Prognosis and safety of radium-223 with concurrent abiraterone acetate or enzalutamide use for metastatic castration-resistant prostate cancer: Real-world data of Japanese patients.

Autor: Miyoshi Y; Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan., Yasui M; Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan., Ttsutsumi S; Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan., Kawahara T; Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan., Uemura KI; Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan., Hayashi N; Department of Urology Graduate School of Medicine Yokohama City University Yokohama Japan., Nozawa M; Department of Urology Faculty Medicine Kindai University Osaka Japan., Yoshimura K; Department of Urology Faculty Medicine Kindai University Osaka Japan., Uemura H; Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan., Uemura H; Department of Urology Faculty Medicine Kindai University Osaka Japan.
Jazyk: angličtina
Zdroj: BJUI compass [BJUI Compass] 2020 Sep 05; Vol. 2 (1), pp. 31-38. Date of Electronic Publication: 2020 Sep 05 (Print Publication: 2021).
DOI: 10.1002/bco2.42
Abstrakt: Objectives: To evaluate the real-world data on the efficacy and safety of a combination therapy with radium-223 (Ra-223) and second-generation androgen-receptor targeting agents (ARTAs), including abiraterone acetate (ABI) and enzalutamide (ENZ), among Japanese patients with bone metastatic castration-resistant prostate cancer (CRPC).
Patients and Methods: We retrospectively reviewed 79 patients with bone metastatic CRPC who were treated with Ra-223. The number of patients with concurrent ARTA use was 24:17 receiving ABI and 7 receiving ENZ. We evaluated the overall survival (OS) according to ARTA use and compared the survival of patients treated with Ra-223 with or without ARTA using multivariate analysis.
Results: The median survival in the entire cohort was 23.5 months. The patients receiving Ra-223 combined with ARTA showed a tendency of better OS than patients treated with Ra-223 alone, although no significant difference was observed (median OS, 26.5 vs 23.5 months; P  = .115). A multivariate analysis showed that the extent of disease on bone scan (EOD) scores and pain at baseline were significant predictors of OS. The concurrent use of bone-modifying agents (BMAs) was not significant for favorable OS ( P  = .050). However, the concurrent use of second-generation ARTA was not a significant factor for OS. Regarding safety, a bone fracture occurred in only one (4.2%) of 24 patients treated with combined Ra-223 and ARTA therapy.
Conclusion: Our real-world data analysis suggested that Ra-223 combined with a second-generation ARTA is well tolerated in Japanese patients. The EOD score and pain at baseline are significant prognostic factors for OS, but the concurrent use of second-generation ARTA has no influence on OS among men treated with Ra-223. The concurrent use of BMA yields a marginally favorable OS.
Competing Interests: The authors have nothing to disclose.
(© 2020 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.)
Databáze: MEDLINE
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