San Francisco, CA USA (UroToday.com) Caffo and colleagues presented abstract 332 describing the way physicians in Italy choose between abiraterone acetate and docetaxel for first line treatment of metastatic castration-resistant prostate cancer (mCRPC). The study did not include enzalutamide as this was not available in Italy at the time of the study.
The authors performed a retrospective chart review of men treated in five Italian hospitals after abiraterone acetate became available (September 2014-August 2015). The study included 70 men with mCRPC treated during that time. Of these, 49 received abiraterone acetate, and 21 received docetaxel. The men who received abiraterone acetate were significantly older than men treated with docetaxel (75.8 vs 69.7 years, P=0.002). In addition, men receiving abiraterone acetate received a higher number of hormonal therapies prior to inclusion (2.19 vs 1.76, P=0.03). The men treated with abiraterone acetate also had a significantly longer time between the start of their initial hormonal therapy and the start of treatment for mCRPC (47.6 vs 21.2 mgs, P=0.01). Men receiving abiraterone acetate were less frequently symptomatic from their disease (27% vs 67%, P=0.02%). The two groups appeared to have similar rates of liver, lung, and bone metastases.
The investigators point out that this is the first study to explore practice patterns in Italy related to first line treatment of mCRPC. As we may expect, men treated with chemotherapy rather than AR-directed therapy up front have a different phenotype. Further prospective work assessing this that incorporates enzalutamide use and clinical outcomes may prove useful in the race to clarify medication sequencing in the mCRPC population.
Presented By:
Dr. Orazio Caffo, MD
Reported By:
Alicia K. Morgans, MD, at the 2016 Genitourinary Cancers Symposium - January 7 - 9, 2016 – San Francisco, CA
Assistant Professor of Medicine Medical Oncologist
Vanderbilt - Ingram Cancer Center