Keiichiro Mori1,2, Noriyoshi Miura1,3, Hadi Mostafaei1,4, Fahad Quhal1,5, Reza Sari Motlagh1, Benjamin Pradere1,6, Shoji Kimura1,2, Takahiro Kimura2, Shin Egawa2, Alberto Briganti7, Pierre I Karakiewicz8, Shahrokh F Shariat9,10,11,12,13,14,15,16. 1. Department of Urology, Medical University of Vienna, Vienna, Austria. 2. Department of Urology, The Jikei University School of Medicine, Tokyo, Japan. 3. Department of Urology, Ehime University Graduate School of Medicine, Ehime, Japan. 4. Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. 5. Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia. 6. Department of Urology, CHRU Tours, Francois Rabelais University, Tours, France. 7. Division of Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy. 8. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC, Canada. 9. Department of Urology, Medical University of Vienna, Vienna, Austria. shahrokh.shariat@meduniwien.ac.at. 10. Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia. shahrokh.shariat@meduniwien.ac.at. 11. Department of Urology, Weill Cornell Medical College, New York, NY, USA. shahrokh.shariat@meduniwien.ac.at. 12. Department of Urology, University of Texas Southwestern, Dallas, TX, USA. shahrokh.shariat@meduniwien.ac.at. 13. Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria. shahrokh.shariat@meduniwien.ac.at. 14. Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic. shahrokh.shariat@meduniwien.ac.at. 15. Department of Urology, University of Jordan, Amman, Jordan. shahrokh.shariat@meduniwien.ac.at. 16. European Association of Urology Research Foundation, Arnhem, Netherlands. shahrokh.shariat@meduniwien.ac.at.
Abstract
BACKGROUND: This systematic review and meta-analysis aimed to assess the prognostic value of sequential of abiraterone (ABI) and enzalutamide (ENZ) therapy in patients with castration-resistant prostate cancer (CRPC). METHODS: PUBMED, Web of Science, Cochrane Library, and Scopus databases were searched for articles published prior to December 2019 according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. Studies were deemed eligible if they compared overall survival (OS), combined progression-free survival (PFS), combined prostate specific antigen (PSA)-PFS, and PSA response rates in CRPC patients receiving sequential ABI/ENZ or vice versa. PSA response to both the first and second agents was defined as a >50% decrease in PSA achieved with each of these agents. Formal meta-analyses were performed for these outcomes. RESULTS: Ten studies with 1096 patients were eligible for the systematic review and eight studies with 643 patients for the meta-analysis. The ABI-to-ENZ sequence was significantly associated with better PFS (pooled hazard ratio (HR): 0.62, 95% confidential interval (CI): 0.49-0.78, P < 0.001), and PSA-PFS (pooled HR: 0.48, 95% CI: 0.38-0.61, P < 0.001) than the ENZ-to-ABI sequence. PSA response rates of both agents were significantly better with the ABI-to-ENZ sequence (risk ratio: 0.21, 95% CI: 0.09-0.47, P < 0.001). In contrast, treatment sequence was not significantly associated with OS (pooled HR: 0.77, 95% CI: 0.59-1.01, P = 0.055). CONCLUSIONS: ABI-to-ENZ sequential therapy in patients with CRPC was associated with better PFS, PSA-PFS, and PSA response rates. Regardless of sequencing, response to drug therapy was transient for both ABI and ENZ when either agent was used as a secondary therapy. Despite this, treatment sequencing is important to achieve the maximum possible benefit from available drugs in CRPC.
BACKGROUND: This systematic review and meta-analysis aimed to assess the prognostic value of sequential of abiraterone (ABI) and enzalutamide (ENZ) therapy in patients with castration-resistant prostate cancer (CRPC). METHODS: PUBMED, Web of Science, Cochrane Library, and Scopus databases were searched for articles published prior to December 2019 according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. Studies were deemed eligible if they compared overall survival (OS), combined progression-free survival (PFS), combined prostate specific antigen (PSA)-PFS, and PSA response rates in CRPC patients receiving sequential ABI/ENZ or vice versa. PSA response to both the first and second agents was defined as a >50% decrease in PSA achieved with each of these agents. Formal meta-analyses were performed for these outcomes. RESULTS: Ten studies with 1096 patients were eligible for the systematic review and eight studies with 643 patients for the meta-analysis. The ABI-to-ENZ sequence was significantly associated with better PFS (pooled hazard ratio (HR): 0.62, 95% confidential interval (CI): 0.49-0.78, P < 0.001), and PSA-PFS (pooled HR: 0.48, 95% CI: 0.38-0.61, P < 0.001) than the ENZ-to-ABI sequence. PSA response rates of both agents were significantly better with the ABI-to-ENZ sequence (risk ratio: 0.21, 95% CI: 0.09-0.47, P < 0.001). In contrast, treatment sequence was not significantly associated with OS (pooled HR: 0.77, 95% CI: 0.59-1.01, P = 0.055). CONCLUSIONS:ABI-to-ENZ sequential therapy in patients with CRPC was associated with better PFS, PSA-PFS, and PSA response rates. Regardless of sequencing, response to drug therapy was transient for both ABI and ENZ when either agent was used as a secondary therapy. Despite this, treatment sequencing is important to achieve the maximum possible benefit from available drugs in CRPC.
Authors: Wassim Abida; Joshi J Alumkal; Rahul R Aggarwal; Michael T Schweizer; David M Nanus; Allan J Pantuck; Elisabeth I Heath; Eric Campeau; Sarah Attwell; Karen Norek; Margo Snyder; Lisa Bauman; Sanjay Lakhotia; Felix Y Feng; Eric J Small Journal: Clin Cancer Res Date: 2020-07-21 Impact factor: 12.531
Authors: Rana R McKay; Lucia Kwak; Jett P Crowdis; Jamie M Sperger; Shuang G Zhao; Wanling Xie; Lillian Werner; Rosina T Lis; Zhenwei Zhang; Xiao X Wei; Joshua M Lang; Eliezer M Van Allen; Rupal S Bhatt; Evan Y Yu; Peter S Nelson; Glenn J Bubley; R Bruce Montgomery; Mary-Ellen Taplin Journal: Clin Cancer Res Date: 2021-04-13 Impact factor: 12.531
Authors: Daniel J George; Neeraj Agarwal; Oliver Sartor; Cora N Sternberg; Bertrand Tombal; Fred Saad; Kurt Miller; Niculae Constantinovici; Helen Guo; John Reeves; XiaoLong Jiao; Per Sandström; Frank Verholen; Celestia S Higano; Neal Shore Journal: Prostate Cancer Prostatic Dis Date: 2022-02-21 Impact factor: 5.455