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Poster display session

2438 - Outcomes of Prechemotherapy (pCRx) Abiraterone Acetate (AA) or Enzalutamide (E) for Metastatic Castration-Resistant Prostate Cancer (mCRPC) after ADT + Docetaxel (D) or ADT alone for Metastatic Hormone Sensitive Prostate Cancer (mHSPC) in a Multi-Institution Hospital-based Registry.

Date

10 Sep 2017

Session

Poster display session

Topics

Cytotoxic Therapy;  Prostate Cancer

Presenters

Edoardo Francini

Citation

Annals of Oncology (2017) 28 (suppl_5): v269-v294. 10.1093/annonc/mdx370

Authors

E. Francini1, S. Yip2, N.S. Ahmed2, H. Li3, L. Ardolino4, C.P. Evan1, M. Kaymakcalan1, G.K. Shaw1, P. Kantoff5, M.E. Taplin1, N. Alimohamed2, A.M. Joshua4, D.Y.C. Heng2, C.J. Sweeney6

Author affiliations

  • 1 Lank Center For Genitourinary Oncology, Dana-Farber Cancer Institute, 02215 - Boston/US
  • 2 Genitourinary Oncology, Tom Baker Cancer Centre, T2N 4N2 - Calgary/CA
  • 3 Departments Oncology And Community Health Sciences, University of Calgary, Calgary/CA
  • 4 Medical Oncology, Saint Vincent's Hospital, 2010 - Sydney/AU
  • 5 Department Of Medicine, Memorial Sloan Kettering Cancer Center, 10065 - New York/US
  • 6 Lank Center For Genitourinary Oncology, Dana-Farber Cancer Institute, Boston/US
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Resources

Abstract 2438

Background

The E3805: CHAARTED trial noted that the addition of D to ADT was associated with a hazard ratio (HR) of 0.56 (95% confidence interval [CI], 0.44 to 0.70; P 

Methods

A cohort of mCRPC patients (pts) treated with pCRx AA or E for mCRPC between 2014 and 2017 was identified from three hospitals’ IRB approved databases. Patients were grouped by use of D for mHSPC. This time frame was chosen as ADT+D became a valid therapeutic option for mHSPC in 2014 and thus time to pCRx and follow-up were short. The endpoints included OS (time to death from all causes) from ADT start, time to AA/E start from ADT start, and OS from AA/E start. Survival outcomes were analyzed by Kaplan-Meier method.

Results

Of the 102 identified, 50 (49%) had previously received ADT alone, while 52 (51%) had ADT+D. No statistically significant difference in OS from ADT start or from AA/E start was observed between the 2 cohorts (Table 1). Notably, survival in both groups from ADT start was shorter than commonly reported. Yet, deaths in the ADT+D group were 12 vs. 21 in the ADT alone, after a median follow-up of 24.4 and 29.8 months, respectively.

Conclusions

In a cohort of ADT/ADT+D treated mCRPC pts with short times to pCRx AA/E and follow-up, the efficacy of AA/E is similar regardless of previous use of D. It is possible that the pts selected for ADT+D had poorer prognostic factors and yet still did at least as well with AA/E and deaths were lesser. Larger sample sizes, longer follow-up, and better characterization of patient and tumor factors are needed to assess the efficacy of different sequences.Table:

806P

pCRx AA/EN (%)N Deaths (median follow-up mo)Median OS from ADT start (95% CI mo)P-valueTime to AA/E start (95% CI mo)P-valueMedian OS from AA/E start (95% CI mo)P-value
ADT50 (49%)21 (29.8)33.5 (22.4 – NR)0.204711.0 (8.5 – 13.7)0.726517.3 (13.7 – NR)0.6514
ADT+D52 (51%)12 (24.4)NR (NR-NR)12.8 (11.1 – 15.7)NR (13.1 – NR)

Clinical trial identification

Legal entity responsible for the study

Edoardo Francini

Funding

None

Disclosure

P. Kantoff: SAB/consulting: Astellas, Bayer, Bellicum, BIND Biosciences Inc, BN Immunotherapeutics, DRGT, Ipsen Pharmaceuticals, Janssen, Metamark, MTG Therapeutics, New England Research Institutes, Omnitura, OncoCellMDX, Progenity, Sanofi, Tarveda Therapeutics. M.E. Taplin: Research funding and advisory board for Janssen and Medivation. N. Alimohamed: Consulting or advisory role for: Bayer, Sanofi, Pfizer, Astellas, Merck Inc., Novartis Pharma, Roche-Peru. D.Y.C. Heng: Consulting or advisory role: Pfizer, Novartis, Bristol-Myers Squibb, Janssen, Astellas Pharma. C.J. Sweeney: Consultant with compensation for: Astellas, Bayer, Genentech, Janssen, Pfizer, Sanofi. Research funding from: Astellas, Janssen, Sotio, Sanofi. All other authors have declared no conflicts of interest.

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