Background: Early CRPC (<12 months, m) with 1st hormonal therapy (HT) was found to predict poor efficacy of 2nd HT, but did not seem to impair the benefit of D-based chemotherapy. We evaluated the impact of this variable in our cohort of patients (pts) treated also with second-line chemotherapy C. Methods: Records of 132 consecutive mCRPC pts were retrospectively collected in 9 centers. PSA response ≥ 30% and time to biochemical progression (TTBP) with 1st- and 2nd-HT, D and C were evaluated according to time to progression to CRPC (<12 m and ≥12 m). PSA-response, TTBP and Overall Survival (OS) were compared using exact, Wilcoxon and log-rank tests, respectively. Results: All patients received first HT, D and C, and 94 of them received second HT. Time to CRPC <12 m was associated with a reduced OS and poor PSA-response and TTBP with second HT. Taxanes showed a similar PSA response whatever the time to CRPC but TTBP was slightly shorter in men with time to CRPC <12m. Conclusions: This retrospective analysis of 132 pts with mCRPC suggests that rapid progression to CRPC (<12 m) is associated with a poor prognosis and a low response to second-HT. PSA response to taxanes does not seem to be affected by time to CRPC, but TTBP is shorter in men with early CRPC. Prospective randomized trials are needed to confirm these results.

* Includes orchiectomy, LHRH agonist, LHRH agonist + anti-androgen. ** Before (46.8%) or after (53.2%) docetaxel: includes antiandrogen, diethystilboestrone, estramustine, ketoconazole, abiraterone (after D), enzalutamide (after D). PFS and OS in months.