title: Enzalutamide after docetaxel and abiraterone acetate treatment in prostate cancer: a pooled analysis of 10 case series.
abstract: There are emerging data regarding the therapeutic benefit of enzalutamide (ENZ) in the treatment of patients with castration-resistant prostate cancer (CRPC) pretreated with docetaxel and abiraterone acetate. To systematically evaluate the evidence regarding the efficacy of ENZ after docetaxel and abiraterone acetate treatment in CRPC, we performed a pooled analysis of all available studies. Studies that enrolled CRPC patients treated with ENZ after docetaxel and abiraterone acetate treatment were identified using PubMed, Web of Science, SCOPUS, The Cochrane Register of Controlled Trials, and EMBASE. A systematic review was conducted to calculate the pooled response rate (RR) and the 95% confidence interval (CI). Pooled median progression-free survival (PFS) and overall survival (OS), weighted on the number of patients of each of the selected trials, were also calculated. We tested for significant heterogeneity using the Cochran χ(2) test and the I(2) index. Ten publications were selected for inclusion in this analysis. The number of included patients was 536 (range, 23-137). Overall, the pooled RR (reduction of prostate-specific antigen by > 50%) was 22.9% (95% CI, 19.3%-27.1%). The median PFS was 3.1 months (range, 1.4-4.9 months). The median OS was 8.3 months (range, 2.85-10.6 months). In patients sensitive to abiraterone, the RR to ENZ was 35% (95% CI, 27.2%-43.7%). ENZ is moderately effective in CRPC patients who were pretreated with chemotherapy and abiraterone acetate. The greater benefit is confined in patients who responded to abiraterone acetate. Further prospective evaluations of ENZ are required and the mechanisms of resistance have to be better understood.
authors.affiliation: Oncology Department, Medical Oncology Unit, Azienda Ospedaliera Treviglio, Treviglio, Italy. Electronic address: faupe@libero.it.
authors.forename: Fausto
authors.initials: F
authors.lastname: Petrelli
authors.affiliation: Oncology Department, Medical Oncology Unit, Azienda Ospedaliera Treviglio, Treviglio, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Coinu
authors.affiliation: Oncology Department, Medical Oncology Unit, Azienda Ospedaliera Treviglio, Treviglio, Italy.
authors.forename: Karen
authors.initials: K
authors.lastname: Borgonovo
authors.affiliation: Oncology Department, Medical Oncology Unit, Azienda Ospedaliera Treviglio, Treviglio, Italy.
authors.forename: Mary
authors.initials: M
authors.lastname: Cabiddu
authors.affiliation: Oncology Department, Medical Oncology Unit, Azienda Ospedaliera Treviglio, Treviglio, Italy.
authors.forename: Mara
authors.initials: M
authors.lastname: Ghilardi
authors.affiliation: Oncology Department, Radiotherapy Unit, Azienda Ospedaliera Treviglio, Treviglio, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Lonati
authors.affiliation: Oncology Department, Medical Oncology Unit, Azienda Ospedaliera Treviglio, Treviglio, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Barni
mesh_terms: D000069501:Abiraterone Acetate / Q000627:therapeutic use; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D000077143:Docetaxel; D006801:Humans; D008297:Male; D008875:Middle Aged; D009570:Nitriles; D010669:Phenylthiohydantoin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000401:mortality; D016019:Survival Analysis; D043823:Taxoids / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D009570:Nitriles; D043823:Taxoids; D000077143:Docetaxel; D010669:Phenylthiohydantoin; C540278:enzalutamide; D000069501:Abiraterone Acetate
keywords: Abiraterone; Castration-resistant prostate cancer; Docetaxel; Enzalutamide; Pretreated