Comparison of infection risk between enzalutamide and abiraterone in patients with prostate cancer.
Asian
abiraterone
adverse event
androgen receptor signaling inhibitors
antiandrogen
cohort
enzalutamide
infection
prostate cancer
Journal
Cancer
ISSN: 1097-0142
Titre abrégé: Cancer
Pays: United States
ID NLM: 0374236
Informations de publication
Date de publication:
21 Jul 2024
21 Jul 2024
Historique:
revised:
13
06
2024
received:
30
04
2024
accepted:
14
06
2024
medline:
21
7
2024
pubmed:
21
7
2024
entrez:
21
7
2024
Statut:
aheadofprint
Résumé
Enzalutamide and abiraterone may differ in their immunomodulatory effects, and the prednisone coadministered with abiraterone can be immunosuppressive. This study aimed to compare the risk of different types of infection in patients with prostate cancer receiving enzalutamide or abiraterone in combination with androgen deprivation therapy. Patients with prostate cancer receiving enzalutamide or abiraterone in addition to androgen deprivation therapy in Hong Kong between December 1999 to March 2021 were identified in this retrospective cohort study and followed up until September 2021, death, or crossover. Outcomes, including any sepsis, pneumonia, urinary tract infection, cellulitis or skin abscess, central nervous system infections, and tuberculosis, were analyzed as both time-to-event outcomes (multivariable Fine-Gray regression, with mortality considered a competing event) and recurrent-event outcomes (multivariable negative binomial regression). Altogether, 1582 patients were analyzed (923 abiraterone users; 659 enzalutamide users) with a median follow-up of 10.6 months (interquartile range: 5.3-19.9 months). Compared to abiraterone users, enzalutamide users had lower cumulative incidences of sepsis (adjusted subhazard ratio [SHR] 0.70 [0.53-0.93], p = .014), pneumonia (adjusted SHR 0.76 [0.59-0.99], p = .040), and cellulitis or skin abscess (adjusted SHR 0.55 [0.39-0.79], p = .001), but not urinary tract infection (adjusted SHR 0.91 [0.62-1.35], p = .643). Associations between exposure and central nervous system infections and tuberculosis were not assessed because of low event rates. Analyzing the outcomes as recurrent events gave similar results. Enzalutamide use may be associated with a lower risk of urinary tract infection in patients with diabetes mellitus. Compared to abiraterone users, enzalutamide users have significantly lower risks of sepsis, pneumonia, cellulitis, or skin abscess.
Sections du résumé
BACKGROUND
BACKGROUND
Enzalutamide and abiraterone may differ in their immunomodulatory effects, and the prednisone coadministered with abiraterone can be immunosuppressive. This study aimed to compare the risk of different types of infection in patients with prostate cancer receiving enzalutamide or abiraterone in combination with androgen deprivation therapy.
METHODS
METHODS
Patients with prostate cancer receiving enzalutamide or abiraterone in addition to androgen deprivation therapy in Hong Kong between December 1999 to March 2021 were identified in this retrospective cohort study and followed up until September 2021, death, or crossover. Outcomes, including any sepsis, pneumonia, urinary tract infection, cellulitis or skin abscess, central nervous system infections, and tuberculosis, were analyzed as both time-to-event outcomes (multivariable Fine-Gray regression, with mortality considered a competing event) and recurrent-event outcomes (multivariable negative binomial regression).
RESULTS
RESULTS
Altogether, 1582 patients were analyzed (923 abiraterone users; 659 enzalutamide users) with a median follow-up of 10.6 months (interquartile range: 5.3-19.9 months). Compared to abiraterone users, enzalutamide users had lower cumulative incidences of sepsis (adjusted subhazard ratio [SHR] 0.70 [0.53-0.93], p = .014), pneumonia (adjusted SHR 0.76 [0.59-0.99], p = .040), and cellulitis or skin abscess (adjusted SHR 0.55 [0.39-0.79], p = .001), but not urinary tract infection (adjusted SHR 0.91 [0.62-1.35], p = .643). Associations between exposure and central nervous system infections and tuberculosis were not assessed because of low event rates. Analyzing the outcomes as recurrent events gave similar results. Enzalutamide use may be associated with a lower risk of urinary tract infection in patients with diabetes mellitus.
CONCLUSIONS
CONCLUSIONS
Compared to abiraterone users, enzalutamide users have significantly lower risks of sepsis, pneumonia, cellulitis, or skin abscess.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.
