Abiraterone or Enzalutamide in Advanced Castration-Resistant Prostate Cancer: An Indirect Comparison

Chopra, Akhil; Georgieva, Mina; Lopes, Gilberto; Yeo, Chong Ming; Haaland, Benjamin

doi:10.1002/pros.23309

Cited by 30 publications

(22 citation statements)

References 34 publications

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“…Chopra et al performed indirect comparisons between ABI and ENZA in both pre-docetaxel and post-docetaxel settings based on published phase 3 RCTs [39] and found that ENZA outperformed ABI with prednisone in terms of radiographic PFS, time until PSA progression, and PSA response rate but not OS in both the pre-and post-docetaxel settings. The rate of adverse events of grade ≤3 was similar between ABI and ENZA.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Oncologic Outcomes between Two Alternative Sequences with Abiraterone Acetate and Enzalutamide in Patients with Metastatic Castration-Resistant Prostate Cancer: A Systematic Review and Meta-Analysis

Chung

Kang

Kim

et al. 2019

Cancers

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Sequential treatment of androgen receptor axis targeted agents (ARAT), abiraterone acetate (ABI) and enzalutamide (ENZA), in metastatic castration-resistant prostate cancer (mCRPC) demonstrated some positive effects, but cross-resistances between ABI and ENZA that reduce activity have been suggested. Therefore, we conducted a meta-analysis to compare oncologic outcomes between the treatment sequences of ABI-ENZA and ENZA-ABI in patients with mCRPC. The primary endpoint was a combined progression-free survival (PFS), and the secondary endpoint was overall survival (OS). A total of five trials on 553 patients were included in this study. Each of the included studies was retrospective. In two studies including both chemo-naïve and post-chemotherapy mCRPC patients, for ABI-ENZA compared with ENZA-ABI, pooled hazard ratios (HRs) for PFS and OS were 0.37 (p < 0.0001; 95% confidence intervals (CIs), 0.23-0.60) and 0.64 (p = 0.10; 95% CIs, 0.37-1.10), respectively. In three studies with chemo-naïve mCRPC patients only, for ABI-ENZA compared with ENZA-ABI, pooled HRs for PFS and OS were 0.57 (p = 0.02; 95% CIs, 0.35-0.92) and 0.86 (p = 0.39; 95% CIs, 0.61-1.21), respectively. The current meta-analysis revealed that ABI-ENZA had a significantly more favorable oncological outcome, but the level of evidence was low. Therefore, large-scale randomized trials may be needed.

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Section: Discussionmentioning

confidence: 99%

Comparison of Oncologic Outcomes between Two Alternative Sequences with Abiraterone Acetate and Enzalutamide in Patients with Metastatic Castration-Resistant Prostate Cancer: A Systematic Review and Meta-Analysis

Chung

Kang

Kim

et al. 2019

Cancers

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“…Во-вторых, в отличие от оригинального исследования общая выживаемость (OS) и выживаемость без прогрессирования (PFS) в варианте «абиратерон» в настоящем исследовании определялись с учетом результатов непрямого сравнения энзалутамида и абиратерона по формулам: В настоящее время доступны результаты нескольких работ, в которых проводилось непрямое сравнение энзалутамида и абиратерона и рассчитаны необходимые ОР по указанным конечным точкам [10,11]. В обоих исследованиях получены выводы о статистически значимо более высокой эффективности энзалутамида по сравнению с абиратероном по критерию выживаемости без радиографического прогрессирования и отсутствии статистически значимых различий в показателях общей выживаемости.…”

Section: материалы и методыunclassified

“…Однако в 2017 г. было выпущено обновление резуль татов рандомизированного контролируемого исследования PREVAIL [13], в котором содержатся актуализированные данные по ключевым конечным точкам: общей выживаемости и выживаемости без радиографического прогрессирования. В этой работе длительность наблюдения при оценке общей выживаемости составила 45 мес, при оценке выживаемости без прогрессирования -36 мес (в более ранней публикации по исследованию PREVAIL [12], которая лежит в основе опубликованных непрямых сравнений [10,11], соответствующие периоды наблюдений составили 33 и 18 мес). В свою очередь, в последних опубликованных данных по абиратерону [14] длительность наблюдения при оценке общей выживаемости составила 35 мес и при оценке выживаемости без радиографического прогрессирования -33 мес.…”

