790P - Activity of sequential new drugs (NDs) post-docetaxel (DOC) failure, in metastatic castration-resistant prostate cancer (mCRPC) patients (pts). Upd...

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Prostate Cancer
Presenter Orazio Caffo
Citation Annals of Oncology (2014) 25 (suppl_4): iv255-iv279. 10.1093/annonc/mdu336
Authors O. Caffo1, U. De Giorgi2, L. Fratino3, G. Facchini4, U. Basso5, D. Alesini6, D. Gasparro7, C. Ortega8, M. Tucci9, F. Verderame10, E. Campadelli11, G. Lo Re12, R. Sabbatini13, M. Donini14, G. Procopio15, D. Sartori16, P.A. Zucali17, F. Carrozza18, A. D'Angelo19, F. Morelli20
  • 1Oncology, S. CHIARA HOSPITAL, 38122 - TRENTO/IT
  • 2Medical Oncology, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, 47014 - Meldola (FC)/IT
  • 3Medical Oncology, CRO Aviano, Aviano/IT
  • 4Medical Oncology, NCI Pascale, Neaples/IT
  • 5Medical Oncology, IOV-IRCCS, 35138 - Padova/IT
  • 6Department Of Radiological, Oncological And Anatomopathological Sciences, La Sapienza University of Rome, Rome/IT
  • 7Medical Oncology, Civil Hospital, Parma/IT
  • 8Medical Oncology, IRCC - Fondazione Piemontese per la Ricerca sul Cancro, Candiolo/IT
  • 9Medical Oncology, University of Turin, Orbassano/IT
  • 10Medical Oncology, Villa Sofia Cervello Hospital, Palermo/IT
  • 11Medical Oncology, Civil Hospital, Lugo di Romagna/IT
  • 12Oncology, Medical Oncology, Pordenone/IT
  • 13Medical Oncology, Ospedale Policlinico-Modena, Modena/IT
  • 14Medical Oncology, Civil Hospital, Cremona/IT
  • 15Oncologia Medica, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milano/IT
  • 16Medical Oncology, Civil Hospital, Mirano/IT
  • 17Department Of Oncology, Humanitas Cancer Center IRCCS, Rozzano/IT
  • 18Medical Oncology, Civil Hospital, Faenza/IT
  • 19Medical Oncology, Civil Hospital, Taormina/IT
  • 20Oncohematology, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo/IT

Abstract

Aim

Abiraterone acetate (AA), cabazitaxel (CABA), and enzalutamide (ENZ) may prolong survival in mCRPC pts progressing after DOC, although it is not clear how to use NDs, to best exploit their efficacy and avoiding their possible cross resistances. We report updated results (preliminary data reported at ASCO 2014) from a large series of pts, receiving 2 NDs (or 3 in a limited series) after DOC progression in routine clinical practice.

Methods

All NDs were available in Italy through a compassionate use program (CUP), or after the regulatory authorities approval (Only CABA in 2012 and AA in 2013). Based on a multi-institutional collaboration, we collected data of pts who received at least 2 NDs after DOC.

Results

A consecutive series of 254 mCRPC pts, median age 71 yrs (46-91), with bone (89%), nodal (56%) or visceral (20%) mets, was identified. All received NDs as 2nd and 3rd line after DOC, but 37 also as 4th line. The biochemical response rate (bRR) (PSA ≥ 50%) was 37% in 2nd line, 24% in 3rd and 34% in 4th line, while the rate of objective response (oRR) was 14%, 14% and 11%, respectively, and the median PFS was 6, 4 and 3 months, respectively. The table reports the outcomes of AA, CABA and ENZ according to the sequence adopted.

3rd line 4th line
Sequence eval pts bRR (%) oRR (%) median PFS (months) eval pts bRR (%) oRR (%) median PFS (months)
AA post CABA 68 28 18 4 4 25 25 1
AA post ENZ 12 8 0 3 6 0 0 2
CABA post AA 88 28 16 4 2 50 0 NE
CABA post ENZ 16 25 12 4 10 20 20 3
ENZ post AA 49 20 10 3 5 20 0 4
ENZ post CABA 21 14 9 5 10 0 0 3

Conclusions

To our knowledge this retrospective study reports the highest number of pts treated post-DOC with at least 2 NDs and it is the first to provide 4th-line data. It appears from our findings that similar bRR and oRR are achieved by CABA and ENZ while AA seems less active in 3rd line and responses in 4th line are rare.

Disclosure

O. Caffo: Honoraria from Sanofi-Aventis and Janssen-Cilag; U. De Giorgi, R. Sabbatini and G. Procopio: Honoraria from Janssenn; P.A. Zucali: Honoraria from Janssenn and Sanofi-Aventis. All other authors have declared no conflicts of interest.