Abstract:
BACKGROUND:Alternative anti-androgen therapy (AAT) with flutamide after combined androgen blockade (CAB) therapy with bicalutamide for metastatic prostate cancer is common. However, no studies have compared enzalutamide without AAT with enzalutamide after AAT with flutamide as treatment for castration-resistant prostate cancer (CRPC). We aimed to compare the efficacies of flutamide and enzalutamide for CRPC. METHODS:In our hospital, 55 patients were diagnosed with CRPC after CAB therapy and administered flutamide or enzalutamide between May 2014 and December 2017. Patients with flutamide failure were administered enzalutamide. We evaluated the (1) prostate-specific antigen (PSA) best response with initial therapy, (2) PSA progression-free survival with initial therapy (PSA-PFS), (3) PSA best response with enzalutamide therapy, (4) PSA-PFS of enzalutamide therapy, and (5) overall survival (OS). RESULTS:As first-line therapy, patients were administered enzalutamide (n = 29) or flutamide (n = 26). In the flutamide group, 18 patients showed disease progression and were administered enzalutamide. PSA best response was statistically higher in the enzalutamide group. PSA-PFS was significantly longer in the enzalutamide group [hazard ratio (HR) 0.42, 95% confidence interval (CI) 0.19-0.92, p = 0.024]. However, there was no significant difference in PSA best response with enzalutamide therapy and PSA-PFS between the first- and second-line enzalutamide therapies (HR 0.80, 95% CI 0.33-1.94, p = 0.62). There was no significant difference in OS between enzalutamide and flutamide groups (HR 1.85, 95% CI 0.53-6.42, p = 0.33). CONCLUSIONS:AAT with subsequent flutamide after CAB therapy with bicalutamide may be suitable for some CRPC patients.
journal_name
Int J Clin Oncoljournal_title
International journal of clinical oncologyauthors
Iguchi T,Tamada S,Kato M,Yasuda S,Otoshi T,Hamada K,Yamasaki T,Nakatani Tdoi
10.1007/s10147-019-01413-1subject
Has Abstractpub_date
2019-07-01 00:00:00pages
848-856issue
7eissn
1341-9625issn
1437-7772pii
10.1007/s10147-019-01413-1journal_volume
24pub_type
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pub_type: 杂志文章,meta分析
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pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 临床试验,杂志文章
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