{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T20:27:49Z","timestamp":1783024069390,"version":"3.54.6"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["25K12244"],"award-info":[{"award-number":["25K12244"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The introduction of novel androgen receptor signaling inhibitors (ARSIs) has substantially transformed the systemic treatment landscape for non\u2010metastatic castration\u2010resistant prostate cancer (nmCRPC). Unfortunately, ARSI therapy is associated with considerable adverse events (AEs) and high medical costs. Dose reduction has been proposed as a potential strategy to improve tolerability and reduce costs; however, the efficacy, safety, and cost\u2010effectiveness of reduced\u2010dose ARSIs in patients with nmCRPC remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This multicenter retrospective study included 251 patients with nmCRPC who underwent ARSI therapy. Patients were categorized into reduced\u2010dose (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200946) and full\u2010dose (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009205) groups according to the initial ARSI dose. The prostate\u2010specific antigen progression\u2010free survival (PSA\u2010PFS), metastasis\u2010free survival (MFS), and overall survival (OS) were compared between the groups. AEs and monthly medical costs for the first ARSI treatment were also evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No significant differences in PSA\u2010PFS, MFS, or OS were observed between the two groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.307,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.199, and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.287, respectively). Multivariable analysis showed that the initial ARSI dose was not significantly associated with MFS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.984). The incidence rates of any\u2010grade and grade \u2265\u20093 AEs did not significantly differ between the two groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.171 and\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20091.000, respectively). In contrast, the median monthly cost of the first ARSI treatment was significantly lower in the reduced\u2010dose group than in the full\u2010dose group ($998 vs. $1644,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Reduced\u2010dose ARSI therapy was associated with comparable oncological outcomes to full\u2010dose therapy in patients with nmCRPC, while suggesting potential cost savings. Dose reduction may be considered a treatment option in selected populations, such as elderly patients, who were predominant in our cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pros.70203","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T18:16:08Z","timestamp":1779819368000},"page":"1233-1240","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy, Safety, and Cost\u2010Effectiveness of Reduced versus Full Initial Doses of Androgen Receptor Signaling Inhibitors in Non\u2010Metastatic Castration\u2010Resistant Prostate Cancer: A Multicenter Retrospective Study"],"prefix":"10.1002","volume":"86","author":[{"given":"Himawari","family":"Asanuma","sequence":"first","affiliation":[{"name":"Department of Urology Hirosaki University Graduate School of Medicine Hirosaki 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