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Title: Beyond cabazitaxel: Late line treatments in metastatic castration resistant prostate cancer: A retrospective multicentre analysis.
Austin Authors: Chazan, Grace;Anton, Angelyn;Wong, Shirley;Shapiro, Julia;Weickhardt, Andrew J ;Azad, Arun;Kwan, Edmond M;Spain, Lavinia;Gunjur, Ashray ;Torres, Javier;Parente, Phillip;Parnis, Francis;Goh, Jeffrey;Gibbs, Peter;Tran, Ben
Affiliation: Olivia Newton-John Cancer Wellness and Research Centre
Department of Medicine, University of Queensland, St Lucia, Australia
Department of Medicine, University of Adelaide, Adelaide, Australia
Adelaide Cancer Centre, Adelaide, Australia
Eastern Health, Melbourne, Australia
Peter MacCallum Cancer Centre, Melbourne, Australia
Western Health, Melbourne, Australia
Royal Brisbane and Women's Hospital, Brisbane, Australia
Department of Medical Oncology, Monash Health, Melbourne, Australia
Goulburn Valley Health, Shepparton, Australia
Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
Walter and Eliza Hall Institute, Melbourne, Australia
Issue Date: 30-Jan-2022 2022
Publication information: Asia-Pacific Journal of Clinical Oncology 2022; 18(6)
Abstract: Multiple life-prolonging therapies are available for metastatic castration-resistant prostate cancer (mCRPC). However, the optimal treatment strategy following progression through standard treatment with docetaxel, androgen receptor signaling inhibitor (ARSI) and cabazitaxel, remains unclear. We aimed to describe treatment patterns in men with mCRPC following progression on standard treatments and determine whether subsequent treatment choice impacts overall survival. Clinicopathologic and treatment data were extracted from the electronic CRPC Australian Database (ePAD) for patients who had received docetaxel, ARSIs and cabazitaxel in any order. Data were analyzed to compare groups that did versus did not receive subsequent systemic therapy. Treatment sequences, median duration of treatment, and median overall survival (mOS) were reported for each treatment group. Ninety-eight eligible patients were identified, with 51 receiving subsequent systemic therapy. Those who received further treatment were younger (68 vs. 71 years, p < .01) but did not have any other differences in clinicopathologic features compared to those who received no further treatment. Patients who received upfront docetaxel were more likely to proceed to subsequent treatment (p = .02). Subsequent systemic therapies varied, the most common being carboplatin-based regimens (n = 13, 25.5%) and many patients were rechallenged with ARSI (n = 10, 19.6%) or docetaxel (n = 6, 11.8%). There was no difference in mOS according to subsequent systemic therapy (p = .09). This retrospective multicenter analysis demonstrates the variation in treatment sequences used for mCRPC in the real-world setting. In the absence of high quality, prospective evidence, our results suggest that subsequent treatment choice does not influence survival outcomes and the optimal choice is guided by individual patient and disease-related factors.
DOI: 10.1111/ajco.13732
ORCID: 0000-0001-9713-1872
Journal: Asia-Pacific Journal of Clinical Oncology
PubMed URL: 35098653
PubMed URL:
Type: Journal Article
Subjects: advanced
metastatic castration-resistant prostate cancer
treatment sequence
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