Influence of abiraterone and enzalutamide on body composition in patients with metastatic castration resistant prostate cancer.

Loss of skeletal muscle (SM) and gain of subcutaneous fat (SCF) are known side-effects of androgen-deprivation in treatment of prostate cancer. Scarce data is available concerning the effects of abiraterone/pred (ABI) on body composition and no published data regarding enzalutamide (ENZA).

Our objective was to analyse the effects of ENZA on SM/SCF and to compare the results with ABI in patients with metastatic castration-resistant prostate-cancer (mCRPC).

54 patients starting ABI (n = 17) or ENZA (n = 37) at a single-centre between 2012 and 2018 were retrospectively identified. SM and SCF were assessed using CT-scans at baseline and after a median of 10.8 months on treatment. A deep learning image-segmentation software was used to quantify SM and SCF. In a subgroup of patients receiving ENZA within a trial, we investigated change of SM using serial timepoints.

Median time of treatment with ABI/ENZA was 14.6 months. A significant loss of SM compared to baseline was observed for ENZA (mean loss 5.2%, p<0.0001) and ABI (mean loss 3.0%, p = 0.02). SCF was not significantly altered. The effects of both drugs did not differ significantly. Loss of SM occurred early on during treatment with ENZA.

Treatment with ENZA seems to lead to a loss of SM which is comparable to that of ABI. Further evaluation in larger patient-cohorts is warranted. In routine care, counselling of patients about side effects of ABI/ENZA should include discussions about SM loss.

Cancer treatment and research communications. 2020 Dec 01 [Epub ahead of print]

Stefanie Fischer, Sebastian Clements, Alan McWilliam, Andrew Green, Tine Descamps, Christoph Oing, Silke Gillessen

Manchester Cancer Research Centre, Division of Cancer Sciences, University of Manchester, 555 Wilmslow Road, Manchester M204GJ, United Kingdom; The Christie NHS Foundation Trust, Wilmslow Road, Manchester M204BX, United Kingdom; Cantonal Hospital St. Gallen, Department of Medical Oncology and Haematology, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland. Electronic address: ., University of Manchester, Oxford Rd, Manchester M13 9PL, United Kingdom., Division of Cancer Sciences, University of Manchester, Radiotherapy Related Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M204BX, United Kingdom., Cancer Research UK Manchester Institute Cancer Biomarker Centre, University of Manchester, Alderley Park, SK10 4TG, Macclesfield, United Kingdom., Manchester Cancer Research Centre, Division of Cancer Sciences, University of Manchester, 555 Wilmslow Road, Manchester M204GJ, United Kingdom; Department of Oncology, Haematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20251 Hamburg, Germany., Manchester Cancer Research Centre, Division of Cancer Sciences, University of Manchester, 555 Wilmslow Road, Manchester M204GJ, United Kingdom; Department of Medical Oncology, Istituto Oncologico della Svizzera Italiana, Via Ospedale 12,6500 Bellinzona, Switzerland.

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