Comparison of real-life data of abiraterone acetate and enzalutamide in metastatic castration-resistant prostate cancer

Sci Rep. 2021 Jul 8;11(1):14131. doi: 10.1038/s41598-021-93659-x.

Abstract

To compare enzalutamide (E) and abiraterone acetate (AA) in terms of efficacy, survival and to characterize prognostic factors affecting survival in metastatic castration-resistant prostate cancer (mCRPC) patients. A total of 250 patients treated with E or AA in 5 centers were included. The number of patients with no prostate specific antigen (PSA) decline was higher in the AA group than that in the E group, and the proportion of patients with a PSA decline of ≥ 50% was higher in the E group (p = 0.020). Radiological progression free survival (rPFS) and overall survival (OS) were significantly longer in the E group when compared to that in the AA group (p < 0.001 and p = 0.027, respectively). In the E group, rPFS was significantly longer than that in the AA group in both pre- and post-docetaxel settings (p = 0.010 and p = 0.003, respectively). OS was similar in the pre-docetaxel setting; but in the post-docetaxel setting, E group had a significantly longer OS than the AA group (p = 0.021). In the multivariate analysis performed in the whole patient group, we found that good prognostic factors for rPFS were E treatment, being ≥ 75 years and a PSA decline of ≥ 50% while there was no factor affecting OS. With longer OS and PFS, E seems to be more suitable for mCRPC patients in the post-docetaxel setting than AA.

MeSH terms

  • Abiraterone Acetate / administration & dosage*
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / administration & dosage
  • Benzamides / administration & dosage*
  • Disease-Free Survival
  • Docetaxel / administration & dosage*
  • Humans
  • Kallikreins / genetics
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Nitriles / administration & dosage*
  • Phenylthiohydantoin / administration & dosage*
  • Prognosis
  • Progression-Free Survival
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms, Castration-Resistant / blood
  • Prostatic Neoplasms, Castration-Resistant / drug therapy*
  • Prostatic Neoplasms, Castration-Resistant / pathology
  • Taxoids / administration & dosage
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Benzamides
  • Nitriles
  • Taxoids
  • Docetaxel
  • Phenylthiohydantoin
  • enzalutamide
  • Kallikreins
  • Prostate-Specific Antigen
  • Abiraterone Acetate