AUA 2017: Population-based analysis in treatment toxicity among men with castration-resistant prostate cancer
Boston, MA (UroToday.com) Dr. Nam presented on the treatment toxicity in men with castrate resistant prostate cancer. By performing a population based analysis of over 2400 men in Ontario, Canada they were able to describe the toxicity and overall survival. All men were treated with contemporary treatments including abiraterone, enzalutamide, docetaxel or cabazitaxel for castrate resistant prostate cancer. They found docetaxel had the greatest cumulative exposure in their population. While abiraterone and enzalutamide were not associated with significant toxicities, docetaxel was associated with significant any-cause (HR 1.29, 95% CI 1.15-1.44) and treatment related toxicities (HR 1.52 95%CI 1.33-1.74). Cabazitaxel was also associated with more treatment related toxicities (HR 5.94 95%CI 1.87-18.92). Importantly, they found for patients who began treatment for their metastatic castrate resistant prostate cancer after the introduction of enzalutamide and abiraterone to the market, there was a 30% improvement in survival compared to prior to their introduction.
This work is valuable because there is little post-marketing data regarding the toxicity and effectiveness of the treatments used in castrate resistant prostate cancer. Importantly, they found no real increase in toxicities with the use of enzalutamide and abiraterone with prolonged survival. In addition they found that there were increased toxicities associated with docetaxel and cabazitaxel.
Presented By: Robert Nam, MD, MSc, FRCSC
Written By: Janet Baack Kukreja (@janetkukreja), MD, MPH, Urologic Oncology Fellow, Department of Urology, UT MD Anderson Cancer Center, Houston, TX, Ashish M. Kamat, MD, MBBS, FACS, Wayne B. Duddlesten Professor, Department of Urology, UT MD Anderson Cancer Center, Houston TX
at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA