Safety and efficacy of abiraterone acetate (AA) in patients aged 75 or more with metastatic castration-resistant prostate cancer (mCRPC) in both pre-chemotherapy or post-chemotherapy settings: Real-life experience from thirteen Italian centers.

Authors

null

Zuzana Sirotova

Oncology and Onco-hematology, Regional Hospital Parini, Aosta, Italy

Zuzana Sirotova , Giulia Courthod , Alfredo Tartarone , Orazio Caffo , Francesca Maines , Maurizio Bertuccelli , Franco Morelli , Gianmauro Numico , Pamela Guglielmini , Giuseppe Fornarini , Veronica Prati , Erica Palesandro , Cinzia Ortega , Alessandra Mosca , Stefania Miraglia , Valentina Perrone , Elena Fea , Giacomo Allegrini , Alessandro Mozzicafreddo , Marina Schena

Organizations

Oncology and Onco-hematology, Regional Hospital Parini, Aosta, Italy, IRCCS Referall Cancer Center of Basilicata, Rionero in Vulture, Italy, Santa Chiara Hospital, Trento, Italy, General Hospital, Livorno, Italy, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy, SS. Antonio e Biagio General Hospital, Alessandria, Italy, San Martino Hospital, Genova, Italy, Humanitas, Gradenigo, Italy, Institute for Cancer Research and Treatment, Candiolo, Italy, ASLCN2 - Alba-Bra, Alba, Italy, Oncology, Maggiore Della Carita University Hospital, Novara, Italy, Hospital Martini, Turin, Italy, S.Croce & Carle Teaching Hospital, Cuneo, Italy

Research Funding

Other

Background: Prostate cancer affects mainly elderly patients (pts) that have different comorbidities. AA is a selective androgen synthesis inhibitor that showed the efficacy in either chemotherapy (CT) naive pts or those pretreated with docetaxel. Its oral administration and good tolerability make it a manegeable treatment for elderly mCRPC pts. Methods: We collected retrospectively data regarding mCRPC pts aged ≥75 years treated with AA in 13 Italian Centers since April 2013. The median age was 79 years (r. 75-90) with 48% of pts being octagerians. Post CT pts had more extensive disease, higher baseline PSA and ECOG PS. Nearly all the pts had comorbidities, the most frequent being hypertension present in 146 pts (58%), 43 pts (17%) had diabetes type II. We evaluated duration of the AA treatment, overall response rate (ORR), 50% PSA decline, time to progression (TTP) and overall survival (OS). We reported all toxicities observed. Results: A total of 252 pts ,147 pre treated with docetaxel and 105 chemo naive, were included. Median duration of treatment with AA was 8,6 months in post CT and 11,5 in CT naive pts. ORR was 35,3% in pre docetaxel and 27,4% in post docetaxel group. 64 pts (65%) and 51 pts (46%) obtained 50% PSA reduction in pre and post docetaxel group, respectively. Median TTP was 8,6 in post docetaxel and 11,9 in CT naive pts. We observed a median OS of 13,8 months in post CT group while for CT naive pts data were not yet mature. AA was well tolerated with only 8 pts (3,2%) who discontinued treatment due to toxicity, while in 4 pts (1,6%) temporary dose reductions were performed. The most frequent G3 toxicities were hypertension and liver toxicity with 4 pts (1,6%) and 5 pts (2%), respectively. After progressing on AA, 85 pts (34%) received at least one subsequent treatment. 40 pts (15,9%) are still on treatment with AA. Conclusions: Even if almost all the pts reported comorbidities at AA start and 72 pts (28,6%) had PS ECOG 2, only a small proportion of them discontinued the treatment due to toxicity confirming that AA is well tolerated and efficient treatment also for elderly patients.

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Abstract Details

Meeting

2018 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Prostate Cancer

Track

Prostate Cancer,Prostate Cancer

Sub Track

Prostate Cancer - Advanced Disease

Citation

J Clin Oncol 36, 2018 (suppl 6S; abstr 209)

DOI

10.1200/JCO.2018.36.6_suppl.209

Abstract #

209

Poster Bd #

K7

Abstract Disclosures