Predictors of resistance to abiraterone acetate or enzalutamide in patients with metastatic castration-resistant prostate cancer in post-docetaxel setting: a single-center cohort study

Autor: Eduard Vrdoljak, Davor Eterović, Tomislav Omrčen
Rok vydání: 2020
Předmět:
0301 basic medicine
Oncology
Male
Cancer Research
Abiraterone Acetate
Docetaxel
Single Center
Cohort Studies
chemistry.chemical_compound
Prostate cancer
0302 clinical medicine
Antineoplastic Combined Chemotherapy Protocols
Pharmacology (medical)
Neoplasm Metastasis
Aged
80 and over
Abiraterone acetate
Middle Aged
Prostatic Neoplasms
Castration-Resistant
Treatment Outcome
030220 oncology & carcinogenesis
Benzamides
Disease Progression
Hormonal therapy
Kallikreins
medicine.drug
Cohort study
Adult
medicine.medical_specialty
Antineoplastic Agents
03 medical and health sciences
Internal medicine
Nitriles
Phenylthiohydantoin
medicine
Enzalutamide
Humans
Aged
Pharmacology
business.industry
Prostate-Specific Antigen
medicine.disease
Confidence interval
030104 developmental biology
chemistry
Drug Resistance
Neoplasm
abiraterone
enzalutamide
prostate cancer
resistance
Prednisone
business
Zdroj: Anti-cancer drugs. 31(7)
ISSN: 1473-5741
Popis: Treatment with abiraterone acetate or enzalutamide is one of the approved approaches in men with metastatic castration-resistant prostate cancer (mCRPC) in the post-docetaxel setting. However, a significant fraction of patients do not respond to treatment, and we aimed to determine their characteristics. From April 2015 to May 2019, 71 patients with mCRPC were treated with abiraterone acetate (N = 34) or enzalutamide (N = 37) at our institution. Resistance to treatment was defined as radiological or scintigraphic progression within 3 months, as documented at the first control. After a median follow-up of 14.9 months, resistance was detected in 22 patients (31%). Many of the baseline characteristics differed between responders and nonresponders but did not serve as predictors with clinically acceptable certainty. To overcome this, the resistance score was defined as the number of positive out of the following six predictors: (1) not only prostate specific antigen (PSA) progression after docetaxel (2) Eastern Cooperative Oncology Group (ECOG) performance status >1 (3) duration of metastatic disease 52 ng/mL (5) serum alkaline phosphatase >119 g/L (6) serum hemoglobin (Hb) concentration 3 positive predictors. Therefore, by using a cutoff of four positive predictors, the resistance score showed both a high sensitivity of 82% [57–96% ; 95% confidence interval (CI)] and a specificity of 88% (74–96% ; 95% CI). The proposed resistance score integrates the diagnostic performances of multiple predictors and may serve to decide which patients with mCRPC should be offered treatments other than hormonal therapy.
Databáze: OpenAIRE
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