Enzalutamide After Docetaxel and Abiraterone Therapy in Metastatic Castration-Resistant Prostate Cancer
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Enzalutamide is a novel antiandrogen which is approved for the treatment of metastatic, castration-resistant prostate cancer (mCRPC) after taxane-based chemotherapy. The efficacy of enzalutamide after the sequence docetaxel and abiraterone is not proven.
Thirty-five mCRPC patients in the German compassionate use program, who received enzalutamide after progression with taxane-based chemotherapy and abiraterone were prospectively evaluated. The endpoints of the study were overall survival, radiologic progression-free survival and safety.
The median treatment duration on enzalutamide was 2.8 months. The median overall survival was 7.5 months [95% confidence interval (CI) 4.7–10.3] while median progression-free survival assessed by imaging was 3.1 months (95% CI 1.4–4.8). The most common toxicities of all grades were anemia and weight loss.
Although the results are limited by a small patient number, the consecutive use of enzalutamide and abiraterone after taxane-based chemotherapy shows a modest clinical activity. Thus, sequence therapy alternating between chemotherapy and antihormonal drugs might be a more promising approach in mCRPC treatment.
KeywordsAbiraterone Antihormonal drugs Castration-resistant prostate cancer Chemotherapy Docetaxel Enzalutamide Metastatic Oncology Taxane
We thank Brigitta Grau, Tanja Gröber and Manel Stiasny for their support and of course the patients with their families.
Conflict of interest
No funding or sponsorship was received for this study or publication of this article. Dr. Schmid received lecture fees from Astellas Pharma GmbH and travel grants from GlaxoSmithKline GmbH & Co. KG.
Dr. von Klot received lecture fees from Janssen-Cilag GmbH. Prof. Gschwend received lecture fees and honoraria from Astellas Pharma GmbH, Janssen-Cilag GmbH, Pfizer GmbH, Bayer AG, Amgen GmbH, Novartis AG, Roche GmbH, and GlaxoSmithKline GmbH & Co. KG.
Prof. Kuczyk received lecture fees and honoraria from Astellas Pharma GmbH, Janssen-Cilag GmbH, Novartis Pharma, Pfizer GmbH, Bayer AG and GlaxoSmithKline GmbH & Co. KG.
Prof. Merseburger received lecture fees and honoraria from Astellas Pharma GmbH, Janssen-Cilag GmbH, Novartis Pharma, Pfizer GmbH, Bayer AG and GlaxoSmithKline GmbH & Co. KG.
Prof. Retz received lecture fees and honoraria from Astellas Pharma GmbH, Janssen-Cilag GmbH, Pfizer GmbH, Bayer AG and GlaxoSmithKline GmbH & Co. KG. Mr. Geith, Mrs. Boker, Dr. Tauber and Dr. Seitz declare no conflict of interest.
Compliance with ethics guidelines
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 and 2008. Informed consent was obtained from all patients for being included in the study.
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