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

IF 2.3 3区 医学 Q3 ONCOLOGY
Francisco Botelho , Isaac Braga , Ricardo Leão , Frederico Teves , Jorge Dias , Filipe Rodrigues , Jorge Oliveira , Isabel Augusto , Catarina Portela , Joana Febra , Sandra Custódio , Patrícia Liu , Patrícia Gago , André Miranda , Carlos Silva , Luís Pacheco-Figueiredo
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Abstract

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.

阿比特龙、恩扎鲁胺和卡巴齐他赛一线和二线治疗转移性阉割耐药前列腺癌的真实数据--葡萄牙的一项多中心研究
引言和目的 治疗转移性阉割耐药前列腺癌(mCRPC)的新药已获批准,首先是在多西他赛前使用,然后是在多西他赛前使用。我们旨在评估阿比特龙(Abi)、恩扎鲁胺(Enz)和卡巴齐他赛(Cab)在mCRPC患者中的实际日常治疗效果,将其与RCT结果进行比较,并比较Abi与Enz。材料与方法我们回顾性收集了葡萄牙北部六家主要肿瘤医院截至2020年12月接受阿比、恩佐胺或卡巴齐他赛治疗的所有连续mCRPC患者的数据。结果共纳入470例多西他赛前治疗(163例阿比和307例恩佐胺)和373例多西他赛后治疗(160例阿比、148例恩佐胺和59例卡巴齐他赛),中位随访时间为35个月。平均年龄为73.1岁,84.4%的患者ECOG状态为2级,59%的患者ISUP分级≥4级,28.0%的患者患有少转移性疾病。在一线治疗中,Abi 和 Enz 的 PSA 降低 50%的患者比例分别为 64.4% 和 80.4%(P < .001),平均治疗时间(DT)分别为 10 个月和 14 个月(P = .037),中位总生存期(OS)分别为 25 个月和 30 个月(P = .17)。在二线治疗中,Abi、Enz和Cab的结果分别为:PSA降低50%的患者比例分别为40.4%、57.4%和24.6%(Abi vs Enz的P=0.004);DT分别为7、8和3个月(Abi vs Enz的P=0.27);OS分别为17、22和10个月(Abi vs Enz的P=0.07)。结论这些药物在真实世界中具有良好的疗效,与随机临床试验报告的疗效相似,但由于纳入了更广泛的患者样本,预期的例外情况是OS较低。我们的研究结果进一步证明,在这种情况下,Enz的疗效可能优于Abi。
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来源期刊
Clinical genitourinary cancer
Clinical genitourinary cancer 医学-泌尿学与肾脏学
CiteScore
5.20
自引率
6.20%
发文量
201
审稿时长
54 days
期刊介绍: Clinical Genitourinary Cancer is a peer-reviewed journal that publishes original articles describing various aspects of clinical and translational research in genitourinary cancers. Clinical Genitourinary Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of genitourinary cancers. The main emphasis is on recent scientific developments in all areas related to genitourinary malignancies. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.
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