‐line treatment for advanced prostate cancer.
ISSN:1347-9032
1349-7006
1349-7006
DOI:10.1111/cas.14889