Evidence map›Paper›PMID 42190045›Full record

ArticleThe Prostate2026

Efficacy, Safety, and Cost-Effectiveness of Reduced versus Full Initial Doses of Androgen Receptor Signaling Inhibitors in Non-Metastatic Castration-Resistant Prostate Cancer: A Multicenter Retrospective Study.

Himawari Asanuma, Naoki Fujita, Shumon Kato, Yohei Kawashima, Masanao Shinohara, Ryuji Tabata, Fumiya Yoneyama, Ryuma Tanaka, Takuya Oishi, Hikari Miura and 9 more

Abstract readMulticenter Study
In one paragraph

Article in The Prostate, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Himawari AsanumaDepartment of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Naoki FujitaDepartment of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.ORCID 0000-0001-8284-9582
Shumon KatoDepartment of Urology, Ageo Central General Hospital, Ageo, Japan.
Yohei KawashimaDepartment of Urology, Ageo Central General Hospital, Ageo, Japan.
Masanao ShinoharaDepartment of Urology, Ageo Central General Hospital, Ageo, Japan.
Ryuji TabataDepartment of Urology, Sano Kosei General Hospital, Sano, Japan.
Fumiya YoneyamaDepartment of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Ryuma TanakaDepartment of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Takuya OishiDepartment of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Hikari MiuraDepartment of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Kyo TogashiDepartment of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Kazutaka OkitaDepartment of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Hirotaka HoriguchiDepartment of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Toshikazu TanakaDepartment of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Daisuke NoroDepartment of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Yuichiro SuzukiDepartment of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Satoshi SatoDepartment of Urology, Ageo Central General Hospital, Ageo, Japan.
Chikara OhyamaDepartment of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Shingo HatakeyamaDepartment of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.ORCID 0000-0002-0026-4079

Funding

Japan Society for the Promotion of Science 25K12244
6 · The paper itself

Abstract

backgroundThe introduction of novel androgen receptor signaling inhibitors (ARSIs) has substantially transformed the systemic treatment landscape for non-metastatic castration-resistant 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-effectiveness of reduced-dose ARSIs in patients with nmCRPC remain unclear.

methodsThis multicenter retrospective study included 251 patients with nmCRPC who underwent ARSI therapy. Patients were categorized into reduced-dose (n = 46) and full-dose (n = 205) groups according to the initial ARSI dose. The prostate-specific antigen progression-free survival (PSA-PFS), metastasis-free survival (MFS), and overall survival (OS) were compared between the groups. AEs and monthly medical costs for the first ARSI treatment were also evaluated.

resultsNo significant differences in PSA-PFS, MFS, or OS were observed between the two groups (p = 0.307, p = 0.199, and p = 0.287, respectively). Multivariable analysis showed that the initial ARSI dose was not significantly associated with MFS (p = 0.984). The incidence rates of any-grade and grade ≥ 3 AEs did not significantly differ between the two groups (p = 0.171 and P = 1.000, respectively). In contrast, the median monthly cost of the first ARSI treatment was significantly lower in the reduced-dose group than in the full-dose group ($998 vs. $1644, p < 0.001).

conclusionsReduced-dose ARSI therapy was associated with comparable oncological outcomes to full-dose 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.

Indexed as

Androgen Receptor AntagonistsProstatic Neoplasms, Castration-ResistantAgedAged, 80 and overCost-Benefit AnalysisCost-Effectiveness AnalysisDose-Response Relationship, DrugHumansMaleMiddle AgedProstate-Specific AntigenRetrospective StudiesSignal TransductionTreatment OutcomeAndrogen Receptor AntagonistsProstate-Specific Antigencost‐effectivenessnmCRPCnovel ARSIoncological outcomesreduced dosesafety

Identifiers

PMID42190045
PMCPMC13327704

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.