Tulane University School of Medicine, New Orleans, LA
A. Oliver Sartor , Matthew R. Cooperberg , Andrew J. Armstrong , Nicholas J. Vogelzang , Jeffrey L. Vacirca , Mark C. Scholz , Shaker R. Dakhil , Luke T. Nordquist , Elisabeth I. Heath , Nancy N. Chang , Jennifer Susan LIll , Celestia S. Higano
Background: Sip-T is an autologous immunotherapy approved for asymptomatic or minimally symptomatic metastatic castration-resistant prostate cancer (mCRPC).Many therapeutic agents have been approved in a short time frame, and their optimal sequencing in mCRPC is under investigation. The sequencing of agents post–sip-T treatment on PROCEED (NCT01306890) and factors associated with a shorter time to first ACI (tACI) are described. Methods: The number of unique and most common sequences and sequence trends were analyzed. Post–sip-T ACIs evaluated were abiraterone (abi), enzalutamide (enz), docetaxel (D), and cabazitaxel (cbz), excluding radium-223 due to its late approval relative to PROCEED initiation. The tACI and factors associated with shorter tACI were assessed. Results: 1902 pts received ≥1 sip-T infusion, and an estimated 37.0% and 21.2%had not received an ACI at 1 and 2 y, respectively, post–sip-T. 1331 (70%) pts received abi, enz, D, or cbz after sip-T. 47 therapy sequences were recorded post–sip-T, with the most used therapies in order of prevalence: abi alone, enz alone, D alone, abi → enz, abi → D, D → enz, and D → abi. The most common post–sip-T sequences beginning with abi, enz, or D are below (Table). Only 25 pts received cbz as the first ACI post–sip-T. Pts who received abi prior to sip-T had a shorter median tACI (4.6 mos) compared with all pts (8.3 mos) or pts with D prior to sip-T (7.3 mos). Higher baseline alkaline phosphatase, lower hemoglobin, and prior radical prostatectomy were associated with shorter tACI. Conclusions: In the evolving mCRPC space, 47 unique ACI sequences were recorded post-sip-T. The most common sequences post–sip-T were abi, enz, and D as single agents. Prior abi was associated with a shorter tACI post–sip-T, which warrants longer follow-up. While many pts received subsequent therapy, ~20% had not received an ACI at 2 y post–sip-T. Clinical trial information: NCT01306890
Abi (N = 730) | abi alone | abi → enz | abi → D | abi → enz → D | abi → D → enz |
Pts | 413 | 120 | 76 | 40 | 25 |
D (N = 340) | D alone | D → enz | D → abi | D → cbz | D → abi → enz |
Pts | 127 | 52 | 50 | 32 | 14 |
Enz* (N = 236) | enz alone | enz → abi | enz → D | enz → cbz | enz → D → cbz |
Pts | 157 | 25 | 25 | 11 | 7 |
*Many pts in PROCEED received their first ACI prior to FDA approval of enz pre-D.
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