Michael Rowe,Stuart  Walter,Ayesha  Hidayat,Hannah  Donkers,Andrew  Browne,Timothy  Norris,Adam  Pollard,Deborah  Victor,John McGrane,
Real World Patterns of PSA Response and Survival with Abiraterone and Enzalutamide in Metastatic Castrate Resistant Prostate Cancer (mCRPC)
Clinical Oncology and Research
2020
2613-4942
http://dx.doi.org/10.31487/j.COR.2020.07.11
https://www.sciencerepository.org/real-world-patterns-of-psa-response-and-survival-with-abiraterone_COR-2020-7-111 
Abstract: Background: We investigated our institution’s mCRPC enzalutamide or abiraterone patients examining
PSA responses and impact of sequencing of these drugs.
Methods: All enzalutamide / abiraterone mCRPC patients (2011-2018) were included. Rates of PSA >50%
response (PSA50) were compared. Time to treatment failure (TTF) and overall survival (OS) was analysed
as per lines of previous therapy and timing of chemotherapy.
Results: 363 patients included (Enza n=236, Abi n=127), with 15.6 months median follow-up. PSA50 was
greater in enzalutamide group (58% vs 31% p<0.0005) but TTF was similar for both groups (median Abi
4.2m vs Enza 6m, p=0.965). There was no significant median OS difference between the groups (Enza
13.8m vs Abi 12.5m p=0.065). Number of lines of prior therapy (p=0.735) or timing of chemotherapy before
or after Abi/Enza (p=0.21) had no significant OS impact.
Conclusion: Enzalutamide showed higher PSA50 response than abiraterone. Previous lines of therapy or
sequencing of chemotherapy with abiraterone / enzalutamide showed no significant survival differences
indicating no detriment in either treatment sequence.Keywords: Metastatic prostate cancer, enzalutamide, abiraterone, androgen receptor targeted agents, treatment sequence