Concurrent or layered treatment with radium-223 and enzalutamide or abiraterone/prednisone: real-world clinical outcomes in patients with metastatic castration-resistant prostate cancer

被引:29
作者
Shore, Neal [1 ]
Higano, Celestia S. [2 ,3 ]
George, Daniel J. [4 ]
Sternberg, Cora N. [5 ]
Saad, Fred [6 ]
Tombal, Bertrand [7 ]
Miller, Kurt [8 ]
Kalinovsky, Jan [9 ]
Jiao, XiaoLong [10 ]
Tangirala, Krishna [10 ]
Sartor, Oliver [11 ]
机构
[1] Carolina Urol Res Ctr, Myrtle Beach, SC 29572 USA
[2] Univ Washington, Dept Med, Seattle, WA 98195 USA
[3] Fred Hutchinson Canc Res Ctr, 1124 Columbia St, Seattle, WA 98104 USA
[4] Duke Univ, Dept Med & Surg, Duke Canc Inst, Durham, NC USA
[5] New York Presbyterian Hosp, Weill Cornell Dept Med, New York, NY USA
[6] Univ Montreal, Hosp Ctr, Montreal, PQ, Canada
[7] Clin Univ St Luc, Div Urol, UCLouvain, IREC, Brussels, Belgium
[8] Charite Univ Med Berlin, Urol Klin & Hochschulambulanz, Berlin, Germany
[9] Bayer Consumer Care AG, Basel, Switzerland
[10] Bayer HealthCare Pharmaceut, Whippany, NJ USA
[11] Tulane Univ, Sch Med, Tulane Canc Ctr, 1430 Tulane Ave, New Orleans, LA 70112 USA
关键词
SYMPTOMATIC SKELETAL EVENTS; INCREASED SURVIVAL; PLUS PREDNISONE; OPEN-LABEL; DICHLORIDE; ACETATE; PLACEBO; ACCESS;
D O I
10.1038/s41391-020-0236-0
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background In this study, we evaluated real-world data on radium-223 plus abiraterone/prednisone or enzalutamide. Previously, the ERA 223 trial (NCT02043678) demonstrated increased fracture risk with concurrent treatment with radium-223 and abiraterone plus prednisone/prednisolone in patients with metastatic castration-resistant prostate cancer (mCRPC). Methods We used the Flatiron Health database to perform a retrospective study of patients with mCRPC treated with radium-223. Treatment with radium-223 plus abiraterone/prednisone or enzalutamide was defined as concurrent if both drugs started within 30 days of one another, or layered when the second drug started >= 30 days after the first. The index date was defined as the day of the first radium-223 dose. Outcome measures included symptomatic skeletal events (SSEs), overall survival (OS), and patterns of treatments received. Results Of the 625 patients treated with radium-223, 22% received it together with abiraterone/prednisone and 27% with enzalutamide. When these agents were combined, they were often initiated in a layered fashion (73% layered, 23% concurrent). Prior or concomitant bone health agents (BHAs) were received by 67% and 55% of patients, respectively. Median follow-up was 9 months. Overall, incidence rates for SSEs and pathologic fractures were 0.35 and 0.11 patients per person-year, respectively. Median OS from mCRPC diagnosis was 28.1 months. Conclusions In this real-world setting, combination treatments with radium-223 and abiraterone/prednisone or enzalutamide were common. These agents were more commonly given in a layered than a concurrent fashion. Incidence rates for SSEs were reduced when BHAs were used; however, BHAs were underutilized.
引用
收藏
页码:680 / 688
页数:9
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