Docetaxel Versus Androgen-Receptor Signaling Inhibitors (ARSI) as Second-Line Therapy After Failure of First-Line Alternative ARSI for the Elderly ≥ 75 Years Old With Metastatic Castration-Resistant Prostate Cancer (mCRPC): A SPARTACUSS—Meet-URO 26 Real-World Study

Anna Patrikidou; Calogero Saieva; Richard Lee-Ying; Pier Vitale Nuzzo; Talal El Zarif; Heather McClure; Matthew Davidsohn; Marc Eid; Gian Paolo Spinelli; Fabio Catalano; Malvina Cremante; Giuseppe Fotia; Sabrina Rossetti; Loana Valenca; Charles Vauchier; Carlotta Ottanelli; Livia Andrade; Vincenzo Gennusa; Ricardo Pereira Mestre; Giuseppe Fornarini; Sandro Pignata; Giuseppe Procopio; Daniele Santini; Praful Ravi; Christopher Sweeney; Daniel Heng; Ugo De Giorgi; Karim Fizazi; Antonio Russo; Edoardo Francini; SPARTACUSS Group

doi:10.1016/j.clgc.2024.102230

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Docetaxel Versus Androgen-Receptor Signaling Inhibitors (ARSI) as Second-Line Therapy After Failure of First-Line Alternative ARSI for the Elderly ≥ 75 Years Old With Metastatic Castration-Resistant Prostate Cancer (mCRPC): A SPARTACUSS—Meet-URO 26 Real-World Study

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Docetaxel Versus Androgen-Receptor Signaling Inhibitors (ARSI) as Second-Line Therapy After Failure of First-Line Alternative ARSI for the Elderly ≥ 75 Years Old With Metastatic Castration-Resistant Prostate Cancer (mCRPC): A SPARTACUSS—Meet-URO 26 Real-World Study

Anna Patrikidou, Calogero Saieva, Richard Lee-Ying, Pier Vitale Nuzzo, Talal El Zarif, Heather McClure, Matthew Davidsohn, Marc Eid, Gian Paolo Spinelli, Fabio Catalano, …

Clinical genitourinary cancer, Vol.22(6), p.102230

12/2024

DOI: 10.1016/j.clgc.2024.102230

PMID: 39461026

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Abstract

Androgen receptor signalling inhibitors (ARSIs) abiraterone acetate (AA) enzalutamide (Enza), are currently the standard first-line (L1) treatments for metastatic castration-resistant prostate cancer (mCRPC), and docetaxel (D) is reserved as second-line (L2) after ARSI failure. Nonetheless, D use in men ≥ 75 years old is restricted owing to treatment toxicities and patient comorbidities, and a L2 alternative ARSI is frequently used. We aimed to evaluate real-life survival and toxicity outcomes of these elderly patients after failure of L1 ARSI treatment. We retrospectively evaluated efficacy and safety in a real-world international cohort of consecutive patients ≥ 75 years old when starting L1 ARSI for mCRPC according to the choice of L2 treatment (D versus alternative ARSI). Of the 122 identified patients, 57 (46.7%) had received L2 ARSI and 65 (53.3%) L2 D. No difference was found in the L1 overall survival (OS) for the ARSI and D groups (32.8 vs. 30.0 months, respectively; Hazard ratio [HR] = 1.22; 95% CI, 0.77-1.95; P = .40) or in the L2 OS (18.5 vs. 17.8 months, respectively; HR = 1.09; 95% CI, 0.69-1.74; P = .71). No difference was observed for rPFS from L2 (P = .12), although a trend was observed for a numerically improved rPFS on D. Within the limitations of a retrospective design and small population, our study suggests that D or ARSI after failure of L1 alternative ARSI are clinically comparable L2 options for elderly patients with mCRPC. Docetaxel use in elderly mCRPC patients is restricted. We retrospectively evaluated efficacy and safety in 122 mCRPC patients ≥ 75 years old regarding choice of L2 treatment (alternative ARSI or docetaxel). No difference existed in L2 OS (P = .71) and PFS (P = .12) or L1 OS (P = .40). Docetaxel or alternative ARSI appear as comparable options for these patients after failure of L1 ARSI.

Abiraterone

Enzalutamide

Geriatric oncology

Older men

Taxane

Details

Title: Subtitle: Docetaxel Versus Androgen-Receptor Signaling Inhibitors (ARSI) as Second-Line Therapy After Failure of First-Line Alternative ARSI for the Elderly ≥ 75 Years Old With Metastatic Castration-Resistant Prostate Cancer (mCRPC): A SPARTACUSS—Meet-URO 26 Real-World Study
Creators: Anna Patrikidou - Institut Gustave Roussy
Calogero Saieva - Piedmont Reference Center for Epidemiology and Cancer Prevention
Richard Lee-Ying - Tom Baker Cancer Centre, Calgary, Alberta, Canada
Pier Vitale Nuzzo - Cornell University
Talal El Zarif - Dana-Farber Cancer Institute
Heather McClure - Harvard University
Matthew Davidsohn - Dana-Farber Cancer Institute
Marc Eid - Harvard University
Gian Paolo Spinelli - Sapienza University of Rome
Fabio Catalano - Ospedale Policlinico San Martino
Malvina Cremante - Ospedale Policlinico San Martino
Giuseppe Fotia - Fondazione IRCCS Istituto Nazionale dei Tumori
Sabrina Rossetti - Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale"
Loana Valenca - D’Or Institute for Research and Education
Charles Vauchier - Institut Gustave Roussy
Carlotta Ottanelli - University of Florence
Livia Andrade - D’Or Institute for Research and Education
Vincenzo Gennusa - University of Palermo
Ricardo Pereira Mestre - Institute of Oncology Research
Giuseppe Fornarini - Ospedale Policlinico San Martino
Sandro Pignata - Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale"
Giuseppe Procopio - Fondazione IRCCS Istituto Nazionale dei Tumori
Daniele Santini - Policlinico Umberto I
Praful Ravi - Dana-Farber Cancer Institute
Christopher Sweeney - Centre for Cancer Biology
Daniel Heng - Tom Baker Cancer Centre, Calgary, Alberta, Canada
Ugo De Giorgi - Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori
Karim Fizazi - Institut Gustave Roussy
Antonio Russo - University of Palermo
Edoardo Francini - University of Florence
SPARTACUSS Group
Resource Type: Journal article
Publication Details: Clinical genitourinary cancer, Vol.22(6), p.102230
DOI: 10.1016/j.clgc.2024.102230
PMID: 39461026
ISSN: 1558-7673
eISSN: 1938-0682
Publisher: Elsevier Inc
Language: English
Date published: 12/2024
Academic Unit: Internal Medicine
Record Identifier: 9985221245302771

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