Comparative Assessment of Efficacies Between 2 Alternative Therapeutic Sequences With Novel Androgen Receptor-Axis-Targeted Agents in Patients With Chemotherapy-Naïve Metastatic Castration-Resistant Prostate Cancer

Lactate dehydrogenase predicts combined progression‐free survival after sequential therapy with abiraterone and enzalutamide for patients with castration‐resistant prostate cancer

“…Lastly, patient follow-up could not be standardized, owing to the retrospective nature of the study. The present study may confirm the results of previous retrospective studies 11,12 that sequential therapy with abiraterone followed by enzalutamide had longer combined PFS and PSA-PFS in patients with CRPC compared to the sequence with enzalutamide followed by abiraterone. Study findings also indicate low LDH before the first ARAT agent to be predictive of better combined PFS in patients receiving sequential therapy.…”

“…In addition, a multivariate analysis demonstrated significantly improved PFS and better PSA response for the A‐E sequence, with decreased efficacy of each ARAT agent when used as the second drug. Another retrospective study by Miyake et al also showed that PSA‐PFS was significantly prolonged in those with chemotherapy‐naïve CRPC who received A‐E sequential therapy . Our study confirmed that combined PFS and total PSA‐PFS were significantly improved in patients in the A‐E group in Kaplan‐Meier analysis.…”

“…Another retrospective study by Miyake et al also showed that PSA-PFS was significantly prolonged in those with chemotherapy-naïve CRPC who received A-E sequential therapy. 12 Our study confirmed that combined PFS and total PSA-PFS were significantly improved in patients in the A-E group in Kaplan-Meier analysis. Multivariate analysis also suggested that the A-E group may be better to the E-A group, although the difference was marginal possibly due to the small number of patients involved (P = 0.056).…”

“…No prospective studies have been conducted to explore the optimal sequential use of these drugs to date. Two retrospective reports have shown that OS was unchanged but progression‐free survival (PFS) or prostate‐specific antigen (PSA)‐PFS was more favorable in those who received abiraterone‐to‐enzalutamide sequencing, although the reason is yet to be clarified.…”

Editorial Comment to Exploring the optimal sequence of abiraterone and enzalutamide in patients with chemotherapy‐naïve castration‐resistant prostate cancer: The Kyoto‐Baltimore collaboration

“…Miyake et al . also carried out a retrospective analysis in 108 consecutive patients with metastatic CRPC who sequentially received ABI and ENZA, including 49 patients with ABI‐to‐ENZA and the others with ENZA‐to‐ABI . The combined prostate‐specific antigen progression‐free survival in the ABI‐to‐ENZA group (median 18.4 months) was significantly superior to that of the ENZA‐to‐ABI group (median 12.8 months).…”