Authors (including presenting author) :
Wan KL(1)(2), Zhou RK(1), Lee CP(1), Ng V(2), Chow CP(2), Choi AY(2)
Affiliation :
(1) School of Pharmacy, The Chinese University of Hong Kong
(2) Department of Pharmacy, Princess Margaret Hospital
Keyword 2: :
Enzalutamide
Keyword 3: :
metastatic castration-resistant prostate cancer
Introduction :
Abiraterone and enzalutamide are androgen receptor inhibitors approved for the first-line treatment of metastatic castration-resistant prostate cancer (mCRPC). Their superiority over placebo has been demonstrated in several landmark trials, irrespective of patients’ prior chemotherapy history. However, no phase III head-tohead studies has been conducted to compare these two agents with similar clinical roles. This study aims to compare the efficacy and safety of abiraterone and enzalutamide using local clinical data.
Objectives :
This is a retrospective, single-centered study conducted in Princess Margaret
Hospital. Patients aged 18 years or older, diagnosed with mCRPC, and initiated on
abiraterone or enzalutamide between 1st January 2019 and 31st December 2022, were
identified. An electronic chart reviewed was performed to retrieve pertinent clinical data. The primary endpoint is overall survival, with secondary endpoints include time to prostate-specific antigen (PSA) progression, PSA response rate and adverse effects recorded.
Methodology :
A total of 145 patients were included in the study, with 52 patients receiving
abiraterone and 93 patients receiving enzalutamide. Regarding the primary endpoint,
the median overall survival period was 38 months in the abiraterone group and 26
months in the enzalutamide group; the results were not statistically significant (Hazard ratio [HR], 1.28; 95% confidence interval [CI] 0.79 to 2.07; P = 0.31). Secondary endpoints regarding time to PSA progression (abiraterone 11.9 months vs enzalutamide 8.4 months; HR, 1.26; 95% CI 0.84 to 1.90; P = 0.27), were also not statistically significant. Adverse effects were comparable between the treatment groups.
Result & Outcome :
No significant difference in OS and time to PSA progression were identified between abiraterone and enzalutamide in the treatment of patients with mCRPC. Selection of therapeutic agents for the treatment of mCRPC should continue to be based upon patient-specific factors and side effects profiles.