Références
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70(1):7‐30. doi:10.3322/caac.21590
Wang L, Lu B, He M, Wang Y, Wang Z, Du L. Prostate cancer incidence and mortality: global status and temporal trends in 89 countries from 2000 to 2019. Front Public Health. 2022;10:811044. doi:10.3389/fpubh.2022.811044
de Wit R, de Bono J, Sternberg CN, et al. Cabazitaxel versus abiraterone or enzalutamide in metastatic prostate cancer. N Engl J Med. 2019;381(26):2506‐2518. doi:10.1056/NEJMoa1911206
Tagawa ST, Ramaswamy K, Huang A, et al. Survival outcomes in patients with chemotherapy‐naive metastatic castration‐resistant prostate cancer treated with enzalutamide or abiraterone acetate. Prostate Cancer Prostatic Dis. 2021;24(4):1032‐1040. doi:10.1038/s41391‐021‐00318‐3
Yin L, Hu Q. CYP17 inhibitors‐‐abiraterone, C17,20‐lyase inhibitors and multi‐targeting agents. Nat Rev Urol. 2014;11(1):32‐42. doi:10.1038/nrurol.2013.274
Schalken J, Fitzpatrick JM. Enzalutamide: targeting the androgen signalling pathway in metastatic castration‐resistant prostate cancer. BJU Int. 2016;117(2):215‐225. doi:10.1111/bju.13123
Wei Z, Chen C, Li B, Li Y, Gu H. Efficacy and safety of abiraterone acetate and enzalutamide for the treatment of metastatic castration‐resistant prostate cancer: a systematic review and meta‐analysis. Front Oncol. 2021;11:732599. doi:10.3389/fonc.2021.732599
Attard G, Murphy L, Clarke NW, et al. Abiraterone acetate and prednisolone with or without enzalutamide for high‐risk non‐metastatic prostate cancer: a meta‐analysis of primary results from two randomised controlled phase 3 trials of the STAMPEDE platform protocol. Lancet. 2022;399(10323):447‐460. doi:10.1016/s0140‐6736(21)02437‐5
De Nunzio C, Lombardo R, Tema G, et al. Adverse events related to abiraterone and enzalutamide treatment: analysis of the EudraVigilance database and meta‐analysis of registrational phase III studies. Prostate Cancer Prostatic Dis. 2020;23(2):199‐206. doi:10.1038/s41391‐019‐0182‐x
Chan JSK, Satti DI, Lee YHA, et al. Temporal trends in cardiovascular burden among patients with prostate cancer receiving androgen deprivation therapy: a population‐based cohort study. Br J Cancer. 2023;128(12):2253‐2260. doi:10.1038/s41416‐023‐02271‐5
Chan JSK, Satti DI, Lee YHA, et al. High visit‐to‐visit cholesterol variability predicts heart failure and adverse cardiovascular events: a population‐based cohort study. Eur J Prev Cardiol. Oct 20 2022;29(14):e323‐e325. doi:10.1093/eurjpc/zwac097
Lee YHA, Hui JMH, Leung CH, et al. Major adverse cardiovascular events of enzalutamide versus abiraterone in prostate cancer: a retrospective cohort study. Prostate Cancer Prostatic Dis. 2023. doi:10.1038/s41391‐023‐00757‐0
Lee YHA, Zhou J, Hui JMH, et al. Risk of new‐onset prostate cancer for metformin versus sulfonylurea use in type 2 diabetes mellitus: a propensity score‐matched study. J Natl Compr Canc Netw. 2022;20(6):674‐682. doi:10.6004/jnccn.2022.7010
Nielsen RO, Bertelsen ML, Ramskov D, et al. Time‐to‐event analysis for sports injury research part 1: time‐varying exposures. Br J Sports Med. 2019;53(1):61‐68. doi:10.1136/bjsports‐2018‐099408
European Medicines Agency Product Information ‐ Abiraterone (Zytiga).
