Real-life Data on First- and Second-Line Treatment of Metastatic Castration-Resistant Prostate Cancer With Abiraterone, Enzalutamide and Cabazitaxel - A multicentric Study From Portugal.

Autor: Botelho F; Department of Urology, Centro Hospitalar Universitário S. João, Porto, Portugal; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal. Electronic address: francisco.botelho@gmail.com., Braga I; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; Department of Urology, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal., Leão R; Department of Urology, CUF and Hospital de Braga, Braga, Portugal., Teves F; Department of Urology, Centro Hospitalar Universitário do Porto, Porto, Portugal., Dias J; Department of Urology, Centro Hospitalar de Vila Nova Gaia/Espinho, Vila Nova de Gaia, Portugal., Rodrigues F; Department of Urology, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal., Oliveira J; Department of Urology, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal., Augusto I; Department of Oncology, Centro Hospitalar Universitário S. João, Porto, Portugal., Portela C; Department of Oncology, Hospital de Braga, Braga, Portugal., Febra J; Department of Oncology, Centro Hospitalar Universitário do Porto, Porto, Portugal., Custódio S; Department of Oncology, Centro Hospitalar de Vila Nova Gaia/Espinho, Vila Nova de Gaia, Portugal., Liu P; Department of Oncology, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal., Gago P; Department of Oncology, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal., Miranda A; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal., Silva C; Department of Urology, Centro Hospitalar Universitário S. João, Porto, Portugal; Department of Urology, Faculdade de Medicina da Universidade do Porto, Porto, Portugal., Pacheco-Figueiredo L; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; Department of Urology, Private Hospitals of Braga Sul and Gaia, Trofa Saúde Group, Portugal.
Jazyk: angličtina
Zdroj: Clinical genitourinary cancer [Clin Genitourin Cancer] 2024 Dec; Vol. 22 (6), pp. 102169. Date of Electronic Publication: 2024 Jul 18.
DOI: 10.1016/j.clgc.2024.102169
Abstrakt: Introduction and Objectives: New drugs for metastatic castrate resistant prostate cancer (mCRPC) were approved, first in the pos-docetaxel and then in the pre-docetaxel setting. We aim to assess the real daily practice benefit of abiraterone (Abi), enzalutamide (Enz) and cabazitaxel (Cab) in patients with mCRPC, compare it with RCT results and compare Abi vs Enz.
Materials and Methods: We retrospectively collected the data of all consecutive mCRPC patients treated with Abi, Enz or Cab in the six major oncological hospitals in the north of Portugal until December 2020.
Results: A total of 470 treatments pre-docetaxel (163 Abi and 307 Enz) and 373 pos-docetaxel (160 Abi, 148 Enz and 59 Cab) were included, with median follow-up time of 35 months. Mean age was 73.1, 84.4% had ECOG status < 2, ISUP grade was ≥ 4 in 59% and 28.0% had oligometastatic disease. In first line, for Abi and for Enz respectively, the proportion of patients with PSA reduction > 50% was 64.4% and 80.4% (P < .001), the mean duration of treatment (DT) was 10 and 14 months (P = .037) and the median overall survival (OS) was 25 months and 30 months (P = .17). In second line the results for Abi, Enz and Cab were respectively: proportion of patients with PSA reduction > 50% was 40.4%, 57.4% and 24.6% (p for Abi vs Enz=0.004); DT was 7, 8, and 3 months (p for Abi vs Enz = 0.27); OS was 17, 22 and 10 months (p for Abi vs. Enz = 0,07).
Conclusion: These drugs have good efficacy in real-world evidence, similar to those reported in randomized clinical trials, with the expected exception of lower OS due to the inclusion of a broader sample of patients. Our results add to the evidence that Enz might have better efficacy in this setting compared with Abi.
Competing Interests: Disclosure The following authors declare to have received remuneration from consulting and lectures of the following companies: Francisco Botelho: Astellas, Janssen-Cilag, Bayer, MSD Isaac Braga: Astellas, Janssen-Cilag, Bayer Frederico Teves: Astellas, Ipsen, Janssen-Cilag, Bayer, Glaxo, Jaba-Recordatti, Medtronic Ricardo Leão: Roche, Janssen-Cilag, Ipsen. Carlos Silva: Astellas, Janssen-Cilag, Astra Zéneca, Menarini, Ferring, Pfizer, Glaxo, Bayer. Luís Pacheco-Figueiredo: Astellas. The remaining authors have no confit of interest to declare.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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