BACKGROUND: In metastatic castration-resistant prostate cancer (mCRPC), optimal treatment sequences are unknown. We assessed second-line taxane (TT) versus androgen receptor-targeted therapy (ART), after initial ART failure, in United States oncology community practices. PATIENTS AND METHODS: Using electronic medical records, patients with mCRPC receiving first-line ART and second-line therapy (TT, ART) were identified. Response and overall survival (OS) were evaluated from second-line therapy initiation. Multivariate analyses were adjusted for year, age, metastases, opioid use, prostate-specific antigen (PSA), hemoglobin, alkaline phosphatase, and albumin levels. RESULTS: Of 546 patients receiving first-line ART, 206 and 340 received second-line TT and ART. Compared with patients receiving second-line ART, patients receiving TT were younger (median, 74 vs. 79 years), more had intermediate-high Halabi risk scores (59% vs. 35%), had higher opioid use (42% vs. 22%), median PSA (116 vs. 48 ng/mL), alkaline phosphatase (112 vs. 87 U/L), and lactate dehydrogenase (254 vs. 201 U/L), and had lower hemoglobin (11.2 vs. 12.3 g/dL) and albumin levels (3.8 vs. 4.0 g/dL); all P < .001. Response rates were higher with second-line TT versus ART (clinical response, 44.2% vs. 24.7%; P = .006; PSA response, 44.5% vs. 28.7%; P = .004). OS did not differ between cohorts (hazard ratio [HR], 0.90; P = .511). Among patients with a poor prognosis (hemoglobin < 11 g/d; albumin < lower limit of normal), those receiving second-line TT versus ART showed improved OS (HR, 0.52; P = .004 and HR, 0.36; P = .003, respectively). CONCLUSIONS: Despite more severe disease profiles, patients with mCRPC receiving second-line TT versus ART achieved higher response rates after initial ART. Poor prognosis patients had improved OS with second-line TT versus ART.
BACKGROUND: In metastatic castration-resistant prostate cancer (mCRPC), optimal treatment sequences are unknown. We assessed second-line taxane (TT) versus androgen receptor-targeted therapy (ART), after initial ART failure, in United States oncology community practices. PATIENTS AND METHODS: Using electronic medical records, patients with mCRPC receiving first-line ART and second-line therapy (TT, ART) were identified. Response and overall survival (OS) were evaluated from second-line therapy initiation. Multivariate analyses were adjusted for year, age, metastases, opioid use, prostate-specific antigen (PSA), hemoglobin, alkaline phosphatase, and albumin levels. RESULTS: Of 546 patients receiving first-line ART, 206 and 340 received second-line TT and ART. Compared with patients receiving second-line ART, patients receiving TT were younger (median, 74 vs. 79 years), more had intermediate-high Halabi risk scores (59% vs. 35%), had higher opioid use (42% vs. 22%), median PSA (116 vs. 48 ng/mL), alkaline phosphatase (112 vs. 87 U/L), and lactate dehydrogenase (254 vs. 201 U/L), and had lower hemoglobin (11.2 vs. 12.3 g/dL) and albumin levels (3.8 vs. 4.0 g/dL); all P < .001. Response rates were higher with second-line TT versus ART (clinical response, 44.2% vs. 24.7%; P = .006; PSA response, 44.5% vs. 28.7%; P = .004). OS did not differ between cohorts (hazard ratio [HR], 0.90; P = .511). Among patients with a poor prognosis (hemoglobin < 11 g/d; albumin < lower limit of normal), those receiving second-line TT versus ART showed improved OS (HR, 0.52; P = .004 and HR, 0.36; P = .003, respectively). CONCLUSIONS: Despite more severe disease profiles, patients with mCRPC receiving second-line TT versus ART achieved higher response rates after initial ART. Poor prognosis patients had improved OS with second-line TT versus ART.
Authors: Howard I Scher; Ryon P Graf; Nicole A Schreiber; Anuradha Jayaram; Eric Winquist; Brigit McLaughlin; David Lu; Martin Fleisher; Sarah Orr; Lori Lowes; Amanda Anderson; Yipeng Wang; Ryan Dittamore; Alison L Allan; Gerhardt Attard; Glenn Heller Journal: JAMA Oncol Date: 2018-09-01 Impact factor: 31.777
Authors: Ryon P Graf; Melanie Hullings; Ethan S Barnett; Emily Carbone; Ryan Dittamore; Howard I Scher Journal: Eur Urol Date: 2019-10-21 Impact factor: 20.096
Authors: Fernando Cotait Maluf; Felipe Moraes Toledo Pereira; Adriano Gonçalves Silva; Aldo Lourenço Abbade Dettino; Ana Paula Garcia Cardoso; André Seeke Sasse; Andrey Soares; Ariel Galapo Kann; Daniel Herchenhorn; Denis Leonardo Fontes Jardim; Diego Emilio Lopera Cortés; Fábio Roberto Kater; Igor A Protzner Morbeck; João Francisco Navarro Reolon; José Augusto Rinck; Juan Jose Zarbá; Juan Pablo Sade; Karine Martins da Trindade; Leonardo Atem G A Costa; Lucas V Dos Santos; Manuel Caitano Maia; Mariana Bruno Siqueira; Silke Gillessen Journal: JCO Glob Oncol Date: 2021-04