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Importance of androgen-deprivation therapy during enzalutamide treatment in men with metastatic castration-resistant prostate cancer following chemotherapy: results from retrospective, multicenter data

Prostate Cancer and Prostatic Diseases volume 22, pages 150–158 (2019)Cite this article

Subjects

Abstract

Background

Enzalutamide can significantly prolong the survival of patients with metastatic castration-resistant prostate cancer (mCRPC). However, there is a paucity of evidence on continuing androgen-deprivation therapy (ADT) for mCRPC. Here, we analyzed the effect of concomitant ADT during enzalutamide treatment in men with mCRPC following chemotherapy.

Methods

We retrospectively reviewed the medical records of 232 patients with mCRPC who received oral enzalutamide (160 mg per day) following chemotherapy at 9 tertiary centers in Korea between 2014 and 2016. The primary endpoint was overall survival, while secondary endpoints included time to prostate-specific antigen (PSA) progression and radiographic progression-free survival.

Results

The median age of the patients was 71 years (interquartile range, 64–75 years). The proportion of patients in a grade group ≥4 was 77.6%. The rate of concomitant ADT was 29.3%, and the all-cause mortality rate was 27.1% (n = 63). Median overall survival, time to PSA progression, and radiographic progression-free survival were 24.0, 8.0, and 10.0 months, respectively. Notably, concomitant ADT showed a significant association with longer overall survival (median duration not reached vs. 18.2 months; p = 0.008). After adjusting for confounding factors, concomitant ADT was still associated with longer overall survival (hazard ratio, 0.35; 95% confidence interval, 0.17–0.72).

Conclusion

Concomitant ADT during enzalutamide treatment may improve the survival of patients with mCRPC following chemotherapy.

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Authors and Affiliations

  1. Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea

    Chang Wook Jeong & Cheol Kwak

  2. Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Minyong Kang & Seong Soo Jeon

  3. Department of Urology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, South Korea

    Seung Il Jung & Dong Deuk Kwon

  4. Department of Urology, Kyungpook National University School of Medicine, Daegu, South Korea

    Tae-Hwan Kim

  5. Department of Urology, Pusan National University Yangsan Hospital, Yangsan, South Korea

    Sung Woo Park

  6. Center for Prostate Cancer, National Cancer Center, Goyang, South Korea

    Jae Young Joung

  7. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Jun Hyuk Hong, Hanjong Ahn & Choung-Soo Kim

  8. Department of Urology, St. Mary Hospital, Catholic University College of Medicine, Seoul, South Korea

    Ji Youl Lee

  9. Department of Urology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Byung Ha Chung

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  1. Chang Wook Jeong
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Correspondence to Cheol Kwak.

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Jeong, C.W., Kang, M., Il Jung, S. et al. Importance of androgen-deprivation therapy during enzalutamide treatment in men with metastatic castration-resistant prostate cancer following chemotherapy: results from retrospective, multicenter data. Prostate Cancer Prostatic Dis 22, 150–158 (2019). https://doi.org/10.1038/s41391-018-0088-z

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