Section: материалы и методыunclassified

Pharmacoeconomic aspects of using enzalutamide and abiraterone for treatment of chemotherapy-naive patients with metastatic castration-resistant prostate cancer

2019

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Background. Enzalutamide and abiraterone are hormonal antineoplastic drugs used for treatment of metastatic castration-resistant prostate cancer (mCRPC). Both drugs were proved to be effective in randomized controlled trials.Objective. Pharmacoeconomic analysis of using enzalutamide and abiraterone for treatment of chemotherapy-naive patients with mCRPC from the perspective of Russian healthcare system in 2019.Materials and methods. We proposed a Markov model of mCRPC progression on three treatment options: enzalutamide, abiraterone or active monitoring with no antineoplastic treatment in the 1st line setting. The model was based on indirect treatment comparison of considered drugs. Modelling period was 5 years. The model was used for calculating per patient medical costs, and further cost–effectiveness, cost–utility and budget impact analysis.Results. Monthly medication costs of enzalutamide were 183 551 rubles, which were 23 766 rubles (11.5 %) less than for abiraterone (207 224 rubles). 5-year total medical costs for enzalutamide were 5633 thousand rubles per patient, that were 67 499 rubles (1.2 %) less than for abiraterone. Incremental cost/effectiveness ratio for enzalutamide vs active monitoring was 533 thousand rubles per one life-month gained, compared to 623 thousand rubles per one life-month gained for abiraterone. If 7328 mCRPC chemotherapy-naive patients receive enzalutamide, Russian government healthcare spending will be 495 million rubles (1.2 %) less, compared to abiraterone.Conclusion. With comparable costs enzalutamide is a cost-effective treatment option of chemotherapy-naive mCRPC patients, compared to abiraterone, in Russia.

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“…Hormone‐dependency is another key issue in PCa pathogenesis as the condition depends on androgen receptor (AR) signaling. For this reason, advanced PCa is treated with androgen deprivation therapy (ADT; Chopra, Georgieva, Lopes, Yeo, & Haaland, ). However, nearly all ADT patients relapse and progress to CRPC.…”

Section: Prostate Pathologymentioning

confidence: 99%

Overview of Genetically Engineered Mouse Models of Prostate Cancer and Their Applications in Drug Discovery

2018

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Prostate cancer (PCa) is the most common malignant visceral neoplasm in males in Western countries. Despite progress made in the early treatment of localized malignancies, there remains a need for therapies effective against advanced forms of the disease. Genetically engineered mouse (GEM) models are valuable tools for addressing this issue, particularly in defining the cellular and molecular mechanisms responsible for tumor initiation and progression. While cell and tissue culture systems are important models for this purpose as well, they cannot recapitulate the complex interactions within heterotypic cells and the tumor microenvironment that are crucial in the initiation and progression of prostate tumors. Limitations of GEM models include resistance to developing invasive and metastatic tumors that resemble the advanced stages of human PCa. Nonetheless, because genetic models provide valuable information on the human condition that would otherwise be impossible to obtain, they are increasingly employed to identify molecular targets and to examine the efficacy of cancer therapeutics. The aim of this overview is to provide a brief but comprehensive summary of GEM models for PCa, with particular emphasis on the strengths and weaknesses of this experimental approach. © 2018 by John Wiley & Sons, Inc.

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Abiraterone or Enzalutamide in Advanced Castration-Resistant Prostate Cancer: An Indirect Comparison

Cited by 30 publications

References 34 publications

Comparison of Oncologic Outcomes between Two Alternative Sequences with Abiraterone Acetate and Enzalutamide in Patients with Metastatic Castration-Resistant Prostate Cancer: A Systematic Review and Meta-Analysis

Comparison of Oncologic Outcomes between Two Alternative Sequences with Abiraterone Acetate and Enzalutamide in Patients with Metastatic Castration-Resistant Prostate Cancer: A Systematic Review and Meta-Analysis

Pharmacoeconomic aspects of using enzalutamide and abiraterone for treatment of chemotherapy-naive patients with metastatic castration-resistant prostate cancer

Overview of Genetically Engineered Mouse Models of Prostate Cancer and Their Applications in Drug Discovery

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