Riekhof F, Yan Y, Bennett CL, et al. Hospitalizations among veterans treated for metastatic prostate cancer with abiraterone or enzalutamide. Clin Genitourin Cancer. 2023;22(2):18‐26.e3. doi:10.1016/j.clgc.2023.07.006
Tachachartvanich P, Sanchez SS, Gomez SL, John EM, Smith MT, Fejerman L. Plasma glucocorticogenic activity, race/ethnicity and alcohol intake among San Francisco Bay Area women. PLoS One. 2020;15(6):e0233904. doi:10.1371/journal.pone.0233904
Whirledge SD, Jewell CM, Barber LM, et al. Generating diversity in human glucocorticoid signaling through a racially diverse polymorphism in the beta isoform of the glucocorticoid receptor. Lab Invest. 2017;97(11):1282‐1295. doi:10.1038/labinvest.2017.76
Pal SK, Moreira D, Won H, et al. Reduced T‐cell numbers and elevated levels of immunomodulatory cytokines in metastatic prostate cancer patients de novo resistant to abiraterone and/or enzalutamide therapy. Int J Mol Sci. 2019;20(8):1831. doi:10.3390/ijms20081831
Nitzan O, Elias M, Chazan B, et al. Urinary tract infections in patients with type 2 diabetes mellitus: review of prevalence, diagnosis, and management. Diabetes Metab Syndr Obes. 2015;8:129‐136. doi:10.2147/dmso.S51792
Ahmed AE, Abdelkarim S, Zenida M, et al. Prevalence and associated risk factors of urinary tract infection among diabetic patients: a cross‐sectional study. Healthcare (Basel). 2023;11(6):861. doi:10.3390/healthcare11060861
Costenaro F, Rodrigues TC, Kater CE, Auchus RJ, Papari‐Zareei M, Czepielewski MA. Combined 17α‐hydroxylase/17,20‐lyase deficiency due to p.R96W mutation in the CYP17 gene in a Brazilian patient. Arq Bras Endocrinol Metabol. 2010;54(8):744‐748. doi:10.1590/s0004‐27302010000800014
Lim HY, Müller N, Herold MJ, Van Den Brandt J, Reichardt HM. Glucocorticoids exert opposing effects on macrophage function dependent on their concentration. Immunology. 2007;122(1):47‐53. doi:10.1111/j.1365‐2567.2007.02611.x
Da Silva JA, Jacobs JW, Kirwan JR, et al. Safety of low dose glucocorticoid treatment in rheumatoid arthritis: published evidence and prospective trial data. Ann Rheum Dis. 2006;65(3):285‐293. doi:10.1136/ard.2005.038638
Grijalva CG, Chen L, Delzell E, et al. Initiation of tumor necrosis factor‐α antagonists and the risk of hospitalization for infection in patients with autoimmune diseases. JAMA. 2011;306(21):2331‐2339. doi:10.1001/jama.2011.1692
Heatley H, Tran TN, Bourdin A, et al. Observational UK cohort study to describe intermittent oral corticosteroid prescribing patterns and their association with adverse outcomes in asthma. Thorax. 2023;78(9):860‐867. doi:10.1136/thorax‐2022‐219642
Dixon WG, Abrahamowicz M, Beauchamp ME, et al. Immediate and delayed impact of oral glucocorticoid therapy on risk of serious infection in older patients with rheumatoid arthritis: a nested case‐control analysis. Ann Rheum Dis. 2012;71(7):1128‐1133. doi:10.1136/annrheumdis‐2011‐200702
Fizazi K, Scher HI, Molina A, et al. Abiraterone acetate for treatment of metastatic castration‐resistant prostate cancer: final overall survival analysis of the COU‐AA‐301 randomised, double‐blind, placebo‐controlled phase 3 study. Lancet Oncol. 2012;13(10):983‐992. doi:10.1016/s1470‐2045(12)70379‐0
Ryan CJ, Smith MR, Fizazi K, et al. Abiraterone acetate plus prednisone versus placebo plus prednisone in chemotherapy‐naive men with metastatic castration‐resistant prostate cancer (COU‐AA‐302): final overall survival analysis of a randomised, double‐blind, placebo‐controlled phase 3 study. Lancet Oncol. 2015;16(2):152‐160. doi:10.1016/s1470‐2045(14)71205‐7
McKay RR, Werner L, Jacobus SJ, et al. A phase 2 trial of abiraterone acetate without glucocorticoids for men with metastatic castration‐resistant prostate cancer. Cancer. 2019;125(4):524‐532. doi:10.1002/cncr.31836
Attard G, Reid AH, Yap TA, et al. Phase I clinical trial of a selective inhibitor of CYP17, abiraterone acetate, confirms that castration‐resistant prostate cancer commonly remains hormone driven. J Clin Oncol. 2008;26(28):4563‐4571. doi:10.1200/jco.2007.15.9749
Gill D, Gaston D, Bailey E, et al. Efficacy of eplerenone in the management of mineralocorticoid excess in men with metastatic castration‐resistant prostate cancer treated with abiraterone without prednisone. Clin Genitourin Cancer. 2017;15(4):e599‐e602. doi:10.1016/j.clgc.2016.12.008