Enzalutamide versus flutamide for castration-resistant prostate cancer after combined androgen blockade therapy with bicalutamide: a retrospective study.
Aged
Aged, 80 and over
Androgen Antagonists
/ therapeutic use
Antineoplastic Agents
/ therapeutic use
Benzamides
Disease Progression
Disease-Free Survival
Flutamide
/ adverse effects
Humans
Male
Middle Aged
Nitriles
Phenylthiohydantoin
/ adverse effects
Prostate-Specific Antigen
/ blood
Prostatic Neoplasms, Castration-Resistant
/ drug therapy
Retrospective Studies
Castration-resistant prostate cancer
Enzalutamide
Flutamide
Journal
International journal of clinical oncology
ISSN: 1437-7772
Titre abrégé: Int J Clin Oncol
Pays: Japan
ID NLM: 9616295
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
received:
29
12
2018
accepted:
05
02
2019
pubmed:
12
2
2019
medline:
8
8
2019
entrez:
12
2
2019
Statut:
ppublish
Résumé
Alternative anti-androgen therapy (AAT) with flutamide after combined androgen blockade (CAB) therapy with bicalutamide for metastatic prostate cancer is common. However, no studies have compared enzalutamide without AAT with enzalutamide after AAT with flutamide as treatment for castration-resistant prostate cancer (CRPC). We aimed to compare the efficacies of flutamide and enzalutamide for CRPC. In our hospital, 55 patients were diagnosed with CRPC after CAB therapy and administered flutamide or enzalutamide between May 2014 and December 2017. Patients with flutamide failure were administered enzalutamide. We evaluated the (1) prostate-specific antigen (PSA) best response with initial therapy, (2) PSA progression-free survival with initial therapy (PSA-PFS), (3) PSA best response with enzalutamide therapy, (4) PSA-PFS of enzalutamide therapy, and (5) overall survival (OS). As first-line therapy, patients were administered enzalutamide (n = 29) or flutamide (n = 26). In the flutamide group, 18 patients showed disease progression and were administered enzalutamide. PSA best response was statistically higher in the enzalutamide group. PSA-PFS was significantly longer in the enzalutamide group [hazard ratio (HR) 0.42, 95% confidence interval (CI) 0.19-0.92, p = 0.024]. However, there was no significant difference in PSA best response with enzalutamide therapy and PSA-PFS between the first- and second-line enzalutamide therapies (HR 0.80, 95% CI 0.33-1.94, p = 0.62). There was no significant difference in OS between enzalutamide and flutamide groups (HR 1.85, 95% CI 0.53-6.42, p = 0.33). AAT with subsequent flutamide after CAB therapy with bicalutamide may be suitable for some CRPC patients.
Sections du résumé
BACKGROUND
BACKGROUND
Alternative anti-androgen therapy (AAT) with flutamide after combined androgen blockade (CAB) therapy with bicalutamide for metastatic prostate cancer is common. However, no studies have compared enzalutamide without AAT with enzalutamide after AAT with flutamide as treatment for castration-resistant prostate cancer (CRPC). We aimed to compare the efficacies of flutamide and enzalutamide for CRPC.
METHODS
METHODS
In our hospital, 55 patients were diagnosed with CRPC after CAB therapy and administered flutamide or enzalutamide between May 2014 and December 2017. Patients with flutamide failure were administered enzalutamide. We evaluated the (1) prostate-specific antigen (PSA) best response with initial therapy, (2) PSA progression-free survival with initial therapy (PSA-PFS), (3) PSA best response with enzalutamide therapy, (4) PSA-PFS of enzalutamide therapy, and (5) overall survival (OS).
RESULTS
RESULTS
As first-line therapy, patients were administered enzalutamide (n = 29) or flutamide (n = 26). In the flutamide group, 18 patients showed disease progression and were administered enzalutamide. PSA best response was statistically higher in the enzalutamide group. PSA-PFS was significantly longer in the enzalutamide group [hazard ratio (HR) 0.42, 95% confidence interval (CI) 0.19-0.92, p = 0.024]. However, there was no significant difference in PSA best response with enzalutamide therapy and PSA-PFS between the first- and second-line enzalutamide therapies (HR 0.80, 95% CI 0.33-1.94, p = 0.62). There was no significant difference in OS between enzalutamide and flutamide groups (HR 1.85, 95% CI 0.53-6.42, p = 0.33).
CONCLUSIONS
CONCLUSIONS
AAT with subsequent flutamide after CAB therapy with bicalutamide may be suitable for some CRPC patients.
Identifiants
pubmed: 30741370
doi: 10.1007/s10147-019-01413-1
pii: 10.1007/s10147-019-01413-1
doi:
Substances chimiques
Androgen Antagonists
0
Antineoplastic Agents
0
Benzamides
0
Nitriles
0
Phenylthiohydantoin
2010-15-3
Flutamide
76W6J0943E
enzalutamide
93T0T9GKNU
Prostate-Specific Antigen
EC 3.4.21.77
Types de publication
Comparative Study
Journal Article
Langues
eng
Pagination
848-856Références
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