Yanagisawa T, Kimura T, Mori K, et al. - Patients with high-risk metastatic hormone-sensitive prostate cancer (mHSPC) who received androgen deprivation therapy (ADT) with abiraterone acetate were shown to experience significant prolongation in the time to castration-resistant prostate cancer (CRPC) vs those treated with bicalutamide, despite limitations regarding the time-dependent bias. However, there is a requirement for further study with longer follow-up.

• This is a retrospective study of 312 patients with high-risk mHSPC who had received ADT with bicalutamide (n = 212) or abiraterone acetate (n = 100).

• Two-year overall survival and cancer-specific survival for bicalutamide vs abiraterone was noted to be 77.8% vs 79.5% and 81.1% vs 82.5%, respectively.

• A significantly longer median time to CRPC was evident in the abiraterone group vs the bicalutamide group (NA vs 13 months).

• Independent prognostic risk factors for time to CRPC were: Gleason score ≧9, high alkaline phosphatase, high lactate dehydrogenase, liver metastasis, and bicalutamide.

• In patients having each of these prognostic factors, a prolonged time to CRPC was observed due to treatment with abiraterone.