The authors enrolled 146 patients for the study: 103 patients (70.5%) who were chemotherapy naïve and 43 (29.5%) who were previously treated with docetaxel. After documenting baseline characteristics, clinical end points were defined according to the Prostate Cancer Working Group 2 definitions.
The confirmed PSA response rate was 54.4% in the chemo-naïve group, but only 34.9% in chemo-pretreated patients; this is consistent with prior studies, as there is sometimes cross-resistance between therapies. On survival analyses, patients who were chemo-naïve had better median PSA-progression free survival (14.0 months vs. 7.7 months), clinical or radiographic progression-free survival (17.0 months vs. 12.2 months), and overall survival (27.0 months vs. 18.0 months).
While responses were good in both group, it appeared to be better in chemo-naïve group. However, this is an unfair assessment. A better comparison would have accounted for the start time of therapy with docetaxel, as the chemotherapy also provides survival benefit – if accounted for, the group could better assess the efficacy of abiraterone vs. docetaxol-abiraterone.
While this study reassures us that abiraterone is effective in the Asian population, it does not address the sequencing question.
Speaker(s): Yunjie Yang, China
Institution(s): Fudan University, China
Written by: Thenappan Chandrasekar, MD, Clinical Fellow, University of Toronto, twitter: @tchandra_uromd, at the 37th Congress of Société Internationale d’Urologie - October 19-22, 2017- Lisbon, Portugal