Instituto Valenciano de Oncología, Valencia, Spain
Miguel Angel Climent Duran , M Isabel Sáez , Josep M. Piulats , A. Montesa , Isabel Chirivella , Alejandro gonzalez Forastero , Cristina Caballero Diaz , Lucia Heras , Begona Mellado , Sergio Vazquez-Estevez , David Olmos , Ignacio Duran , María José Juan Fita
Background: Different treatments efficacy for mCRPC when progression after docetaxel x 6 cycles + ADT (as CHAARTED scheme) are unknown as all pivotal trials where performed in patients who progressed to mCPRC after ADT. Methods: A retrospective analysis of 175 mCRPC patients of 10 spanish hospitals who were treated with docetaxel + ADT as first line treatment was performed. Patients characteristics at diagnosis (age, gleason) and at progression to mCRPC were analyzed (PSA, presence of visceral mets, type of progression). As efficacy endpoints, clinical and objective response, and survival from progression to mCRPC were analyzed. Results: Median age at diagnosis 65.2 years old (range 44-84). Metastatic at diagnosis 173. Bone metastasis 155 (88,5%), visceral 31 (17.7%), gleason >7 130 (74,3%), number docetaxel cycles: 6 (80%), 5 (5,7%), <5 (14,3 %). Median survival from diagnosis: 35 months. Progression to CRPC 78pts (44.5%) Type of progression: PSA 74/78 (94,9%), clinical 45/78 (57.7%), radiological 59/78 (75.6%). Median survival from progression to CRPC: 10.3 months. Treatments frequency, clinical benefit (RP/EE) and median survival: abi 30 (38.4%)/ 7(23.3%)/ 15.7 m; enza 12 (15.4%)/ 4 (33.3%)/ 10.4 m, caba 14(17.9%)/ 3(21.4%)/ 6.4m; Other treatments frequency: Ra223 4 (5.1%), docetaxel 4 (5.1%), others/no treatment/BSC 14 (17.8%). Clinical and radiological progression before treatment was 36.7%/63.3% in abi patients, 58.3%/63.7% in enza and 93.9%/93.9% in caba pts. Visceral (mostly hepatic) metastasis were more frequent in caba (57.1%) than in abi (11.8%) or enza (0%) pts. Median PSA value abi 375/ caba 1633. Conclusions: Although AA seems be more effective than cabazitaxel in mCRPC progressed after docetaxel + ADT in HSPC, patients treated with caba are of worse prognosis.
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