Treatment sequence in castration-resistant prostate cancer: A retrospective study in the new anti-androgen era

Hoshi,Senji; Numahata,Kenji; Ono,Kunio; Yasuno,Nobuhiro; Bilim,Vladimir; Hoshi,Kiyotsugu; Amemiya,Hiroshi; Sasagawa,Isoji; Ohta,Shoichiro

doi:10.3892/mco.2017.1361

Treatment sequence in castration-resistant prostate cancer: A retrospective study in the new anti-androgen era

Authors:
- Senji Hoshi
- Kenji Numahata
- Kunio Ono
- Nobuhiro Yasuno
- Vladimir Bilim
- Kiyotsugu Hoshi
- Hiroshi Amemiya
- Isoji Sasagawa
- Shoichiro Ohta
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Affiliations: Department of Urology, Yamagata Prefectural Central Hospital, Yamagata 990‑2214, Japan, Department of Urology, Ishinomaki Red Cross Hospital, Ishinomaki, Miyagi 986‑0861, Japan, Department of Pharmacy, Kan‑etsu Hospital, Tsurugashima, Saitama 350‑2213, Japan, Department of Urology, Niigata Cancer Center Hospital, Niigata 951‑8133, Japan, Department of Urology, Yamagata Tokushukai Hospital, Yamagata 990‑0834, Japan, Department of Urology, Sakado Central Hospital, Sakado, Saitama 350‑0233, Japan, Department of Clinical Pathology, Faculty of Pharmaceutical Science, Josai University, Sakado, Saitama 350‑0295, Japan
Published online on: August 3, 2017 https://doi.org/10.3892/mco.2017.1361
Pages: 601-603

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Abstract

In recent years, abiraterone acetate (AA) and enzalutamide (EZL) have become available for the treatment of cancer. Prior clinical trials have demonstrated the benefits of these agents in males with castration‑resistant prostate cancer (CRPC). The optimal sequencing of available therapies in the context of efficacy and known cross‑resistance remains uncertain. Based on the mechanisms of action and accessible clinical data, AA and EZL may be indicated for the early stages of prostate cancer. Until clinical trials are conducted to determine the best treatment sequence, individualized therapy is required for each patient based on the clinicopathological characteristics. In the present study, 46 sequential patients (median age: 77, range 59‑89; median serum PSA level: 56 ng/ml, range 1.5‑3,211) with CRPC treated with EZL (160 mg/day) were retrospectively analyzed between June 2014 and July 2015 at the following institutions: Yamagata Prefectural Central Hospital (Yamagata, Japan); Yamagata Tokushukai Hospital (Yamagata, Japan); Ishinomaki Red Cross Hospital (Ishinomaki, Japan); Kan‑etsu Hospital (Tsurugashima, Japan); Niigata Cancer Center Hospital (Niigata, Japan); Sakado Central Hospital (Sakado, Japan). A total of 18 patients were pre‑treated with Docetaxel (DOC) and 28 patients were DOC‑naïve. Once EZL therapy was initiated, increases in prostate specific antigen (PSA) levels were observed in 3/18 patients (17%) pre‑treated with DOC and in 6/20 (30%) who were DOC‑naïve. In total, 8/28 DOC‑naïve patients were treated with AA without EZL. An increase in the PSA level was observed in only 1/8 (12%) cases following AA treatment in the DOC‑naïve group. It was demonstrated that AA had a better efficacy in DOC‑naïve patients. The efficacy of EZL was limited in AA‑pre‑treated patients following DOC administration.

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