1. Efficacy and safety of abiraterone acetate plus prednisone vs. cabazitaxel as a subsequent treatment after first-line docetaxel in metastatic castration-resistant prostate cancer: results from a prospective observational study (CAPRO).
- Author
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Puente J, González-Del-Alba A, Sala-Gonzalez N, Méndez-Vidal MJ, Pinto A, Rodríguez Á, Cuevas Sanz JM, Muñoz Del Toro JR, Useros Rodríguez E, García García-Porrero Á, and Vázquez S
- Subjects
- Abiraterone Acetate adverse effects, Age Factors, Aged, Aged, 80 and over, Anemia etiology, Antineoplastic Agents, Hormonal adverse effects, Antineoplastic Combined Chemotherapy Protocols, Asthenia etiology, Humans, Kaplan-Meier Estimate, L-Lactate Dehydrogenase analysis, Male, Middle Aged, Multivariate Analysis, Pain etiology, Prednisone adverse effects, Progression-Free Survival, Proportional Hazards Models, Prospective Studies, Spain, Taxoids adverse effects, Treatment Outcome, Abiraterone Acetate therapeutic use, Adenocarcinoma drug therapy, Antineoplastic Agents, Hormonal therapeutic use, Docetaxel therapeutic use, Prednisone therapeutic use, Prostatic Neoplasms, Castration-Resistant drug therapy, Taxoids therapeutic use
- Abstract
Background: To describe the patterns of second-line treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) after docetaxel treatment in a Spanish population, to identify the factors associated with those patterns, and to compare the efficacy and safety of the treatments most frequently administered., Methods: Observational, prospective study conducted in patients with histologically or cytologically confirmed prostate adenocarcinoma; documented metastatic castration-resistant disease; progression after first-line, docetaxel-based chemotherapy with or without other agents., Results: Of the 150 patients recruited into the study, 100 patients were prescribed abiraterone acetate plus prednisone (AAP), 44 patients received cabazitaxel plus prednisone (CP), and 6 patients received other treatments. Age (odds ratio [OR] 1.06, 95% [confidence interval] CI 1.01 to 1.11) and not elevated lactate dehydrogenase (LDH) levels (OR 0.33, 95% CI 0.14 to 0.76) were independently associated with the administration of AAP. Treatment with AAP was associated with significantly longer clinical/radiographic progression-free survival (hazard ratio [HR] 0.57, 95% CI 0.38 to 0.85) and overall survival (OS; HR 0.40, 95% CI 0.21 to 0.76) compared to CP, while no significant differences between the treatments were found regarding biochemical progression-free survival (PFS; HR 0.78 [95% CI 0.49 to 1.24]). However, in a post-hoc Cox regression analysis adjusted for potential confounders there were not differences between AAP and CP in any of the time-to-event outcomes, including overall survival. We observed no new safety signals related to either regimen., Conclusion: Second-line AAP for patients with mCRPC is the most common treatment strategy after progression with a docetaxel-based regimen. When controlling for potential confounders, patients receiving this treatment showed no differences in PFS and OS in comparison to those receiving CP, although these latter results should be confirmed in randomized controlled trials.
- Published
- 2019
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