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Enzalutamide versus Abiraterone Acetate as first-line treatment of castration resistant metastatic prostate cancer in geriatric (>= 75) patients

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dc.contributor.authorYUMUK, PERRAN FULDEN
dc.contributor.authorsAlkan, Ali; Guc, Zeynep Gulsum; Gurbuz, Mustafa; ozgun, Guliz; Degirmencioglu, Serkan; Dogan, Mutlu; Telli, Tugba Akin; Keskin, Ozge; Arslan, Cagatay; Bilgin, Burak; Goksu, Sema Sezgin; Demir, Hacer; Koksoy, Elif Berna; Kostek, Osman; Erturk, Ismail; Sakalar, Teoman; Yasar, Arzu; Turkkan, Gorkem; Kasim, Bu ra; Karaoglu, Aziz; oksuzoglu, Berna cakmak; Yumuk, Fulden; Sendur, Mehmet Ali; Coskun, Hasan Senol; cicin, Irfan; Karadurmu, Nuri; Tanriverdi, Ozgur; Akbulut, Hakan; Urun, Yuksel
dc.date.accessioned2022-03-12T22:59:15Z
dc.date.available2022-03-12T22:59:15Z
dc.date.issued2021
dc.description.abstractIntroduction: The efficacy and tolerability of Enzalutamide and Abiraterone Acetate have been reported in elderly patients with metastatic castration resistant prostate cancer (mCRPC). However, there is no randomized study directly comparing antitumor effects between these 2 agents in geriatric patients. We aimed to evaluate the efficacy of Enzalutamide (ENZA) and Abiraterone Acetate (AA) as a first-line treatment of mCRPC in elderly patients. Materials and methods: The geriatric patients (>= 75 years of age) with a diagnosis of mCRPC and treated with first-line ENZA or AA were included. The impacts of clinical parameters and treatment modalities on overall survival (mOS) were analyzed retrospectively and Cox regression analysis was performed. Results: One hundred thirty-four mCRPC patients (77 in AA, 57 in ENZA), with a median age of 81 (75-93) were analyzed. The patient and disease characteristics were similar between arms. While there were more grade 1-2 toxicities in AA arm (45.5% vs 17.5%, P = 0.001), the discontinuation due to toxicity was similar between groups (8.5% vs 5.9%, P = 0.81). The mOS was 18.0 months (95% CI, 15.2-20.7) in AA, and 20.0 months (95% CI, 4.4-35.5) in ENZA arm (P = 0.47). In multivariate analysis, high Gleason score (>= 8) (HR: 2.0 (95% CI, 1.1-3.4), P = 0.009) and high initial PSA values (>= 100 ng/mL) (HR: 2.6 (95% CI, 1.5-4.8), P = 0.001) were poor prognostic factors. The choice of AA vs ENZA was insignificant as a predictor of OS (HR: 0.87 (95% CI, 0.48-1.56), P = 0.65). Conclusion: In the first-line treatment of mCRPC in elderly (>= 75) patients, AA and ENZA showed similar results in terms of mPFS and mOS. The clinical impacts of second-generation androgen receptor pathway inhibitors in the elderly population should be tested in prospective randomized studies.
dc.identifier.doi10.31083/jomh.2021.041
dc.identifier.eissn1875-6859
dc.identifier.issn1875-6867
dc.identifier.urihttps://hdl.handle.net/11424/237290
dc.identifier.wosWOS:000699924300001
dc.language.isoeng
dc.publisherIMR PRESS
dc.relation.ispartofJOURNAL OF MENS HEALTH
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectMetastatic castration-resistant prostate cancer
dc.subjectEnzalutamide
dc.subjectAbiraterone Acetate
dc.subjectElderly
dc.subjectCHEMOTHERAPY
dc.subjectDOCETAXEL
dc.subjectSURVIVAL
dc.subjectOUTCOMES
dc.subjectSAFETY
dc.subjectMEN
dc.titleEnzalutamide versus Abiraterone Acetate as first-line treatment of castration resistant metastatic prostate cancer in geriatric (>= 75) patients
dc.typearticle
dspace.entity.typePublication
local.avesis.id2142f911-2a12-45cf-a5a6-5285c1c985fb
local.import.packageSS17
local.indexed.atWOS
local.indexed.atSCOPUS
local.journal.numberofpages7
oaire.citation.endPage134
oaire.citation.issue4
oaire.citation.startPage128
oaire.citation.titleJOURNAL OF MENS HEALTH
oaire.citation.volume17
relation.isAuthorOfPublication4e7b3d69-6d73-4c60-89e4-d6fddfddd2aa
relation.isAuthorOfPublication.latestForDiscovery4e7b3d69-6d73-4c60-89e4-d6fddfddd2aa

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