Enzalutamide versus Abiraterone Acetate as first-line treatment of castration resistant metastatic prostate cancer in geriatric (>= 75) patients

Autor: Irfan Cicin, Ozge Keskin, Osman Kostek, Aziz Karaoglu, Yuksel Urun, Büşra Kasım, Hacer Demir, Hakan Akbulut, Berna Oksuzoglu, Görkem Türkkan, Mutlu Dogan, Arzu Yaşar, Ozgur Tanriverdi, Fulden Yumuk, Ismail Erturk, Guliz Ozgun, Hasan Şenol Coşkun, Mustafa Gürbüz, Mehmet Ali Nahit Sendur, Sema Sezgin Goksu, Cagatay Arslan, Teoman Sakalar, Nuri Karadurmuş, Serkan Degirmencioglu, Ali Alkan, Burak Bilgin, Zeynep Gulsum Guc, Tugba Akin Telli, Elif Berna Köksoy
Přispěvatelé: MÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Alkan, Ali
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Oncology
Medicine (General)
castration resistant prostate cancer
clinical evaluation
proportional hazards model
retrospective study
very elderly
Abiraterone Acetate
geriatric patient
law.invention
zoledronic acid
chemistry.chemical_compound
Prostate cancer
Elderly
Randomized controlled trial
law
predictive value
Abiraterone acetate
aged
multivariate analysis
Tolerability
drug withdrawal
Toxicity
medicine.medical_specialty
hypertension
side effect
overall survival
cancer prognosis
Article
R5-920
male
Internal medicine
malaise
Enzalutamide
hypokalemia
medicine
controlled study
human
drug dose reduction
Gleason score
Proportional hazards model
business.industry
denosumab
medicine.disease
major clinical study
Metastatic castration-resistant prostate cancer
Discontinuation
drug efficacy
chemistry
business
Zdroj: Journal of Men's Health, Vol 17, Iss 4, Pp 128-134 (2021)
Popis: Introduction: The efficacy and tolerability of Enzalutamide and Abiraterone Acetate have been reported in elderly patients with metastatic castration resistant prostate cancer (mCRPC). However, there is no randomized study directly comparing antitumor effects between these 2 agents in geriatric patients. We aimed to evaluate the efficacy of Enzalutamide (ENZA) and Abiraterone Acetate (AA) as a first-line treatment of mCRPC in elderly patients. Materials and methods: The geriatric patients (≥75 years of age) with a diagnosis of mCRPC and treated with first-line ENZA or AA were included. The impacts of clinical parameters and treatment modalities on overall survival (mOS) were analyzed retrospectively and Cox regression analysis was performed. Results: One hundred thirty-four mCRPC patients (77 in AA, 57 in ENZA), with a median age of 81 (75–93) were analyzed. The patient and disease characteristics were similar between arms. While there were more grade 1–2 toxicities in AA arm (45.5% vs 17.5%, P = 0.001), the discontinuation due to toxicity was similar between groups (8.5% vs 5.9%, P = 0.81). The mOS was 18.0 months (95% CI, 15.2–20.7) in AA, and 20.0 months (95% CI, 4.4–35.5) in ENZA arm (P = 0.47). In multivariate analysis, high Gleason score (≥8) (HR: 2.0 (95% CI, 1.1–3.4), P = 0.009) and high initial PSA values (≥100 ng/mL) (HR: 2.6 (95% CI, 1.5–4.8), P = 0.001) were poor prognostic factors. The choice of AA vs ENZA was insignificant as a predictor of OS (HR: 0.87 (95% CI, 0.48–1.56), P = 0.65). Conclusion: In the first-line treatment of mCRPC in elderly (≥75) patients, AA and ENZA showed similar results in terms of mPFS and mOS. The clinical impacts of second-generation androgen receptor pathway inhibitors in the elderly population should be tested in prospective randomized studies.
Databáze: OpenAIRE
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