Abiraterone in heavily pretreated patients with metastatic castrate-resistant prostate cancer

Francini, Edoardo; Fiaschi, Anna Ida; Petrioli, Roberto; Bianco, Vincenzo; Laera, Letizia; Francini, Filippo; Roviello, Giandomenico

doi:10.1097/cad.0000000000000258

Cited by 5 publications

(5 citation statements)

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“…One study of 116 patients concentrated on the variables associated with a biochemical response to AA, but only 62 patients were pre‐treated with docetaxel and the rest were chemotherapy naïve . Finally, two small studies respectively described the outcomes of 36 patients who had previously received more than three lines of chemotherapy , and drug safety in 51 patients with cardiovascular morbidities .…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, additional papers describing the COU‐AA‐301 trial have provided further data concerning the advantages of AA in terms of pain relief and skeletal‐related events , reduced fatigue , an improved quality of life , and outcomes in special populations such as patients with visceral metastases or aged >75 years . However, beyond these reports, there are few data concerning the safety and activity of AA in everyday clinical practice .…”

Section: Introductionmentioning

confidence: 99%

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Safety and clinical outcomes of patients treated with abiraterone acetate after docetaxel: results of the Italian Named Patient Programme

et al. 2014

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ObjectiveTo assess the safety and efficacy of abiraterone acetate (AA) in patients with metastatic castration-resistant prostate cancer (mCRPC) treated in a compassionate named patient programme (NPP). Patients and MethodsWe retrospectively reviewed the clinical records of patients with mCRPC treated with AA at the standard daily oral dose of 1000 mg plus prednisone 10 mg/day in 19 Italian hospitals. ResultsWe assessed 265 patients with mCRPC treated with AA. The most frequent (>1%) grade 3-4 toxicities were anaemia (4.2%), fatigue (4.2%), and bone pain (1.5%). The median progression-free survival was 7 months; median overall survival was 17 months after starting AA, and 35 months after the first docetaxel administration. Our study reproduced the clinical outcomes reported in the AA pivotal trial, including those relating to special populations such as the elderly, patients with a poor performance status, symptomatic patients, and patients with visceral metastases. ConclusionsOur data show the safety and activity of AA when administered outside clinical trials, and confirm the findings of the post-docetaxel pivotal trial in the patients as a whole population and in special populations of specific interest.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Safety and clinical outcomes of patients treated with abiraterone acetate after docetaxel: results of the Italian Named Patient Programme

et al. 2014

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“…Five of the 15 patients received Enz immediately after AA; however, no response rates were presented for these 5 patients. Another study reported on 36 patients treated with AA as a fourth-line or fifth-line treatment [23,25]. The OS in this group was 68 weeks; however, these patients were not pretreated with Enz or AA, but were treated with three lines of chemotherapy (Doc and Cab).…”

Section: Discussionmentioning

confidence: 99%

“…The number of reports on fourth-line therapies in mCRPC patients is limited, based on small cohorts and all are retrospective [18,23,24,25]. One study reports on 38 patients treated with miscellaneous fourth-line treatments, with an OS of 20 weeks [18].…”

Section: Discussionmentioning

confidence: 99%

Enzalutamide as a Fourth- or Fifth-Line Treatment Option for Metastatic Castration-Resistant Prostate Cancer

Badrising

Noort²,

Hamberg

et al. 2016

Oncology

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Objective: To evaluate the efficacy of enzalutamide (Enz) as fourth- or fifth-line treatment in men with metastasized castration-resistant prostate cancer (mCRPC), by analyzing a retrospective cohort of heavily pretreated patients. Methods: We evaluated toxicity, overall survival (OS), progression-free survival (PFS) and time to prostate-specific antigen (PSA) progression data from 47 CRPC patients treated with fourth- or fifth-line Enz. Results: All patients were treated with docetaxel and abiraterone acetate and 42 patients (89%) with cabazitaxel. The median age of the patients was 69 years (IQR, 63-73.5), 79% had bone metastases, 55% had lymph node metastases, and 17% had visceral metastases. The median duration of Enz treatment was 12.0 weeks (IQR, 8.3-20.4), and 11 patients (23%) responded to Enz (maximum PSA decline ≥50%). In general, Enz was well tolerated, with the most frequently reported adverse events being fatigue and nausea. The median OS was 40.1 weeks (95% CI, 25.4-61.4), the median PFS was 12.1 weeks (95% CI, 9.9-14.0) and the median time to PSA progression was 15.7 weeks (95% CI, 14.0-28.7). Conclusions: Analysis of this retrospective cohort suggests that Enz is well tolerated and that there is a 23% response rate in heavily pretreated CRPC patients, which is comparable with third-line treatment outcomes.

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“…This phenomenon could be explained by the presence of constitutively activated androgen receptor splice variants, which generally lack the carboxy-terminal ligand-binding domain and could result in resistance to AA and E but which would still be inhibited by tubulin-binding drugs [11]. Another hypothesis could be sought in prostate cancer tissue and in the presence of neuroendocrine cells, as we showed in a prior report [26,27].…”

Section: Discussionmentioning

confidence: 79%

The third line of treatment for metastatic prostate cancer patients: Option or strategy?

Roviello

Petrioli

Laera

et al. 2015

Critical Reviews in Oncology/Hematology

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Abiraterone in heavily pretreated patients with metastatic castrate-resistant prostate cancer

Cited by 5 publications

References 2 publications

Safety and clinical outcomes of patients treated with abiraterone acetate after docetaxel: results of the Italian Named Patient Programme

Safety and clinical outcomes of patients treated with abiraterone acetate after docetaxel: results of the Italian Named Patient Programme

Enzalutamide as a Fourth- or Fifth-Line Treatment Option for Metastatic Castration-Resistant Prostate Cancer

The third line of treatment for metastatic prostate cancer patients: Option or strategy?

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