In a nutshell
This study examined treatment patterns for metastatic castration-resistant prostate cancer (mCRPC) progressing after treatment with abiraterone acetate (Zytiga). Chemotherapy with docetaxel (Taxotere) was the most common subsequent therapy. Authors concluded that patients with mCRPC who progress after AA may still benefit from subsequent docetaxel therapy.
Some background
Prostate cancer is typically driven by androgens, the male sex hormone (such as testosterone). Reducing androgen levels and their effect on cancer cell growth can dramatically improve survival. Hormone therapy is often the first-line treatment for metastatic prostate cancer (cancer that has spread to distant parts of the body). Over time, however, cancer can continue to spread despite standard hormone therapy. This is known as metastatic castration-resistant prostate cancer (mCRPC).
In cases of mCRPC, secondary hormone therapies, such as abiraterone acetate, are often recommended. Abiraterone acetate has been found to improve survival and disease progression in men with mCRPC. However, there are limited studies on therapy options for patients progressing after treatment with abiraterone acetate.
Methods & findings
The aim of this study was to examine treatment patterns for mCRPC progressing after treatment with abiraterone acetate (AA).
The results of a study involving 1,088 men with mCRPC were analyzed. Men were randomly assigned to receive either AA or placebo (control drug with no active effect). Treatment patterns were examined between the two groups and across ages.
36% of men received 2 or more and 15% received 3 or more subsequent therapies after AA. In contrast, 45% of men in the placebo received 2 or more and 22% received 3 or more subsequent therapies.
50.2% of men in the placebo group and 48% of men in the AA group received chemotherapy with docetaxel after disease progression. The average duration of docetaxel therapy was 4.2 months. 40% of men in the AA group showed a decline in cancer markers in the blood of 50% or more after docetaxel treatment. The overall response rate for docetaxel therapy was 27% (based on blood tests). Average time to disease progression was 7.6 months.
43% of men aged 75 years or more who progressed on AA received no subsequent therapy. In contrast, 17% of men aged 75 or less who progressed on AA received no subsequent therapy. Overall, docetaxel was the most common subsequent therapy regardless of age and treatment group.
The bottom line
Authors concluded that patients with mCRPC who progress after AA may still benefit from subsequent docetaxel therapy. Overall, older patients were less likely to be treated with subsequent therapy.
The fine print
Further studies that directly compare different subsequent therapies for mCRPC patients progressing after AA are needed.
Published By :
European Urology
Date :
Jul 08, 2016
