Sequencing in metastatic castration-resistant prostate cancer (mCRPC): Updated results of the FLAC International Database.

Abstract

267 Background: Optimal sequencing of new androgen-receptor targeted agents (ART) abiraterone and enzalutamide with docetaxel (DOC) and cabazitaxel (CABA) is unknown. In this large retrospective cohort of mCRPC patients (pts) treated with CABA after docetaxel (DOC), we evaluated the impact of 3 different sequences: DOC → CABA (group 1, n = 267) Or DOC → ART → CABA (group 2, n = 183) Or DOC → CABA → ART (group 3, n = 124). Methods: Records of 574 consecutive mCRPC patients were retrospectively collected in 44 centres in 6 European countries (France, Spain, UK, Greece, Poland, Turkey) from August 2012 to July 2016. Disease history and clinical characteristics at initiation of DOC therapy and outcomes were collected. Factors influencing OS were evaluated using multivariate stepwise logistic regression. Results: At DOC initiation, median age was 67 years, 83% of pts were ECOG 0-1, 45.1% had pain and 10.8% had visceral metastases. Median number of DOC cycles was 7 (6 in group 2, 7 in groups 1 and 3). Median number of CABA cycles was 6 (6 in groups 1 and 2, 7 in group 3). Median duration of ART treatment was 5.9 and 4.4 mths in groups 2 and 3, retrospectively. Median OS from first DOC cycle were 30.1, 37.1 and 40.1 mths in groups 1, 2 and 3, respectively. Factors influencing OS are summarized in the table below. Conclusions: Results of this retrospective cohort suggest that patients receiving DOC → CAB → ART show the greatest OS. High baseline PSA, short response to first-ADT and clinical progression of pts are major prognostic factors of OS at DOC initiation. The window of opportunity for chemotherapy should not be missed. [Table: see text]

Cabazitaxel in the treatment of castration-resistant cancer: hitting the balance of efficacy and safety

“…Пациенты были сгруппированы в три когорты в зависимости от последовательности назначения кабазитаксела (К) и ИАС: 1) КИАС (n = 266), 2) ИАСК (n = 183), 3) ДК (n = 124). Медиана ОВ с момента старта терапией доцетакселом в группах составила 40,1, 37,1 и 30,1 месяца соответственно [28].…”

Sequential Therapy of Metastatic Castration-Resistant Prostate Cancer: New Possibilities

“…По данным исследований, эффективность кабазитаксела не снижается после терапии доцетакселом и 1 или 2 линий терапии абиратероном и / или энзалутамидом и сопоставима с результатами TROPIC [33,[38][39][40]. Кабазитаксел сохраняет значительную активность после прогрессирования на фоне антиандрогенов нового поколения [41], хотя количество возможных циклов лечения закономерно ниже по сравнению с применением во 2-й линии терапии [42]. Также проспективный анализ данных 3 тыс.…”

Cabazitaxel in the treatment of metastatic castration-resistant prostate cancer: patient selection and special considerations

“…Similar results were seen with a retrospective review of 574 mCRPC cases from the FLAC international database. 22 Patients again were separated into groups based on their treatment history: Group 1: D–C–NHT; Group 2: D–NHT–C; and Group 3: D–C. The median number of cycles was 7 for docetaxel and 6 for cabazitaxel.…”