Efficacy and tolerability of current treatments for hormone-refractory prostate cancer patients with visceral metastases

Future Oncol. 2021 May;17(13):1611-1624. doi: 10.2217/fon-2020-1032. Epub 2021 Feb 26.

Abstract

Aim: To assess the efficacy and tolerability of the first-line treatment options for hormone-refractory prostate cancer patients with visceral metastases. Materials & methods: The records of 191 patients diagnosed with hormone-refractory prostate cancer with visceral metastases were analyzed retrospectively. Results: Docetaxel was administered to 61.2% (n = 117), abiraterone to 14.2% (n = 27) and enzalutamide to 9.4% (n = 18) as the first-line treatment. The median survival of the patients receiving docetaxel, abiraterone and enzalutamide as the first-line treatment during the hormone-refractory period was 15 (95% Cl: 12.9-17) months, 6 (95% Cl: 1.8-10.1) months and 11 (95% Cl: 0.9-23.1) months (p = 0.038), respectively. Conclusion: The present study established a statistically significant difference in favor of docetaxel in terms of overall survival and progression-free survival.

Keywords: hormone-refractory disease; prostate cancer; visceral metastasis.

Plain language summary

Lay abstract The optimal therapeutic option for castration-resistant prostate cancer (CRPC) patients with visceral metastases is unknown. We assessed the efficacy and tolerability of the first-line treatment options for CRPC patients with visceral metastasis. One hundred ninety-one patients diagnosed with CRPC with visceral metastases were included in the study. The present study established a statistically significant difference in favor of docetaxel in terms of overall survival and progression-free survival between first-line docetaxel, abiraterone and enzalutamide treatments in CRPC patients with visceral metastases. For patients who cannot undergo chemotherapy, enzalutamide, among novel androgen pathway inhibitors, may be the most appropriate option, given its numerical, although statistically insignificant, difference in overall survival and its fewer side effects compared with abiraterone.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Androstenes / administration & dosage*
  • Androstenes / adverse effects
  • Benzamides / administration & dosage*
  • Benzamides / adverse effects
  • Docetaxel / administration & dosage*
  • Docetaxel / adverse effects
  • Drug Administration Schedule
  • Humans
  • Male
  • Middle Aged
  • Nitriles / administration & dosage*
  • Nitriles / adverse effects
  • Phenylthiohydantoin / administration & dosage*
  • Phenylthiohydantoin / adverse effects
  • Progression-Free Survival
  • Prostatic Neoplasms, Castration-Resistant / drug therapy*
  • Prostatic Neoplasms, Castration-Resistant / mortality
  • Prostatic Neoplasms, Castration-Resistant / pathology
  • Retrospective Studies

Substances

  • Androstenes
  • Benzamides
  • Nitriles
  • Docetaxel
  • Phenylthiohydantoin
  • enzalutamide
  • abiraterone