Time trends of drug specific adverse events among patients on androgen receptor antagonists: Implications for remote monitoring.

Authors

null

Lauren Fleshner

University Health Network, Toronto, ON, Canada

Lauren Fleshner , Sophie O'Halloran , Katherine Lajkosz , Jacob Wise , Miran Kenk , Susan Nguyen , Neil Eric Fleshner

Organizations

University Health Network, Toronto, ON, Canada, Univeristy Health Network, Toronto, ON, Canada, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, Division of Urologic Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada

Research Funding

Other
University Health Network

Background: In light of the global pandemic, reducing patient exposure via remote monitoring is desirable. Currently, advanced prostate cancer patients prescribed Abiraterone or Enzalutamide are scheduled for an in-person appointment monthly, to screen for adverse events (AEs). We set out to determine time trends of drug specific AEs in order to determine whether reducing in-person visits for patients taking either Abiraterone or Enzalutamide is feasible. Methods: This chart review was conducted on 667 unique advanced prostate cancer patients, being either metastatic hormone sensitive or castration resistant and utilizing Abiraterone or Enzalutamide. Patients who switched courses of treatment and received both drugs were included twice in the data, resulting in 828 “subjects” overall. Data were collected via accessing electronic patient records, to determine the first sign of an AE related to either Abiraterone or Enzalutamide. These AEs include; hypertension, elevated liver enzymes (bilirubin, AST, ALT) or hypokalemia. Survival analysis was used to determine the time to adverse event. All grade AEs are included in this analysis. Results: In this study, 425 and 403 patients received Enzalutamide and Abiraterone, respectively. In total, 36.3% of those who took Enzalutamide experienced an AE, compared to 43.4% of patients on Abiraterone. For patients utilizing Abiraterone, cumulative incidence of AEs at 3,6,9 and 12 months were: 65.0%, 81.2%, 90.9% and 93.9%, respectively. Among Enzalutamide users, cumulative incidence of AEs at 3,6,9 and 12 months were: 46.8%, 67.5%, 81.2% and 88.3%, respectively. The primary first AEs associated with Enzalutamide consumption were hypertension and liver dysfunction (77.48% and 22.52%). In the Abiraterone group, the first associated AEs were liver dysfunction (48.78%), hypertension (46.34%), and hypokalemia (4.88%). Conclusions: These data suggest that the likelihood of attaining AEs associated with Abiraterone or Enzalutamide utilization decreases over time and tend to occur within the first 6 months of therapy. Furthermore, the vast majority of these AEs can be remotely monitored via outside laboratories and remote blood pressure monitoring. In light of the COVID-19 crisis, remote monitoring after 6 months of taking Abiraterone or Enzalutamide would appear appropriate. Efforts to further safely reduce in person visits should be explored.

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

2021 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session: Prostate Cancer - Advanced Disease

Track

Prostate Cancer - Advanced

Sub Track

Impact of COVID-19

Citation

J Clin Oncol 39, 2021 (suppl 6; abstr 40)

DOI

10.1200/JCO.2021.39.6_suppl.40

Abstract #

40

Poster Bd #

Online Only

Abstract Disclosures

Similar Abstracts

Abstract

2024 ASCO Genitourinary Cancers Symposium

Effect of prednisone dosing on mineralocorticoid-related side effects with abiraterone in prostate cancer.

First Author: Maksym Goryachok

First Author: Amy L Shaver

Abstract

2021 ASCO Annual Meeting

Survival of veterans treated with enzalutamide and abiraterone in advanced prostate cancer.

First Author: Martin W. Schoen