Clinical outcomes of volume of disease on patients receiving enzalutamide versus abiraterone acetate plus prednisone as first-line therapy for metastatic castration-resistant prostate cancer

Pier Vitale Nuzzo; Francesco Ravera; Calogero Saieva; Elisa Zanardi; Giuseppe Fotia; Andrea Malgeri; Sabrina Rossetti; Loana Bueno Valenca; Thiago Martins Oliveira; Charles Vauchier; Ricardo Pereira Mestre; Mikol Modesti; Anna Patrikidou; Sandro Pignata; Giuseppe Procopio; Giuseppe Fornarini; Ugo De Giorgi; Antonio Russo; Edoardo Francini; SPARTACUSS Investigators

doi:10.1177/17588359231156147

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Clinical outcomes of volume of disease on patients receiving enzalutamide versus abiraterone acetate plus prednisone as first-line therapy for metastatic castration-resistant prostate cancer

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Clinical outcomes of volume of disease on patients receiving enzalutamide versus abiraterone acetate plus prednisone as first-line therapy for metastatic castration-resistant prostate cancer

Pier Vitale Nuzzo, Francesco Ravera, Calogero Saieva, Elisa Zanardi, Giuseppe Fotia, Andrea Malgeri, Sabrina Rossetti, Loana Bueno Valenca, Thiago Martins Oliveira, Charles Vauchier, …

Therapeutic advances in medical oncology, Vol.15, p.17588359231156147

01/01/2023

DOI: 10.1177/17588359231156147

PMID: 36895852

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Abstract

Background:Androgen receptor signaling inhibitors (ARSis) abiraterone acetate (AA) plus prednisone and enzalutamide (Enza), are currently the most administered first-line treatments for metastatic castration-resistant prostate cancer (mCRPC). AA and Enza have shown similar overall survival (OS) benefits and there is no consensus upon the best option for mCRPC first-line treatment. Volume of disease may represent a useful biomarker to predict response to therapy in such patients. Objectives:In this study, we seek to evaluate the impact of volume of disease on patients treated with first-line AA versus Enza for mCRPC. Design and methods:We retrospectively evaluated a cohort of consecutive patients with mCRPC categorized by volume of disease [high volume (HV) or low volume (LV) per E3805 criteria] at ARSi onset and treatment type (AA or Enza), assessing OS and radiographic progression-free survival (rPFS), from therapy start, as co-primary endpoints. Results:Of the 420 patients selected, 170 (40.5%) had LV and received AA (LV/AA), 76 (18.1%) LV and had Enza (LV/Enza), 124 (29.5%) HV and were given AA (HV/AA), and 50 (11.9%) HV and received Enza (HV/Enza). Among patients with LV, OS was significantly longer when treated with Enza [57.2 months; 95% confidence interval (CI): 52.1-62.2 months] versus AA (51.6 months; 95% CI, 42.6-60.6 months; p = 0.003). Consistently, those with LV receiving Enza showed increased rPFS (40.3 months; 95 CI, 25.0-55.7 months) than those having AA (22.0 months; 95% CI, 18.1-26.0 months; p = 0.004). No significant difference in OS or rPFS was observed in those with HV treated with AA versus Enza (p = 0.51 and p = 0.73, respectively). In multivariate analysis of patients with LV, treatment with Enza was independently associated with better prognosis than AA. Conclusion:Within the intrinsic limitations of a retrospective design and small population, our report suggests that volume of disease could be a useful predictive biomarker for patients starting first-line ARSi for mCRPC.

Life Sciences & Biomedicine

Oncology

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Title: Subtitle: Clinical outcomes of volume of disease on patients receiving enzalutamide versus abiraterone acetate plus prednisone as first-line therapy for metastatic castration-resistant prostate cancer
Creators: Pier Vitale Nuzzo - Cornell University
Francesco Ravera - Cornell University
Calogero Saieva - Piedmont Reference Center for Epidemiology and Cancer Prevention
Elisa Zanardi - Ospedale Policlinico San Martino
Giuseppe Fotia - Fondazione IRCCS Istituto Nazionale dei Tumori
Andrea Malgeri - Campus Bio Medico University Hospital
Sabrina Rossetti - Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale"
Loana Bueno Valenca - D’Or Institute for Research and Education
Thiago Martins Oliveira - D’Or Institute for Research and Education
Charles Vauchier - Lyon 1 Université
Ricardo Pereira Mestre - Ist Oncol Svizzera Italiana, Bellinzona, Switzerland
Mikol Modesti - Università della Svizzera italiana
Anna Patrikidou - Institut Gustave Roussy
Sandro Pignata - Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale"
Giuseppe Procopio - Istituti Ospitalieri di Cremona
Giuseppe Fornarini - Ospedale Policlinico San Martino
Ugo De Giorgi - Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori
Antonio Russo - University of Palermo
Edoardo Francini - University of Florence
SPARTACUSS Investigators
Resource Type: Journal article
Publication Details: Therapeutic advances in medical oncology, Vol.15, p.17588359231156147
DOI: 10.1177/17588359231156147
PMID: 36895852
ISSN: 1758-8340
eISSN: 1758-8359
Publisher: Sage
Number of pages: 9
Language: English
Date published: 01/01/2023
Academic Unit: Internal Medicine
Record Identifier: 9985221144902771

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