Men with metastatic castration-resistant prostate cancer (mCRPC) have similar survival whether they receive first-line treatment with abiraterone or enzalutamide or first-line docetaxel, investigators reported at the European Society of Medical Oncology 2019 Congress in Barcelona, Spain.
First-line treatment with abiraterone or enzalutamide, however, is associated with longer progression-free survival (PFS) than upfront chemotherapy, according to Carlo Cattrini, MD, of the Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre in Madrid, and colleagues.
In the observational prospective PROREPAIR-B study, the investigators compared outcomes of the treatment sequences in 406 men with mCRPC. The group included 218 men treated with first-line abiraterone or enzalutamide and 188 who received first-line docetaxel. The groups did not differ significantly with respect to overall survival (OS) (31.3 vs 29.9 months), but PFS was 10.8 months among the men treated with first-line abiraterone or enzalutamide and 8.3 months in the upfront docetaxel arm, a significant difference between treatment group. Compared with first-line docetaxel, first-line abiraterone or enzalutamide was associated with a significant 50% decreased risk of progression compared with first-line docetaxel.
The investigators found similar results in an exploratory analysis of patients aged 75 years or older.
Cattrini C, Romero-Laorden N, Castro E, et al. Impact of treatment sequence in patients in metastatic castration-resistant prostate cancer (mCRPC): data from the prospective PROREPAIR-B study. Presented at the European Society for Medical Oncology 2019 Congress held September 30 to October 1 in Barcelona, Spain. Poster 880P