There is an increasing incidence of cancer in younger patients, including prostate cancer. Cancers developing in younger patients are reported to have a more aggressive phenotype. There is a need to examine younger patients with metastatic castration-resistant prostate cancer (mCRPC).
Analysis of the prospectively collected, multisite, electronic Prostate Cancer Australian Database (ePAD) was conducted to identify all mCRPC patients enrolled between June 2016 and March 2024. We defined patients diagnosed aged < 55 years as younger patients (YP) and compared their characteristics, treatment patterns and outcomes to the other patients aged ≥ 55 years (OP).
Of 915 patients with mCRPC, 59 (6%) were YP. De-novo metastatic presentation, Gleason score, presence of liver metastasis and PSA doubling time at mCRPC were similar between YP and OP. In the mCRPC setting, first line treatment with docetaxel (19% YP vs. 21% OP; P = .72) and ARPI (68% YP vs. 74% OP; P = .31) was also similar. YP were more likely to receive ≥ 3 lines of therapy for mCRPC (37% YP vs. 23% OP; P = .016). There was no significant difference in overall survival from start of first line therapy (median 41.9 m YP vs. 35.1 m OP; HR 0.73; 95% CI, 0.47-1.15; P = .17) or time-to-treatment discontinuation for ARPI (median 15.8 m YP vs. 14.9 m OP; HR 0.93; 95% CI, 0.61-1.42; P = .75). Age < 55 was not independently associated with survival on multivariable analysis (HR 0.82; 95% CI, 0.52-1.29; P = .38).
Young patients with prostate cancer who go on to develop mCRPC do not appear to have distinct clinical outcomes to other patients.
Clinical genitourinary cancer. 2025 Apr 04 [Epub ahead of print]
Colin Williams, Andrisha-Jade Inderjeeth, Wei Hong, Jane McKenzie, Angelyn Anton, Andrew Weickhardt, Shirley Wong, Jeremy Shapiro, Phillip Parente, Jeffrey Goh, Javier Torres, Annabel Smith, Anthony Joshua, Stephen Brown, Christopher Steer, Julie Johns, Peter Gibbs, Ben Tran, Arun A Azad
Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia; Medical Oncology, St Vincent's Hospital, Melbourne, Australia. Electronic address: ., Medical Oncology, Sir Charles Gairdner Hospital, Perth, Australia; Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia., Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia., Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia; Medical Oncology, Eastern Health, Melbourne, Australia., Medical Oncology, Olivia Newton-John Cancer Wellness and Research Centre, Melbourne, Australia., Medical Oncology, Western Health, Melbourne, Australia., Medical Oncology, Monash University, Melbourne, Australia; Medical Oncology, Cabrini Health, Melbourne, Australia., Medical Oncology, Eastern Health, Melbourne, Australia; Medical Oncology, Monash University, Melbourne, Australia., Medical Oncology, Royal Brisbane and Women's Hospital, Brisbane, Australia., Medical Oncology, Goulburn Valley Health, Shepperton, Australia., Medical Oncology, Lyell McEwin Hospital, Adelaide, Australia., Medical Oncology, Kinghorn Cancer Centre, St Vincent's Hospital, Sydney, Australia; Garvan Institute of Medical Research, Sydney, Australia., Medical Oncology, Grampians Health, Ballarat, Australia., Medical Oncology, Border Medical Oncology, Albury Wodonga regional cancer Centre, Albury, Australia; University of NSW, Rural Clinical Campus, Albury, Australia., Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia; Medical Oncology, Western Health, Melbourne, Australia., Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia., Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia.