Abiraterone acetate treatment in patients with castration-resistant prostate cancer with visceral metastases: a real-world experience

Gaetano Facchini, Carla Cavaliere, Carmine D'Aniello, Gelsomina Iovane, Sabrina Rossetti

Research output: Contribution to journalArticle

Abstract

In the pre-chemotherapy (CT) and post-CT settings of metastatic castration-resistant prostate cancer (mCRPC), abiraterone acetate plus prednisone (AAP) significantly extended median overall survival and radiographic progression-free survival (PFS) compared with prednisone alone. Yet, few data are available on therapy efficacy in the subgroup with visceral metastases, who represent a small population with poor prognosis. The aim of this study was to describe the clinical experience of AAP in patients with mCRPC with liver and/or lung metastases in real-world setting. We retrospectively reviewed the clinical records of patients with mCRPC with liver and/or lung metastases treated at the National Cancer Institute 'Fondazione G. Pascale' from September 2011 to May 2017. Co-primary end points were overall survival and radiographic PFS. Survival estimates were computed using Kaplan-Meier method. Secondary end points were response rate and safety. Of 143 patients with mCRPC treated, 18.9% (N=27) had visceral metastases: 85.2% (N=23) of the lung, 11.1% (N=3) of the liver and 3.7% (N=1) of both. Median PFS was 13.1 months [95% confidence interval (CI): 4.8-NA] in the pre-CT setting (N=11, median follow-up: 12.9 months), and 10.5 months (95% CI: 4.4-16.6) in the post-CT setting (N=16, median follow-up: 17.2 months). Pre-CT and post-CT patients with lung metastases had a median PFS of 16.5 months (95% CI: 4.3-NA) and 11.4 months (95% CI: 4.2-17.0), respectively. AAP tolerability was consistent with that previously reported in patients with mCRPC, without new safety concerns. Our finding provides preliminary evidence that AAP in real-world setting is a potential effective and safe therapeutic option for patients with mCRPC with a more advanced disease associated with the presence of visceral metastases, in both the pre-CT and post-CT settings.

Original languageEnglish
Pages (from-to)179-185
Number of pages7
JournalAnti-Cancer Drugs
Volume30
Issue number2
DOIs
Publication statusPublished - Feb 2019

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Castration
Prostatic Neoplasms
Neoplasm Metastasis
Drug Therapy
Prednisone
Disease-Free Survival
Confidence Intervals
Therapeutics
Liver Neoplasms
Survival
Lung Neoplasms
Safety
Lung
National Cancer Institute (U.S.)
Abiraterone Acetate
Liver
Population

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Abiraterone acetate treatment in patients with castration-resistant prostate cancer with visceral metastases : a real-world experience. / Facchini, Gaetano; Cavaliere, Carla; D'Aniello, Carmine; Iovane, Gelsomina; Rossetti, Sabrina.

In: Anti-Cancer Drugs, Vol. 30, No. 2, 02.2019, p. 179-185.

Research output: Contribution to journalArticle

Facchini, Gaetano ; Cavaliere, Carla ; D'Aniello, Carmine ; Iovane, Gelsomina ; Rossetti, Sabrina. / Abiraterone acetate treatment in patients with castration-resistant prostate cancer with visceral metastases : a real-world experience. In: Anti-Cancer Drugs. 2019 ; Vol. 30, No. 2. pp. 179-185.
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abstract = "In the pre-chemotherapy (CT) and post-CT settings of metastatic castration-resistant prostate cancer (mCRPC), abiraterone acetate plus prednisone (AAP) significantly extended median overall survival and radiographic progression-free survival (PFS) compared with prednisone alone. Yet, few data are available on therapy efficacy in the subgroup with visceral metastases, who represent a small population with poor prognosis. The aim of this study was to describe the clinical experience of AAP in patients with mCRPC with liver and/or lung metastases in real-world setting. We retrospectively reviewed the clinical records of patients with mCRPC with liver and/or lung metastases treated at the National Cancer Institute 'Fondazione G. Pascale' from September 2011 to May 2017. Co-primary end points were overall survival and radiographic PFS. Survival estimates were computed using Kaplan-Meier method. Secondary end points were response rate and safety. Of 143 patients with mCRPC treated, 18.9{\%} (N=27) had visceral metastases: 85.2{\%} (N=23) of the lung, 11.1{\%} (N=3) of the liver and 3.7{\%} (N=1) of both. Median PFS was 13.1 months [95{\%} confidence interval (CI): 4.8-NA] in the pre-CT setting (N=11, median follow-up: 12.9 months), and 10.5 months (95{\%} CI: 4.4-16.6) in the post-CT setting (N=16, median follow-up: 17.2 months). Pre-CT and post-CT patients with lung metastases had a median PFS of 16.5 months (95{\%} CI: 4.3-NA) and 11.4 months (95{\%} CI: 4.2-17.0), respectively. AAP tolerability was consistent with that previously reported in patients with mCRPC, without new safety concerns. Our finding provides preliminary evidence that AAP in real-world setting is a potential effective and safe therapeutic option for patients with mCRPC with a more advanced disease associated with the presence of visceral metastases, in both the pre-CT and post-CT settings.",
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AU - Iovane, Gelsomina

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AB - In the pre-chemotherapy (CT) and post-CT settings of metastatic castration-resistant prostate cancer (mCRPC), abiraterone acetate plus prednisone (AAP) significantly extended median overall survival and radiographic progression-free survival (PFS) compared with prednisone alone. Yet, few data are available on therapy efficacy in the subgroup with visceral metastases, who represent a small population with poor prognosis. The aim of this study was to describe the clinical experience of AAP in patients with mCRPC with liver and/or lung metastases in real-world setting. We retrospectively reviewed the clinical records of patients with mCRPC with liver and/or lung metastases treated at the National Cancer Institute 'Fondazione G. Pascale' from September 2011 to May 2017. Co-primary end points were overall survival and radiographic PFS. Survival estimates were computed using Kaplan-Meier method. Secondary end points were response rate and safety. Of 143 patients with mCRPC treated, 18.9% (N=27) had visceral metastases: 85.2% (N=23) of the lung, 11.1% (N=3) of the liver and 3.7% (N=1) of both. Median PFS was 13.1 months [95% confidence interval (CI): 4.8-NA] in the pre-CT setting (N=11, median follow-up: 12.9 months), and 10.5 months (95% CI: 4.4-16.6) in the post-CT setting (N=16, median follow-up: 17.2 months). Pre-CT and post-CT patients with lung metastases had a median PFS of 16.5 months (95% CI: 4.3-NA) and 11.4 months (95% CI: 4.2-17.0), respectively. AAP tolerability was consistent with that previously reported in patients with mCRPC, without new safety concerns. Our finding provides preliminary evidence that AAP in real-world setting is a potential effective and safe therapeutic option for patients with mCRPC with a more advanced disease associated with the presence of visceral metastases, in both the pre-CT and post-CT settings.

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