Pastora Beardo1, Ignacio Osman2, Begoña San José3, Roberto Llarena4, Belén Congregado5, Josep Campá6, Rafael A Medina-López7, Javier Extramiana8. 1. Department of Urology, Araba University Hospital, c/ José Atxotegi s/n, PC 01009, Vitoria-Gasteiz, Araba, Spain. Electronic address: pastorainmaculada.beardovillar@osakidetza.eus. 2. Department of Urology, UGC Urology and Nephrology, Instituto of Biomedicina of Sevilla, IBIS/Virgen del Rocío, University Hospital/CSIC/ Sevilla University, AV Manuel Siurot s/n, PC 41013, Sevilla, Spain. Electronic address: ignacio.osman.sspa@juntadeandalucia.es. 3. Department of Pharmacy, Cruces University Hospital, Plaza de Cruces s/n, PC 48903, Bilbao, Vizcaya, Spain. Electronic address: begona.sanjoseruiz@osakidetza.eus. 4. Department of Urology, Cruces University Hospital, Plaza de Cruces s/n, PC 48903, Bilbao, Vizcaya, Spain. Electronic address: roberto.llarenaibarguren@osakidetza.eus. 5. Department of Urology, UGC Urology and Nephrology, Instituto of Biomedicina of Sevilla, IBIS/Virgen del Rocío, University Hospital/CSIC/ Sevilla University, AV Manuel Siurot s/n, PC 41013, Sevilla, Spain. Electronic address: belen.congregado.sspa@juntadeandalucia.es. 6. Department of Urology, Araba University Hospital, c/ José Atxotegi s/n, Spain. Electronic address: josepmaria.campabortolo@osakidetza.eus. 7. Department of Urology, UGC Urology and Nephrology, Instituto of Biomedicina of Sevilla, IBIS/Virgen del Rocío, University Hospital/CSIC/ Sevilla University, AV Manuel Siurot s/n, PC 41013, Sevilla, Spain. Electronic address: rantonio.medina.sspa@juntadeandalucia.es. 8. Department of Urology, Araba University Hospital, c/ José Atxotegi s/n, PC 01009, Vitoria-Gasteiz, Araba, Spain. Electronic address: javier.extramianacameno@osakidetza.eus.
Abstract
BACKGROUND: Abiraterone acetate and enzalutamide are standard treatments for chemotherapy-naive metastatic castration-resistant prostate cancer (CN-mCRPC). The purpose of this study was to evaluate the effectiveness and safety of these medications in elderly (≥ 75 years old) compared with young CN-mCRPC patients in a real-world clinical setting. Secondarily, we explored the survival prognostic value of different anatomo-clinical factors in elderly group. METHODS: In this retrospective observational multicentre study, we included 134 consecutive CN-mCRPC patients, 64 young and 70 elderly men, who had received AA or Enz. RESULTS: We did not find significant differences in treatment duration [16.6 months, (95% CI 9-24.2 months) vs. 16.8 months (95% CI: 6.3-27.2 months); p = 0.926] and overall survival [median not reached vs. 23.3 months (95% CI 10.2-36.3 months); p = 0.131] between the young and elderly groups. In elderly group, the only predictors of overall survival with AA or Enz were good ECOG performance status and high G8 score. Adverse events of grade ≥3 was similar in elderly group (12.9%) and in the young group (15.6%). Treatment was discontinued due to AEs in 6.3% of young group and 18.6% of elderly group. CONCLUSIONS: Effectiveness and safety of treatment of CN-mRCPC with Abiraterone acetate and enzalutamide were similar in older and younger patients, although treatment discontinuation due to AEs was more frequent in the older age group. In addition to ECOG PS, assessment using specific geriatric scales as G8 screening tool could help to identify patients aged ≥75 who would most benefit from treatment with new-generation hormone therapy.
BACKGROUND:Abiraterone acetate and enzalutamide are standard treatments for chemotherapy-naive metastatic castration-resistant prostate cancer (CN-mCRPC). The purpose of this study was to evaluate the effectiveness and safety of these medications in elderly (≥ 75 years old) compared with young CN-mCRPC patients in a real-world clinical setting. Secondarily, we explored the survival prognostic value of different anatomo-clinical factors in elderly group. METHODS: In this retrospective observational multicentre study, we included 134 consecutive CN-mCRPC patients, 64 young and 70 elderly men, who had received AA or Enz. RESULTS: We did not find significant differences in treatment duration [16.6 months, (95% CI 9-24.2 months) vs. 16.8 months (95% CI: 6.3-27.2 months); p = 0.926] and overall survival [median not reached vs. 23.3 months (95% CI 10.2-36.3 months); p = 0.131] between the young and elderly groups. In elderly group, the only predictors of overall survival with AA or Enz were good ECOG performance status and high G8 score. Adverse events of grade ≥3 was similar in elderly group (12.9%) and in the young group (15.6%). Treatment was discontinued due to AEs in 6.3% of young group and 18.6% of elderly group. CONCLUSIONS: Effectiveness and safety of treatment of CN-mRCPC with Abiraterone acetate and enzalutamide were similar in older and younger patients, although treatment discontinuation due to AEs was more frequent in the older age group. In addition to ECOG PS, assessment using specific geriatric scales as G8 screening tool could help to identify patients aged ≥75 who would most benefit from treatment with new-generation hormone therapy.
Authors: Giuseppe Fallara; Ingela Franck Lissbrant; Johan Styrke; Francesco Montorsi; Hans Garmo; Pär Stattin Journal: PLoS One Date: 2020-12-28 Impact factor: 3.240