TY - JOUR
T1 - Clinical outcomes of castration-resistant prostate cancer treatments administered as third or fourth line following failure of docetaxel and other second-line treatment
T2 - Results of an Italian multicentre study
AU - Caffo, Orazio
AU - De Giorgi, Ugo
AU - Fratino, Lucia
AU - Alesini, Daniele
AU - Zagonel, Vittorina
AU - Facchini, Gaetano
AU - Gasparro, Donatello
AU - Ortega, Cinzia
AU - Tucci, Marcello
AU - Verderame, Francesco
AU - Campadelli, Enrico
AU - Lo Re, Giovanni
AU - Procopio, Giuseppe
AU - Sabbatini, Roberto
AU - Donini, Maddalena
AU - Morelli, Franco
AU - Sartori, Donata
AU - Zucali, Paolo
AU - Carrozza, Francesco
AU - D'Angelo, Alessandro
AU - Vicario, Giovanni
AU - Massari, Francesco
AU - Santini, Daniele
AU - Sava, Teodoro
AU - Messina, Caterina
AU - Fornarini, Giuseppe
AU - La Torre, Leonardo
AU - Ricotta, Riccardo
AU - Aieta, Michele
AU - Mucciarini, Claudia
AU - Zustovich, Fable
AU - Macrini, Sveva
AU - Burgio, Salvatore Luca
AU - Santarossa, Sandra
AU - D'Aniello, Carmine
AU - Basso, Umberto
AU - Tarasconi, Sara
AU - Cortesi, Enrico
AU - Buttigliero, Consuelo
AU - Ruatta, Fiorella
AU - Veccia, Antonello
AU - Conteduca, Vincenza
AU - Maines, Francesca
AU - Galligioni, Enzo
PY - 2015
Y1 - 2015
N2 - Background: The availability of new agents (NAs) active in patients with metastatic castration-resistant prostate cancer (mCRPC) progressing after docetaxel treatment (abiraterone acetate, cabazitaxel, and enzalutamide) has led to the possibility of using them sequentially to obtain a cumulative survival benefit. Objective: To provide clinical outcome data relating to a large cohort of mCRPC patients who received a third-line NA after the failure of docetaxel and another NA. Design, setting, and participants: We retrospectively reviewed the clinical records of patients who had received at least two successive NAs after the failure of docetaxel. Outcome measurements and statistical analysis: The independent prognostic value of a series of pretreatment covariates on the primary outcome measure of overall survival was assessed using Cox regression analysis. Results and limitations: Weassessed260patientswhoreceivedonethird-lineNAbetween January 2012 and December 2013, including 38 who received a further NA as fourth-line therapy. The median progression-free and overall survival from the start of third-line therapy was, respectively, 4 mo and 11 mo, with no significant differences between the NAs. Performance status, and haemoglobin and alkaline phosphatase levels were the only independent prognostic factors. The limitations of the study are mainly due its retrospective nature and the small number of patients treatedwith some of the sequences. Conclusions: We were unable to demonstrate a difference in the clinical outcomes of third-line NAs regardless of previous NA therapy. Patient summary: It is debated which sequence of treatments to adopt after docetaxel. Our data do not support the superiority of any of the three new agents in third-line treatment, regardless of the previously administered new agent.
AB - Background: The availability of new agents (NAs) active in patients with metastatic castration-resistant prostate cancer (mCRPC) progressing after docetaxel treatment (abiraterone acetate, cabazitaxel, and enzalutamide) has led to the possibility of using them sequentially to obtain a cumulative survival benefit. Objective: To provide clinical outcome data relating to a large cohort of mCRPC patients who received a third-line NA after the failure of docetaxel and another NA. Design, setting, and participants: We retrospectively reviewed the clinical records of patients who had received at least two successive NAs after the failure of docetaxel. Outcome measurements and statistical analysis: The independent prognostic value of a series of pretreatment covariates on the primary outcome measure of overall survival was assessed using Cox regression analysis. Results and limitations: Weassessed260patientswhoreceivedonethird-lineNAbetween January 2012 and December 2013, including 38 who received a further NA as fourth-line therapy. The median progression-free and overall survival from the start of third-line therapy was, respectively, 4 mo and 11 mo, with no significant differences between the NAs. Performance status, and haemoglobin and alkaline phosphatase levels were the only independent prognostic factors. The limitations of the study are mainly due its retrospective nature and the small number of patients treatedwith some of the sequences. Conclusions: We were unable to demonstrate a difference in the clinical outcomes of third-line NAs regardless of previous NA therapy. Patient summary: It is debated which sequence of treatments to adopt after docetaxel. Our data do not support the superiority of any of the three new agents in third-line treatment, regardless of the previously administered new agent.
KW - Abiraterone acetate
KW - Cabazitaxel
KW - Cancer
KW - Castration-resistant prostate
KW - Enzalutamide
KW - Fourth line
KW - Prognostic factors
KW - Third line
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UR - http://www.scopus.com/inward/citedby.url?scp=84942983803&partnerID=8YFLogxK
U2 - 10.1016/j.eururo.2014.10.014
DO - 10.1016/j.eururo.2014.10.014
M3 - Article
C2 - 25457020
AN - SCOPUS:84942983803
VL - 68
SP - 147
EP - 153
JO - European Urology
JF - European Urology
SN - 0302-2838
IS - 1
ER -