Antitumour activity of enzalutamide (MDV3100) in patients with metastatic castration-resistant prostate cancer (CRPC) pre-treated with docetaxel and abiraterone |
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| Institution: | 1. Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, The Institute of Cancer Research, Downs Road, Sutton, Surrey, UK;2. Guy''s and St. Thomas’ NHS Foundation Trust, Great Maze Pond, London, UK;1. Medical Oncology, S. Chiara Hospital, Largo Medaglie d’oro 1, 38122 Trento, Italy;2. Medical Oncology, Azienda Ospedaliera Universitaria Integrata, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy;1. Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA;2. Janssen Research & Development, Menlo Park, CA;3. Janssen Research & Development, Los Angeles, CA;1. Institut Gustave Roussy, University of Paris Sud, Villejuif, France;2. Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA;3. Charité Berlin, Berlin, Germany;4. Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA;5. San Camillo and Forlanini Hospitals, Rome, Italy;6. Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA;7. Medivation, San Francisco, CA, USA;8. Royal Marsden Hospital and the Institute of Cancer Research, Sutton, UK;1. Duke Cancer Institute, Divisions of Medical Oncology and Urology, Departments of Medicine and Surgery, Duke University Medical Center, Durham, NC;2. University of California – San Francisco, San Francisco, CA;3. Department of Radiology, Duke University Medical Center, Durham, NC |
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| Abstract: | BackgroundThe new generation anti-androgen enzalutamide and the potent CYP17 inhibitor abiraterone have both demonstrated survival benefits in patients with metastatic castration-resistant prostate cancer (CRPC) progressing after docetaxel. Preliminary data on the antitumour activity of abiraterone after enzalutamide have suggested limited activity. The antitumour activity and safety of enzalutamide after abiraterone in metastatic CRPC patients is still unknown.Patients and MethodsWe retrospectively identified patients treated with docetaxel and abiraterone prior to enzalutamide to investigate the activity and safety of enzalutamide in a more advanced setting. Prostate specific antigen (PSA), radiological and clinical assessments were analysed.Results39 patients with metastatic CRPC were identified for this analysis (median age 70 years, range: 54–85 years). Overall 16 patients (41%) had a confirmed PSA decline of at least 30%. Confirmed PSA declines of ?50% and ?90% were achieved in 5/39 (12.8%) and 1/39 (2.5%) respectively. Of the 15 patients who responded to abiraterone, two (13.3%) also had a confirmed ?50% PSA decline on subsequent enzalutamide. Among the 22 abiraterone-refractory patients, two (9%) achieved a confirmed ?50% PSA decline on enzalutamide.ConclusionOur preliminary case series data suggest limited activity of enzalutamide in the post-docetaxel and post-abiraterone patient population. |
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| Keywords: | Abiraterone Enzalutamide Castration resistant prostate cancer Hormone therapy Androgen receptor targeting |
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