Efficacy of abiraterone and enzalutamide in patients who had disease progression within twelve months of completing docetaxel for metastatic castration sensitive prostate cancer.

Authors

null

Gang Chen

NCI/NIH, Bethesda, MD

Gang Chen , David James VanderWeele , Fatima Karzai , Marijo Bilusic , Munjid Al Harthy , Philip M. Arlen , Inger L. Rosner , Guinevere Chun , Helen Owens , Anna Couvillon , Amy Hankin , Monique Williams , Lisa M. Cordes , William Douglas Figg , James L. Gulley , William L. Dahut , Ravi Amrit Madan

Organizations

NCI/NIH, Bethesda, MD, University of Chicago Medical Center, Chicago, IL, National Cancer Institute at the National Institutes of Health, Bethesda, MD, National Cancer Institute, Bethesda, MD, Walter Reed National Military Medical Center, Bethesda, MD, National Institutes of Health, Bethesda, MD, Clinical Pharmacology Program, National Institutes of Health, Bethesda, MD, The National Cancer Institute at the National Institutes of Health, Bethesda, MD

Research Funding

NIH

Background: Docetaxel is a standard of care for mCSPC. Enzalutamide and abiraterone have been proven to improve survival in metastatic castration-resistant prostate cancer (mCRPC) patients. Little is known about patients who have been treated with docetaxel for mCSPC and subsequent therapeutic responses. This retrospective analysis is to evaluate the response duration of abiraterone and enzalutamide in patients who previously received docetaxel for mCSPC but developed mCRPC within 12 months. Methods: Clinical Trial NCT02649855 enrolled patients with newly diagnosed mCSPC who were treated with standard androgen deprivation therapy (ADT) and docetaxel (75 mg/m2 every 3 weeks for 6 cycles) sequenced with immunotherapy (PROSTVAC) from February 2016 to present. Patients who had progression (based on consecutive PSA rises or imaging) within 1 year of completing docetaxel and went on to subsequent abiraterone/enzalutamide were evaluated. (Note these are different PSA progression criteria than used in CHAARTED, Sweeney, NEJM, 2015). Results: Of the 46 patients evaluated regardless of immunotherapy sequence, 15 (33%) went on subsequent therapy after progression on docetaxel for mCSPC, with 12 patients starting abiraterone/enzalutamide (6 each with high and low volume disease). The median age was 62 (41-83) years. 7/12 patients (58.3%) initiated enzalutamide and 5/12 patients (41.7%) initiated abiraterone. The median duration of treatment for both was 7.12 (1.53–16.0) months, the median time to prostate-specific antigen (PSA) progression was 5.54 (0–15.83) months; 5/12 (41.7%) of patients did not have PSA response. Of note, patients with low volume disease had a median treatment duration of 5.88 months, 3 of them did not have PSA response. Conclusions: These data from a small cohort suggest that patients who have progression within 12 months of completing docetaxel for mCSPC have limited subsequent benefit from enzalutamide or abiraterone. Additional studies are required to determine optimal timing and treatment sequence for patients with mCSPC who rapidly develop mCRPC. Clinical trial information: NCT02649855

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2019 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

Clinical Trial Registration Number

NCT02649855

Citation

J Clin Oncol 37, 2019 (suppl 7S; abstr 241)

DOI

10.1200/JCO.2019.37.7_suppl.241

Abstract #

241

Poster Bd #

K20

Abstract Disclosures