Optimal treatment sequencing of abiraterone acetate plus prednisone and enzalutamide in patients with castration-resistant metastatic prostate cancer: A systematic review and meta-analysis

Cassinello, Javier; Domínguez-Lubillo, T.; Gómez-Barrera, Manuel; Hernando, T; Parra, Raul O.; Asensio, I.; Moreno, Pedro

doi:10.1016/j.ctrv.2020.102152

Cited by 12 publications

(6 citation statements)

References 53 publications

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“…Time to second PSA progression was longer in the ENZ following ABI arm than in the reverse-order arm (median 19.3 vs 15.2 mo; HR 0.66, 95% CI 0.45–0.97; p = 0.036) [11] . Moreover, a systematic review revealed that ENZ after ABI led to significantly longer PSA progression–free survival than for ABI after ENZ [19] . Similar results were retrospectively reported for 255 CRPC patients in Japan without chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Enzalutamide Versus Abiraterone plus Prednisolone Before Chemotherapy for Castration-resistant Prostate Cancer: A Multicenter Randomized Controlled Trial

Izumi

Shima

Mita

et al. 2022

European Urology Open Science

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Section: Discussionmentioning

confidence: 99%

Enzalutamide Versus Abiraterone plus Prednisolone Before Chemotherapy for Castration-resistant Prostate Cancer: A Multicenter Randomized Controlled Trial

Izumi

Shima

Mita

et al. 2022

European Urology Open Science

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“…Second-line antiandrogen therapy is indicated for the treatment of CRPC patients, supporting the idea that the androgen/AR axis is still active in this progression phase of the tumor [ 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. To date, several mechanisms involving a persistent activity of the androgen/AR axis in CRPC have been elucidated [ 12 , 13 , 42 , 43 , 44 ].…”

Section: The Androgen/ar Axis In Crpcmentioning

confidence: 86%

Dissecting the Hormonal Signaling Landscape in Castration-Resistant Prostate Cancer

Fontana

Limonta

2021

Cells

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Understanding the molecular mechanisms underlying prostate cancer (PCa) progression towards its most aggressive, castration-resistant (CRPC) stage is urgently needed to improve the therapeutic options for this almost incurable pathology. Interestingly, CRPC is known to be characterized by a peculiar hormonal landscape. It is now well established that the androgen/androgen receptor (AR) axis is still active in CRPC cells. The persistent activity of this axis in PCa progression has been shown to be related to different mechanisms, such as intratumoral androgen synthesis, AR amplification and mutations, AR mRNA alternative splicing, increased expression/activity of AR-related transcription factors and coregulators. The hypothalamic gonadotropin-releasing hormone (GnRH), by binding to its specific receptors (GnRH-Rs) at the pituitary level, plays a pivotal role in the regulation of the reproductive functions. GnRH and GnRH-R are also expressed in different types of tumors, including PCa. Specifically, it has been demonstrated that, in CRPC cells, the activation of GnRH-Rs is associated with a significant antiproliferative/proapoptotic, antimetastatic and antiangiogenic activity. This antitumor activity is mainly mediated by the GnRH-R-associated Gαi/cAMP signaling pathway. In this review, we dissect the molecular mechanisms underlying the role of the androgen/AR and GnRH/GnRH-R axes in CRPC progression and the possible therapeutic implications.

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“…Moreover, the sequential use of the two agents has little additional benefit. Although some data suggest that the order abiraterone → enzalutamide is more favourable as compared to the order enzalutamide → abiraterone [14], currently there is no recommendation either for the choice between the two drugs or for the sequential use of them. Still, what about the proportion of patients who would potentially better respond to one of the therapies or the crossover treatment?…”

Section: Discussionmentioning

confidence: 99%

Optimisation of second line antihormonal treatment for castration resistant metastatic prostate cancer

Kullmann¹,

Kocsis²,

Adél³

et al. 2022

JOMH

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Background:The prognosis of castration resistant metastatic prostate cancer has been improved by several recently introduced therapeutic options, among others the second line antihormonal agents. Still, several questions related to the optimal use of these new drugs have remained open. The following ones were addressed in this paper. (1) Is the use of abiraterone + hydrocortisone inferior to abiraterone + prednisone in terms of overall survival? (2) Is the treatment up to prostate specific antigen (PSA) progression inferior to the treatment up to radiological progression in terms of overall survival? (3) Does the level of initial PSA decrease have a predictive value for the duration of response? Methods: As part of our self-assessment the dataset of 62 patients with castration resistant metastatic prostate cancer who started second line antihormonal therapy at our outpatient clinic before 31st of December 2019 was analysed. Results: 35 patients received abiraterone with prednisone substitution, 12 patients received abireterone with hydrocortisone substitution and 15 patients received enzalutamide. 39 patients were treated until clinical or radiological progression and 23 patients were treated until biological progression. (1) Median overall survival of patients substituted with hydrocortisone was not inferior as compared to patients substituted with prednisone (31 months vs. 17 months). ( 2) Median overall survival of patients treated until PSA progression was not inferior as compared to patients treated until radiological progression (32 months vs. 17 months). ( 3) Median overall survival of patients whose first control PSA level was below the normal value was 50% higher than median survival of patients whose first control PSA level was over the normal value (25 months vs. 17 months). Median overall survival of patients treated with abiraterone or enzalutamide was similar (21 months vs. 24 months). Conclusions: The combination of abiraterone + hydrocortisone is not inferior to the combination of abiraterone + prednisone and the treatment up to PSA progression is not inferior to the treatment up to radiological progression in terms of overall survival for patients with castration resistant metastatic prostate cancer.

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Optimal treatment sequencing of abiraterone acetate plus prednisone and enzalutamide in patients with castration-resistant metastatic prostate cancer: A systematic review and meta-analysis

Cited by 12 publications

References 53 publications

Enzalutamide Versus Abiraterone plus Prednisolone Before Chemotherapy for Castration-resistant Prostate Cancer: A Multicenter Randomized Controlled Trial

Enzalutamide Versus Abiraterone plus Prednisolone Before Chemotherapy for Castration-resistant Prostate Cancer: A Multicenter Randomized Controlled Trial

Dissecting the Hormonal Signaling Landscape in Castration-Resistant Prostate Cancer

Optimisation of second line antihormonal treatment for castration resistant metastatic prostate cancer

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