{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T14:07:24Z","timestamp":1788703644472,"version":"build-2803163510"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,19]],"date-time":"2025-04-19T00:00:00Z","timestamp":1745020800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,19]],"date-time":"2025-04-19T00:00:00Z","timestamp":1745020800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    We examined the impact of starting treatment on clinical outcomes in men with metastatic castration-sensitive prostate cancer (mCSPC). This retrospective observational cohort study used claims data from the Medical Data Vision (MDV) hospital-based administrative dataset in Japan. All patients with newly diagnosed mCSPC from 1\u00a0January\u00a02018 to 31\u00a0March\u00a02024 were enrolled and followed up until 30\u00a0September\u20092024. Time-to-event analyses used Kaplan-Meier methods. The risk of death, onset of castration resistance, time to \u2265\u200950% PSA decline (PSA50), \u2265\u200990% PSA decline (PSA90), and undetectable PSA level (\u2264\u20090.2 ng\/mL) was compared between androgen receptor pathway inhibitors (ARPIs) and combined androgen blockade (CAB) or androgen-deprivation therapy (ADT) alone using a Cox proportional hazard model adjusted for age, body mass index, co-morbidities, visceral metastases, and baseline PSA. 22,559 patients with mCSPC had received relevant treatment of whom 15,797 were included in the analysis: 1167 (5.2%) started on apalutamide (APA)\u2009+\u2009ADT, 1407 (6.2%) on enzalutamide\u2009+\u2009ADT, 1262 (5.6%) on abiraterone acetate plus prednisone\u2009+\u2009ADT, and 11,961 (53.0%) on CAB\/ADT alone. The median age was between 74 and 78 years in each group. Bone metastases were present in 60.5% to\u00a072.6% of patients, visceral metastases in 2.8%\u00a0to\u00a05.7%, and nodal metastases in 19.3% to\u00a029.4%. Overall survival and castration resistance-free survival were significantly longer in patients initially treated with APA\u2009+\u2009ADT compared to CAB\/ADT (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001 for both comparisons). In patients with regular PSA assessment, a higher percentage of patients starting with APA\u2009+\u2009ADT achieved PSA50, PSA90 and undetectable PSA at 3 months compared with CAB\/ADT (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0005,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001, respectively). Use of APA\u2009+\u2009ADT as a starting treatment for mCSPC was associated with better clinical outcomes versus traditional CAB or ADT in real-world clinical practice in Japan.\n                  <\/jats:p>","DOI":"10.1038\/s41598-025-93136-9","type":"journal-article","created":{"date-parts":[[2025,4,19]],"date-time":"2025-04-19T10:04:11Z","timestamp":1745057051000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The impact of androgen receptor pathway inhibitors as starting treatment in metastatic castration-sensitive prostate cancer on patient outcomes (OASIS Japan)"],"prefix":"10.1038","volume":"15","author":[{"given":"Masaki","family":"Shiota","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanfang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suneel","family":"Mundle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehregan","family":"Nematian-Samani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiayi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotsugu","family":"Uemura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,19]]},"reference":[{"key":"93136_CR1","unstructured":"World Health Organization. International Agency for Research on Cancer. GLOBOCAN 2020. (2022). https:\/\/gco.iarc.fr\/ cited August 05."},{"key":"93136_CR2","unstructured":"National Cancer Center. National tally of in-hospital cancer registration. Available at: https:\/\/ganjoho.jp\/public\/qa_links\/report\/hosp_c\/hosp_c_registry.html Accessed 02 January 2024."},{"key":"93136_CR3","unstructured":"National Cancer Institute. Surveillance, Epidemiology, and End Results Program.Prostate. SEER Relative Survival Rates by Time Since Diagnosis, 2000\u20132019. https:\/\/seer.cancer.gov\/statistics-network\/explorer\/application.html?site=66&data_type=4&graph_type=6&compareBy=race&chk_race_1=1&hdn_sex=2&age_range=1&stage=106&advopt_precision=1&advopt_show_ci=on&hdn_view=0&advopt_show_apc=on&advopt_display=2 Accessed 07 Aug 2023."