Real world evidence: Abiraterone use post-docetaxel in metastatic castrate-resistant prostate cancer

J Oncol Pharm Pract. 2019 Sep;25(6):1293-1300. doi: 10.1177/1078155218784716. Epub 2018 Jun 27.

Abstract

Objectives: The COU-AA-301 trial demonstrated that in men with metastatic castrate-resistant prostate cancer using abiraterone post-docetaxel increased overall survival. This study aims to assess this conclusion in a real world context.

Design: Retrospective chart review of a provincial Pharmacy BDM Database (a pharmacy dispensing software) and a provincial Electronic Chart (ARIA). Dispensing data, information on the state of the disease before and after abiraterone use, and information regarding effects of abiraterone were gathered.

Setting: Cancer centers in Alberta, Canada.

Patients: Metastatic castrate-resistant prostate cancer (CRPC) patients on abiraterone outside of a clinical trial who have previously had docetaxel chemotherapy for CRPC between February 2012 and May 2014.

Primary outcome: Overall survival from the time of abiraterone initiation.

Results: Overall survival increase of 17 months was consistent with the survival increase of 14.8 months observed in the pivotal trial.

Conclusion: Abiraterone is a valuable therapy post-docetaxel for metastatic CRPC, as in a real world context it demonstrated an increase in overall survival that was consistent with the findings of the clinical trial despite including a patient population of older age and lower performance status.

Keywords: Real world evidence; abiraterone; docetaxel; prostate cancer.

MeSH terms

  • Aged
  • Androstenes / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Clinical Trials, Phase III as Topic
  • Disease Progression
  • Docetaxel / administration & dosage
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Prostatic Neoplasms, Castration-Resistant / drug therapy*
  • Prostatic Neoplasms, Castration-Resistant / pathology
  • Retrospective Studies
  • Survival Rate

Substances

  • Androstenes
  • Docetaxel
  • abiraterone