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Poster display

2139 - Outcomes of metastatic castration-resistant prostate cancer (mCRPC) patients (pts) treated with different new agents (NAs) sequence in post-docetaxel (DOC) setting. An updated analysis from a multicenter Italian study


09 Oct 2016


Poster display


Orazio Caffo


Annals of Oncology (2016) 27 (6): 243-265. 10.1093/annonc/mdw372


O. Caffo1, E. Biasco2, G. Facchini3, L. Fratino4, D. Gasparro5, C. Mosillo6, U. Basso7, D. Santini8, M. Tucci9, C. Ortega10, F. Verderame11, S. Scagliarini12, G. Lo Re13, G. Procopio14, G. Fornarini15, E. Campadelli16, R. Sabbatini17, F. Maines18, U. De Giorgi19

Author affiliations

  • 1 Oncology Department, Ospedale Santa Chiara, 38122 - Trento/IT
  • 2 Polo Oncologico, Azienda Ospedaliera Universitaria S.Chiara, 56126 - Pisa/IT
  • 3 Genitourinary Oncology, Istituto Nazionale Tumori – I.R.C.C.S - Fondazione Pascale, Napoli/IT
  • 4 Medical Oncology, Centro di Riferimento Oncologico, Aviano/IT
  • 5 Medical Oncology, Azienda Ospedaliera di Parma, Parma/IT
  • 6 Medical Oncology, Sapienza – Università di Roma, Roma/IT
  • 7 Medical Oncology Unit 1, Istituto Oncologico Veneto IRCCS, 35128 - Padova/IT
  • 8 Medical Oncology, Libero Istituto Universitario Campus Bio-Medico (LIUCBM), 00128 - Roma/IT
  • 9 Medical Oncology, Azienda Ospedaliero-Universitaria ASOU San Luigi Gonzaga, Orbassano/IT
  • 10 Medical Oncology, Istituto di Candiolo-IRCCS-Fondazione Piemontese per la Ricerca sul Cancro-Onlus, Candiolo/IT
  • 11 Medical Oncology, Ospedale Cervello, Palermo/IT
  • 12 Medical Oncology, Azienda Ospedaliera di Rilievo Nazionale "Antonio Cardarelli"-AORN A. Cardarelli, Napoli/IT
  • 13 Medical Oncology, Azienda Ospedaliera Sta Maria degli Angeli, Pordenone/IT
  • 14 Oncologia Medica, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milano/IT
  • 15 Medical Oncology, IRCCS AOU San Martino - IST-Istituto Nazionale per la Ricerca sul Cancro, Genova/IT
  • 16 Medical Oncology, Ospedale civile, Lugo di Romagna/IT
  • 17 Medical Oncology, Azienda Ospedaliero - Universitaria Policlinico di Modena, Modena/IT
  • 18 Medical Oncology, Ospedale Sta Chiara, 38122 - Trento/IT
  • 19 Medical Oncology, Istituto Tumori della Romagna I.R.S.T., Meldola/IT


Abstract 2139


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 NAs, to best exploit their efficacy and avoiding their possible cross resistances. In 2015, we reported the outcomes of a series of 260 mCRPC pts, receiving at least 2 NAs, after DOC progression in routine clinical practice (Eur Urol. 2015;68:147-53). In the present study we updated the analysis with longer follow-up and by assessing a larger series of pts.


Based on a multi-institutional collaboration, we collected data of pts who received at least 2 NAs after DOC: we assessed biochemical (bRR) and objective response rates (oRR) and progression free survival (PFS) of each NA by treatment line; moreover, we evaluated the overall survival (OS) from the second line start by sequence strategy. For the OS analysis we differentiated three different types of NAs sequences after DOC: one new hormone agent (AA or ENZ) followed by CABA (NHA > CABA); CABA followed by AA or ENZ (CABA > NHA); one NHA followed by the other NHA (NHA > NHA).


A consecutive series of 344 mCRPC pts, median age 71 yrs (43-91), with bone (86%), nodal (55%) or visceral (16%) mets, was identified. All received NDs as 2nd and 3rd line after DOC. The outcomes by both treatment lines and NAs are detailed in the table.

Second line Third line
# pts bRR oRR PFS # pts bRR oRR PFS
AA 190 38.9% 20.0% 7.4 mos 105 27.6% 13.3% 4.6 mos
CABA 113 41.6% 16.8% 6.3 mos 143 27.3% 15.3% 4.4 mos
ENZ 41 41.5% 17.1% 6.2 mos 96 19.8% 8.3% 3.3 mos

We observed a statistically significant difference in terms of OS when compared the three sequence strategies: the median OS of pts treated with NHA®CABA, CABA ®NHA, and NHA ®NHA was respectively 11.9 mos, 13.4 mos, and 8.3 mos, respectively (p = 0.01).


At our knowledge this retrospective study reports the highest number of pts treated post-DOC with at least 2 NAs. Our data confirmed that the activity of NAs decreased in the 3rd line compared to the 2nd line and suggested a cumulative OS advantage when CABA is used in the sequence.

Clinical trial identification


Legal entity responsible for the study

Medical Oncology Dept - Santa Chiara Hospital Trento (Italy)




O. Caffo: Honoraria from Astellas, Bayer, Janssen, Sanofi Aventis.

G. Procopio: Advisor Astellas,Bayer,BMS,Janssen,Novartis Honoraria Amgen,Pfizer. All other authors have declared no conflicts of interest.

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