},{"key":"93136_CR4","unstructured":"National Cancer Center. Latest summary of in-hospital cancer registration survival rate. Available at: https:\/\/ganjoho-jp.translate.goog\/public\/qa_links\/report\/hosp_c\/hosp_c_reg_surv\/latest.html?_x_tr_sl=auto&_x_tr_tl=en&_x_tr_hl=en-US&_x_tr_pto=wapp Accessed 02 January 2024."},{"key":"93136_CR5","doi-asserted-by":"publisher","first-page":"2967","DOI":"10.2147\/OTT.S306345","volume":"14","author":"K Harada","year":"2021","unstructured":"Harada, K. et al. Treatment strategies for metastatic castration-sensitive prostate cancer: from all-comers to personalized approach. Onco Targets Ther. 14, 2967\u20132974. https:\/\/doi.org\/10.2147\/OTT.S306345 (2021).","journal-title":"Onco Targets Ther."},{"key":"93136_CR6","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1200\/EDBK_200967","volume":"38","author":"AW Hahn","year":"2018","unstructured":"Hahn, A. W., Higano, C. S., Taplin, M. E., Ryan, C. J. & Agarwal, N. Metastatic castration-sensitive prostate cancer: optimizing patient selection and treatment. Am. Soc. Clin. Oncol. Educ. Book. 38, 363\u2013371. https:\/\/doi.org\/10.1200\/EDBK_200967 (2018).","journal-title":"Am. Soc. Clin. Oncol. Educ. Book."},{"key":"93136_CR7","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1056\/NEJMoa1704174","volume":"377","author":"K Fizazi","year":"2017","unstructured":"Fizazi, K. et al. Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer. N Engl. J. Med. 377, 352\u2013360. https:\/\/doi.org\/10.1056\/NEJMoa1704174 (2017).","journal-title":"N Engl. J. Med."},{"key":"93136_CR8","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1056\/NEJMoa1903835","volume":"381","author":"ID Davis","year":"2019","unstructured":"Davis, I. D. et al. Enzalutamide with standard first-line therapy in metastatic prostate cancer. N Engl. J. Med. 381, 121\u2013131. https:\/\/doi.org\/10.1056\/NEJMoa1903835 (2019).","journal-title":"N Engl. J. Med."},{"key":"93136_CR9","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1056\/NEJMoa1903307","volume":"381","author":"KN Chi","year":"2019","unstructured":"Chi, K. N. et al. Apalutamide for metastatic, castration-sensitive prostate cancer. N Engl. J. Med. 381, 13\u201324. https:\/\/doi.org\/10.1056\/NEJMoa1903307 (2019).","journal-title":"N Engl. J. Med."},{"key":"93136_CR10","doi-asserted-by":"publisher","first-page":"2294","DOI":"10.1200\/JCO.20.03488","volume":"39","author":"KN Chi","year":"2021","unstructured":"Chi, K. N. et al. Apalutamide in patients with metastatic castration-sensitive prostate cancer: final survival analysis of the randomized, double-blind, phase III TITAN study. J. Clin. Oncol. 39, 2294\u20132303. https:\/\/doi.org\/10.1200\/JCO.20.03488 (2021).","journal-title":"J. Clin. Oncol."},{"key":"93136_CR11","doi-asserted-by":"publisher","first-page":"2974","DOI":"10.1200\/JCO.19.00799","volume":"37","author":"AJ Armstrong","year":"2019","unstructured":"Armstrong, A. J. et al. A randomized, phase III study of androgen deprivation therapy with enzalutamide or placebo in men with metastatic Hormone-Sensitive prostate Cancer. J. Clin. Oncol. 37, 2974\u20132986. https:\/\/doi.org\/10.1200\/JCO.19.00799 (2019).","journal-title":"J. Clin. Oncol."},{"key":"93136_CR12","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.1097\/JU.0000000000003452","volume":"209","author":"W Lowrance","year":"2023","unstructured":"Lowrance, W. et al. Updates to advanced prostate cancer: AUA\/SUO guideline (2023). J. Urol. 209, 1082\u20131090. https:\/\/doi.org\/10.1097\/JU.0000000000003452 (2023).","journal-title":"J. Urol."},{"key":"93136_CR13","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1016\/j.eururo.2016.08.002","volume":"71","author":"P Cornford","year":"2017","unstructured":"Cornford, P. et al. EAU-ESTRO-SIOG guidelines on prostate cancer. Part II: treatment of relapsing, metastatic, and castration-resistant prostate cancer. Eur. Urol. 71, 630\u2013642. https:\/\/doi.org\/10.1016\/j.eururo.2016.08.002 (2017).","journal-title":"Eur. Urol."},{"key":"93136_CR14","doi-asserted-by":"publisher","first-page":"1695","DOI":"10.1016\/S0140-6736(22)00367-1","volume":"399","author":"K Fizazi","year":"2022","unstructured":"Fizazi, K. et al. Abiraterone plus prednisone added to androgen deprivation therapy and docetaxel in de novo metastatic castration-sensitive prostate cancer (PEACE-1): a multicentre, open-label, randomised, phase 3 study with a 2 x 2 factorial design. Lancet 399, 1695\u20131707. https:\/\/doi.org\/10.1016\/S0140-6736(22)00367-1 (2022).","journal-title":"Lancet"},{"key":"93136_CR15","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.1056\/NEJMoa2119115","volume":"386","author":"MR Smith","year":"2022","unstructured":"Smith, M. R. et al. Darolutamide and survival in metastatic, Hormone-Sensitive prostate Cancer. N Engl. J. Med. 386, 1132\u20131142. https:\/\/doi.org\/10.1056\/NEJMoa2119115 (2022).","journal-title":"N Engl. J. Med."},{"key":"93136_CR16","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1016\/j.annonc.2023.02.009","volume":"34","author":"S Chowdhury","year":"2023","unstructured":"Chowdhury, S. et al. Deep, rapid, and durable prostate-specific antigen decline with apalutamide plus androgen deprivation therapy is associated with longer survival and improved clinical outcomes in TITAN patients with metastatic castration-sensitive prostate cancer. Ann. Oncol. 34, 477\u2013485. https:\/\/doi.org\/10.1016\/j.annonc.2023.02.009 (2023).","journal-title":"Ann. Oncol."},{"key":"93136_CR17","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1016\/S1470-2045(23)00063-3","volume":"24","author":"CJ Sweeney","year":"2023","unstructured":"Sweeney, C. J. et al. Testosterone suppression plus enzalutamide versus testosterone suppression plus standard antiandrogen therapy for metastatic hormone-sensitive prostate cancer (ENZAMET): an international, open-label, randomised, phase 3 trial. Lancet Oncol. 24, 323\u2013334. https:\/\/doi.org\/10.1016\/S1470-2045(23)00063-3 (2023).","journal-title":"Lancet Oncol."},{"key":"93136_CR18","unstructured":"MHLW approval of ERLEADA\u00ae (apalutamide) for the treatment of patients with prostate cancer with distant metastases. (2020). Available at: https:\/\/www.nippon-shinyaku.co.jp\/file\/download.php?file_id=3873 Accessed 17 August 2023."},{"key":"93136_CR19","unstructured":"Astellas press release. XTANDI\u00ae (enzalutamide). Approved by Japan MHLW for the treatment of prostate cancer with distant metastasis. May 29, https:\/\/www.astellas.com\/en\/news\/15876 (2020). [accessed 28 Nov 2024]."},{"key":"93136_CR20","unstructured":"Nippon Shinyaku signs a new co-promotion agreement with Janssen Pharmaceutical K.K. for ZYTIGA\u00ae in Japan. Feb 7. (2020). https:\/\/www.nippon-shinyaku.co.jp\/file\/download.php?file_id=3879 [accessed 28 Nov 2024]."},{"key":"93136_CR21","doi-asserted-by":"publisher","unstructured":"Lowentritt, B. et al. Comparison of prostate-specific antigen response in patients with metastatic castration-sensitive prostate cancer initiated on apalutamide or abiraterone acetate: A retrospective cohort study. Urol. Oncol. 41 (252 e219-252 e227). https:\/\/doi.org\/10.1016\/j.urolonc.2023.03.013 (2023).","DOI":"10.1016\/j.urolonc.2023.03.013"},{"key":"93136_CR22","doi-asserted-by":"publisher","unstructured":"Lowentritt, B. et al. Attainment of early, deep prostate-specific antigen response in metastatic castration-sensitive prostate cancer: A comparison of patients initiated on apalutamide or enzalutamide. Urol. Oncol. 41 (253 e251-253 e259). https:\/\/doi.org\/10.1016\/j.urolonc.2023.03.003 (2023).","DOI":"10.1016\/j.urolonc.2023.03.003"},{"key":"93136_CR23","doi-asserted-by":"publisher","first-page":"3984","DOI":"10.1200\/JCO.2006.06.4246","volume":"24","author":"M Hussain","year":"2006","unstructured":"Hussain, M. et al. Absolute prostate-specific antigen value after androgen deprivation is a strong independent predictor of survival in new metastatic prostate cancer: data from Southwest oncology group trial 9346 (INT-0162). J. Clin. Oncol. 24, 3984\u20133990. https:\/\/doi.org\/10.1200\/JCO.2006.06.4246 (2006).","journal-title":"J. Clin. 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Yanfang Liu, Suneel Mundle, Xiayi Wang, Mehregan Nematian-Samani, and Jason Hwang are employees of Johnson & Johnson LLC. Yanfang Liu, Suneel Mundle hold stock\/shares in Johnson & Johnson Pte, Ltd. Hirotsugu Uemura reports grants and other from Takeda, Ono pharm. Astellas, Janssen, Astra Zeneca, personal fees from Bayer, MSD, BMS, Janssen, Takeda, Pfizer, Sanofi, Eisai, and Ono\/BMS outside the submitted work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"13598"}}