A real‐world comparison of docetaxel versus abiraterone acetate for metastatic hormone‐sensitive prostate cancer

Abstract

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Comparison of Short-Term Outcomes and Safety Profiles between Androgen Deprivation Therapy+Abiraterone/Prednisone and Androgen Deprivation Therapy+Docetaxel in Patients with De Novo Metastatic Hormone-Sensitive Prostate Cancer

“…A few clinical studies have compared the efficacy of ADT+docetaxel with that of ADT+abiraterone/prednisone in patients with mHSPC [ 7 8 9 10 ]. A network meta-analysis for mHSPC by Marchioni et al [ 7 ] showed that ADT+abiraterone/prednisone had a statistically significantly lower disease progression rate than ADT+docetaxel; however, no statistically significant difference in OS or adverse effect rate was observed.…”

“…A meta-analysis and a few clinical studies have compared the efficacy of ADT+docetaxel with that of ADT+abiraterone/prednisone in patients with mHSPC [ 7 8 9 10 ]. However, only one multi-institutional study has been conducted, and all studies were not conducted in Korea [ 8 9 10 ].…”

“…A meta-analysis and a few clinical studies have compared the efficacy of ADT+docetaxel with that of ADT+abiraterone/prednisone in patients with mHSPC [ 7 8 9 10 ]. However, only one multi-institutional study has been conducted, and all studies were not conducted in Korea [ 8 9 10 ]. Considering the pathological aggressiveness of Korean patients with prostate cancer in a retrospective cohort study for clinically localized prostate cancer, directly applying the results of these clinical trials is difficult [ 11 ].…”

Advancements in the treatment of metastatic hormone-sensitive prostate cancer

“…In a meta-analysis conducted by Wenzel et al., abiraterone treatment of mHSPC patients with high-volume disease resulted in a median OS of 50.1 months, which exceeded that of docetaxel (45.9 months) and ADT alone (34.0 months); no significant difference in the median OS was identified between docetaxel and ADT alone in the low-volume disease group ( 54 ). In a retrospective, multicenter study that compared the efficacy and safety of abiraterone and docetaxel in the treatment of mHSPC, the abiraterone+ADT group had a significantly longer PFS1, PFS2 (PFS1/PFS2, time from start of ADT to clinical, biochemical, or radiographic progression during first/second line or death from any cause) and OS as compared with the docetaxel+ADT group (23 vs 13 months; p < 0.001; 48 vs 33 months; p = 0.006; 80 vs 61 months; p = 0.040); according to a multivariate analysis of PFS1 (HR = 0.34, 95% CI 0.183–0.623; p = 0.001) and PFS2 (HR = 0.33, 95% CI 0.128–0.827, p = 0.018), abiraterone+ADT was significantly better than docetaxel+ADT, but both resulted in similar OS and toxic effects ( 56 ). The STAMPEDE clinical study demonstrated that the mean QoL score, over the period of 2 years, was +3.9 points higher in patients treated with abiraterone than in those treated with docetaxel, which fails to meet the predefined criterion for a clinically meaningful difference of >4.0 points; the mean QoL score was +5.7 points higher over 1 year, +7.0 points higher at 12 months, and +8.3 points higher at 24 months, suggesting that the patient-reported QoL was better in patients treated with abiraterone compared with those treated with docetaxel over a 2-year period ( 57 ).…”

Biotransformation of Abiraterone Into Five Characteristic Metabolites by the Rat Gut Microbiota and Liver Microsomes

“…Abiraterone (ABR) inhibits the biosynthesis of androgens and estrogens and is mainly used in combination with prednisone for the treatment of mCRPC patients who have previously received docetaxel-containing chemotherapy (4). With the in-depth study of abiraterone clinical trials in recent years, abiraterone was found to be useful in the treatment of newly diagnosed highrisk metastatic castration-sensitive prostate cancer (5)(6)(7). ABR, a steroidal antiandrogen, is insoluble in water, resulting in poor bioavailability (8).…”