Optimal sequencing of new androgen-receptor targeted agents (ART) abiraterone and enzalutamide with docetaxel (D) and cabazitaxel (C) is unknown. In this large retrospective cohort of mCRPC patients, we evaluated the impact of 3 different sequences: D -> C-> ART (group 1), or D -> ART -> C (group 2), or ART -> D -> C (group 3)
Records of 560 consecutive mCRPC patients were retrospectively collected in 31 centres in 7 European countries from Jan 2011 to Jan 2016. Disease history and clinical characteristics at initiation of each therapy were collected. PSA response ≥ 50%, radiological or clinical progression-free survival (PFS) and overall survival (OS) with each treatment sequence were evaluated.
At sequence initiation, patient characteristics were similar between the 3 sequences: median age was 67 years, 95% were ECOG 0-1, 59% had high disease volume, 42.6% had pain and 8% had visceral metastases. Median number of D cycles was 6 in the 3 groups. Median numbers of C cycles were 7, 6 and 5 in groups 1, 2 and 3 respectively. Median duration of follow-up was 33.7, 31.1, and 23.7 months in groups 1, 2 and 3. Main results are provided in the table.