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Open Access Special Issue

Optimisation of second line antihormonal treatment for castration resistant metastatic prostate cancer

  • Kullmann Tamás1,*,
  • Kocsis Károly1
  • Ambrus Adél1
  • Kránitz Noémi2
  • Herczeg Ágnes3
  • Szepesváry Zsolt3

1Department of Oncoradiology, Petz Aladár Hospital, 9024 Győr, Hungary

2Department of Pathology, Petz Aladár Hospital, 9024 Győr, Hungary

3Department of Urology, Petz Aladár Hospital, 9024 Győr, Hungary

DOI: 10.31083/j.jomh1804093 Vol.18,Issue 4,April 2022 pp.1-5

Submitted: 14 October 2021 Accepted: 29 November 2021

Published: 30 April 2022

(This article belongs to the Special Issue Therapy and prognosis of metastatic prostate cancer)

*Corresponding Author(s): Kullmann Tamás E-mail: kullmanndoki@hotmail.com

Abstract

Background: The prognosis of castration resistant metastatic prostate cancer has been improved by several recently introduced therapeu-tic options, among others the second line antihormonal agents. Still, several questions related to the optimal use of these new drugs have remained open. The following ones were addressed in this paper. (1) Is the use of abiraterone + hydrocortisone inferior to abiraterone + prednisone in terms of overall survival? (2) Is the treatment up to prostate specific antigen (PSA) progression inferior to the treatment up to radiological progression in terms of overall survival? (3) Does the level of initial PSA decrease have a predictive value for the duration of response? Methods: As part of our self-assessment the dataset of 62 patients with castration resistant metastatic prostate cancer who started second line antihormonal therapy at our outpatient clinic before 31st of December 2019 was analysed. Results: 35 pa-tients received abiraterone with prednisone substitution, 12 patients received abireterone with hydrocortisone substitution and 15 patients received enzalutamide. 39 patients were treated until clinical or radiological progression and 23 patients were treated until biological progression. (1) Median overall survival of patients substituted with hydrocortisone was not inferior as compared to patients substituted with prednisone (31 months vs. 17 months). (2) Median overall survival of patients treated until PSA progression was not inferior as compared to patients treated until radiological progression (32 months vs. 17 months). (3) Median overall survival of patients whose first control PSA level was below the normal value was 50% higher than median survival of patients whose first control PSA level was over the normal value (25 months vs. 17 months). Median overall survival of patients treated with abiraterone or enzalutamide was similar (21 months vs. 24 months). Conclusions: The combination of abiraterone + hydrocortisone is not inferior to the combination of abiraterone + prednisone and the treatment up to PSA progression is not inferior to the treatment up to radiological progression in terms of overall survival for patients with castration resistant metastatic prostate cancer.

Keywords

Prostate cancer; Abiraterone; Enzalutamide; Hydrocortisone; Biological progression

Cite and Share

Kullmann Tamás,Kocsis Károly,Ambrus Adél,Kránitz Noémi,Herczeg Ágnes,Szepesváry Zsolt. Optimisation of second line antihormonal treatment for castration resistant metastatic prostate cancer. Journal of Men's Health. 2022. 18(4);1-5.

References

[1] Sweeney CJ, Chen YH, Carducci M, Liu G, Jarrard DF, Eisenberger M, et al. Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer. New England Journal of Medicine. 2015; 373: 737–746.

[2] de Bono JS, Logothetis CJ, Molina A, Fizazi K, North S, Chu L, et al. Abiraterone and increased survival in metastatic prostate cancer. New England Journal of Medicine. 2011; 364: 1995–2005.

[3] Scher HI, Fizazi K, Saad F, Taplin M, Sternberg CN, Miller K, et al. Increased Survival with Enzalutamide in Prostate Cancer after Chemotherapy. New England Journal of Medicine. 2012; 367: 1187–1197.

[4] de Bono JS, Oudard S, Ozguroglu M, Hansen S, Machiels JP, Kocak I, et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. The Lancet. 2010; 376: 1147–1154.

[5] Fizazi K, Tran N, Fein L, Matsubara N, Rodriguez-Antolin A, Alekseev BY, et al. Abiraterone plus Prednisone in Metastatic, Castration-Sensitive Prostate Cancer. New England Journal of Medicine. 2017; 377: 352–360.

[6] James ND, de Bono JS, Spears MR, Clarke NW, Mason MD, Dearnaley DP, et al. Abiraterone for prostate cancer not previ-ously treated with hormone therapy. New England Journal of Medicine. 2017; 377: 338–351.

[7] Beer TM, Armstrong AJ, Rathkopf DE, Loriot Y, Sternberg CN, Higano CS, et al. Enzalutamide in metastatic prostate cancer be-fore chemotherapy. New England Journal of Medicine. 2014; 371: 424–433.

[8] Davis ID, Martin AJ, Stockler MR, Begbie S, Chi KN, Chowd-hury S, et al. Enzalutamide with standard first-line therapy in metastatic prostate cancer. New England Journal of Medicine. 2019; 381: 121–131.

[9] Hussain M, Fizazi K, Saad F, Rathenborg P, Shore N, Ferreira U, et al. Enzalutamide in men with nonmetastatic, castration-resistant prostate cancer. New England Journal of Medicine. 2018; 378: 2465–2474.

[10] Smith MR, Saad F, Chowdhury S, Oudard S, Hadaschik BA, Graff JN, et al. Apalutamide Treatment and Metastasis-free Sur-vival in Prostate Cancer. New England Journal of Medicine. 2018; 378: 1408–1418.

[11] Fizazi K, Shore N, Tammela TL, Ulys A, Vjaters E, Polyakov S, et al. Darolutamide in Nonmetastatic, Castration-Resistant Prostate Cancer. New England Journal of Medicine. 2019; 380: 1235–1246.

[12] Tannock IF, de Wit R, Berry WR, Horti J, Pluzanska A, Chi KN, et al. Docetaxel plus prednisone or mitoxantrone plus pred-nisone for advanced prostate cancer. New England Journal of Medicine. 2004; 351: 1502–1512.

[13] Küronya Z, Géczi L, Gyergyay F, Bíró K. The role of steroids in oncological practice. Orvosi Hetilap. 2017; 158: 1651–1657.(In Hungarian)

[14] Cassinello J, Domínguez-Lubillo T, Gómez-Barrera M, Her-nando T, Parra R, Asensio I, et al. Optimal treatment sequencing of abiraterone acetate plus prednisone and enzalutamide in pa-tients with castration-resistant metastatic prostate cancer: a sys-tematic review and meta-analysis. Cancer Treatment Reviews. 2021; 93: 102152.

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