TY - JOUR
T1 - Survival Outcomes From a Cumulative Analysis of Worldwide Observational Studies on Sequential Use of New Agents in Metastatic Castration-Resistant Prostate Cancer
AU - the CASTOR study investigators
AU - Caffo, Orazio
AU - Wissing, Michel
AU - Bianchini, Diletta
AU - Bergman, Andries
AU - Thomsen, Frederik B.
AU - Schmid, Sebastian
AU - Yu, Evan Y.
AU - Bournakis, Evangelos
AU - Sella, Avishay
AU - Zagonel, Vittorina
AU - De Giorgi, Ugo
AU - Tucci, Marcello
AU - Gelderblom, Hans
AU - Galli, Luca
AU - Pappagallo, Giovanni
AU - Bria, Emilio
AU - Sperduti, Isabella
AU - Oudard, Stephane
N1 - Publisher Copyright:
© 2019
PY - 2020/2
Y1 - 2020/2
N2 - Introduction: The sequential use of a number of new agents (NAs) have improved the overall survival (OS) of patients with metastatic castration-resistant prostate cancer whose disease progresses after docetaxel (DOC) treatment. The aim of this study was to assess the cumulative survival outcomes of different sequencing strategies by evaluating the individual data from published studies of patients treated with a post-DOC treatment sequence of 2 NAs. Patients and Methods: The patients’ individual data were analyzed to investigate whether different sequencing strategies lead to differences in OS. Results: We analyzed the data of 1099 evaluable patients. Among the patients treated with a second-line new hormone agent (NHA), median OS from the start of third-line treatment was significantly longer in the patients treated with cabazitaxel (CABA) than in those treated with abiraterone acetate or enzalutamide. Median cumulative OS (cumOS) from the start of second-line treatment was 21.1 months in the patients who received NHA then NHA, 22.1 months in those who received NHA then CABA, and 21.0 months in those who received CABA then NHA. Among the patients with a second-line progression-free survival of ≥6 months, median cumOS was significantly longer in patients who received CABA-including sequences than in those treated with NHA then NHA sequences (29.5 vs. 24.8 months; P = .03). Conclusion: Our findings suggest that the sequential use of NAs with different mechanisms of action improves cumOS regardless of the order in which they are administered, thus supporting the hypothesis of cross-resistance between the 2 NHAs. We assessed 1099 metastatic castration-resistant prostate cancer patients to evaluate the cumulative survival outcomes of different sequencing strategies. Cumulative overall survival from the start of second-line treatment was significantly longer in patients who received cabazitaxel-including sequences and showed a progression-free survival of ≥6 months. The sequential use of new agents with different mechanisms of action could improve disease control.
AB - Introduction: The sequential use of a number of new agents (NAs) have improved the overall survival (OS) of patients with metastatic castration-resistant prostate cancer whose disease progresses after docetaxel (DOC) treatment. The aim of this study was to assess the cumulative survival outcomes of different sequencing strategies by evaluating the individual data from published studies of patients treated with a post-DOC treatment sequence of 2 NAs. Patients and Methods: The patients’ individual data were analyzed to investigate whether different sequencing strategies lead to differences in OS. Results: We analyzed the data of 1099 evaluable patients. Among the patients treated with a second-line new hormone agent (NHA), median OS from the start of third-line treatment was significantly longer in the patients treated with cabazitaxel (CABA) than in those treated with abiraterone acetate or enzalutamide. Median cumulative OS (cumOS) from the start of second-line treatment was 21.1 months in the patients who received NHA then NHA, 22.1 months in those who received NHA then CABA, and 21.0 months in those who received CABA then NHA. Among the patients with a second-line progression-free survival of ≥6 months, median cumOS was significantly longer in patients who received CABA-including sequences than in those treated with NHA then NHA sequences (29.5 vs. 24.8 months; P = .03). Conclusion: Our findings suggest that the sequential use of NAs with different mechanisms of action improves cumOS regardless of the order in which they are administered, thus supporting the hypothesis of cross-resistance between the 2 NHAs. We assessed 1099 metastatic castration-resistant prostate cancer patients to evaluate the cumulative survival outcomes of different sequencing strategies. Cumulative overall survival from the start of second-line treatment was significantly longer in patients who received cabazitaxel-including sequences and showed a progression-free survival of ≥6 months. The sequential use of new agents with different mechanisms of action could improve disease control.
KW - Androgen-receptor targeting agents
KW - Chemotherapy
KW - Second-line
KW - Sequencing
KW - Third-line
UR - http://www.scopus.com/inward/record.url?scp=85076515064&partnerID=8YFLogxK
U2 - 10.1016/j.clgc.2019.09.010
DO - 10.1016/j.clgc.2019.09.010
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C2 - 31767448
AN - SCOPUS:85076515064
SN - 1558-7673
VL - 18
SP - 69-76.e4
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
IS - 1
ER -