Comparison of radiographic progression-free survival and PSA response on sequential treatment using abiraterone and enzalutamide for newly diagnosed castration-resistant prostate cancer: A propensity score matched analysis from multicenter cohort

Kazumasa Komura, Yuya Fujiwara, Taizo Uchimoto, Kenkichi Saito, Naoki Tanda, Tomohisa Matsunaga, Atsushi Ichihashi, Takeshi Tsutsumi, Takuya Tsujino, Yuki Yoshikawa, Yudai Nishimoto, Tomoaki Takai, Koichiro Minami, Kohei Taniguchi, Tomohito Tanaka, Hirofumi Uehara, Hajime Hirano, Hayahito Nomi, Naokazu Ibuki, Kiyoshi TakaharaTeruo Inamoto, Haruhito Azuma

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12 Citations (Scopus)

Abstract

Background: There is emerging evidence that radiographic progression-free survival (rPFS) is highly correlated with overall survival (OS), potentially serving as an indicator of treatment outcome for castration-resistant prostate cancer (CRPC). The objective of this study is to assess rPFS and prostate specific antigen (PSA) response in sequential treatment using androgen signaling inhibitors (ASIs) including abiraterone and enzalutamide in newly diagnosed CRPC. Methods: Propensity score matching was performed to reduce bias by confounding factors between first-line ASIs. The primary endpoints of the study included rPFS, time to PSA progression (TTPP), and PSA response. Results: A paired-matched group of 184 patients were identified. From the initiation of first-line ASIs, there was no significant difference in rPFS, TTPP, and PSA response between treatment arms. From the initiation of second-line ASIs, enzalutamide following abiraterone consistently exhibited longer rPFS (median: 7 and 15 months, p = 0.04), TTPP, and better PSA response compared to the reverse, whereas OS did not reach significance (median: 14 and 23 months, p = 0.35). Conclusion: Although the effect of ASIs as the first line was similar, the extent of cross-resistance might differ towards less resistance in enzalutamide following abiraterone than the reverse.

Original languageEnglish
Article number1251
JournalJournal of Clinical Medicine
Volume8
Issue number8
DOIs
Publication statusPublished - 08-2019

All Science Journal Classification (ASJC) codes

  • General Medicine

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