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Review
. 2021 Jun;112(6):2071-2080.
doi: 10.1111/cas.14889. Epub 2021 May 3.

Recent trend of androgen deprivation therapy in newly diagnosed prostate cancer patients: Comparing between high- and middle-income Asian countries

Jasmine Lim  1 , Mizuki Onozawa  2 , Marniza Saad  3 , Teng Aik Ong  1 ; A-CaP (Asian Prostate Cancer) Study; J-CaP (Japan Prostate Cancer Study Group); M-CaP (Malaysia Prostate Cancer Study Group); Rohan Malek  4 , Hideyuki Akaza  5
Affiliations
Review

Recent trend of androgen deprivation therapy in newly diagnosed prostate cancer patients: Comparing between high- and middle-income Asian countries

Jasmine Lim et al. Cancer Sci. 2021 Jun.

Abstract

The number of newly diagnosed prostate cancer cases varies across Asia, with higher mortality-to-incidence ratio reported in developing nations. Androgen deprivation therapy (ADT), alone or in combination, remains the mainstay of first-line treatment for advanced prostate cancer. Key findings of extensive research and randomized controlled trials have shaped current clinical practice and influenced clinical guideline recommendations. We describe here the recent trend of ADT in newly diagnosed prostate cancer for Asia focusing on Japan (high-income country) and Malaysia (middle-income country) based on the Asian Prostate Cancer (A-CaP) Study. The combination of radiotherapy and ADT or ADT alone was common in patients with intermediate-to-high risk localized and locally advanced disease. For metastatic prostate cancer, maximum androgen blockade (gonadotrophin-releasing hormone [GnRH] agonist/antagonist plus antiandrogen) was prevalent among the Japanese patients while primary ADT alone with GnRH agonist/antagonist was widely practiced in the Malaysian cohort. Upfront combined therapy (ADT plus docetaxel or androgen receptor pathway inhibitor) has significantly improved the outcomes of patients with metastatic castration-naïve prostate cancer. Its application, however, remains low in our cohorts due to patients' financial capacity and national health insurance coverage. Early detection remains the cornerstone in prostate cancer control to improve treatment outcome and patient survival.

Keywords: A-CaP Study; abiraterone acetate; adjuvant ADT; chemohormonal therapy; metastatic prostate cancer.

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Conflict of interest statement

The authors have no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Estimated age‐standardized incidence and mortality rate (A) and mortality‐to‐incidence ratio of prostate cancer (B) in selected Asian countries based on GLOBOCAN 2020 data
FIGURE 2
FIGURE 2
Trends of nonmetastatic (M0) and metastatic (M1) prostate cancer cases in countries included in the Asian Prostate Cancer (A‐CaP) Study
See this image and copyright information in PMC

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