{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T21:46:57Z","timestamp":1776030417936,"version":"3.50.1"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Sichuan Science and Technology Program","award":["2024JDHJ0045"],"award-info":[{"award-number":["2024JDHJ0045"]}]},{"name":"Health Commission of Sichuan Province Medical Science and Technology Program","award":["2024CXTD06"],"award-info":[{"award-number":["2024CXTD06"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The phase 3 TITAN trial revealed that apalutamide plus androgen deprivation therapy (ADT) has significantly improved outcomes in patients with metastatic castration-sensitive prostate cancer (mCSPC). However, the generalizability of these results to Asian and Japanese populations remains unclear. Bayesian methods provide a probabilistic framework offering more clinically meaningful estimates of benefit in such subpopulations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a Bayesian post hoc analysis using reconstructed individual patient data from the published Asian (n\u00a0=\u00a0221) and Japanese (n\u00a0=\u00a051) TITAN trial subpopulations. Bayesian Cox proportional hazards models were fitted under four prespecified priors representing different skepticism levels. Posterior median hazard ratios (HRs), 95% credible intervals (CrIs), and probabilities of any benefit (Pr[HR\u00a0&amp;lt;\u00a01.0]) or substantial benefit (Pr[HR\u00a0&amp;lt;\u00a00.8]) were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The posterior median HR under the neutral prior for overall survival in the Asian cohort was 0.71 (95% CrI 0.44\u20131.14), with Pr[HR\u00a0&amp;lt;\u00a01.0]\u00a0=\u00a092% and Pr[HR\u00a0&amp;lt;\u00a00.8]\u00a0=\u00a069%. Probabilities exceeded 95% under more informative priors. The Japanese cohort demonstrated more pronounced effects (neutral prior HR: 0.55, 95% CrI: 0.22\u20131.35) with \u226590% probability of benefit across all priors. Posterior median HRs for TTmCRPC were 0.32\u20130.35 across priors, with ~100% probability of treatment benefit in both cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This analysis provides strengthened evidence that apalutamide plus ADT offers meaningful clinical benefit for Asian patients with mCSPC. Moreover, our findings support more informed and individualized clinical decision-making, helping clinicians communicate expected outcomes more clearly during shared decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jjco\/hyaf206","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T13:10:31Z","timestamp":1765372231000},"page":"455-460","source":"Crossref","is-referenced-by-count":0,"title":["Clinical efficacy of apalutamide in Asian patients with metastatic castration-sensitive prostate cancer: Bayesian reanalysis of the TITAN trial"],"prefix":"10.1093","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2275-4527","authenticated-orcid":false,"given":"Wei","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Urology, Institute of Science Tokyo , 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510 ,","place":["Japan"]},{"name":"Department of Urology, Zigong Fourth People\u2019s Hospital , 1331 Ziwei Rd., Ziliujing Dist., Zigong 643000, Sichuan ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soichiro","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Urology, Institute of Science Tokyo , 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Hirakawa","sequence":"additional","affiliation":[{"name":"Department of Clinical Biostatistics, Institute of Science Tokyo , 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Clinical Biostatistics, Institute of Science Tokyo , 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shugo","family":"Yajima","sequence":"additional","affiliation":[{"name":"Department of Urology, National Cancer Center Hospital East , 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Urology, Institute of Science Tokyo , 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9454-3345","authenticated-orcid":false,"given":"Motohiro","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Department of Urology, Teikyo University Hospital , 2-11-1 Kaga, Itabashi-Ku, Tokyo 173-8606 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Department of Urology, Institute of Science Tokyo , 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuki","family":"Arita","sequence":"additional","affiliation":[{"name":"Department of Radiology, Memorial Sloan Kettering Cancer Center , 1275 York Avenue, New York, NY 10065 ,","place":["United States"]},{"name":"Department of Radiology and Biomedical Imaging, University of California, San Francisco , 505 Parnassus Avenue, M-391, San Francisco, CA 94143-0628 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuma","family":"Waseda","sequence":"additional","affiliation":[{"name":"Department of Urology, Institute of Science Tokyo , 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510 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