Subscribe

Subscribe Today!

To sign up for our newsletter or print publications, please enter your contact information below.

I'd like to receive:

Continuous Treatment with Enzalutamide and Docetaxel Reduces the Risk for Progression in Patients with Metastatic Castration-Resistant Prostate Cancer

JHOP - April 2022 Vol 12, No 2 - ASCO Highlights, Prostate Cancer
Download PDF

Continuous treatment with the androgen receptor inhibitor enzalutamide, in combination with docetaxel, significantly improved progression-free survival (PFS) compared with placebo plus docetaxel in men with metastatic castration-resistant prostate cancer whose disease progressed while receiving enzalutamide alone in the phase 3b PRESIDE clinical trial. Axel S. Merseburger, MD, PhD, Clinic of Urology, University Hospital Schleswig-Holstein, Lübeck, Germany, reported the results at the 2022 ASCO GU Cancers Symposium.

The investigators hypothesized that continuous treatment with enzalutamide may help maintain control of responsive tumor lesions and may allow the addition of docetaxel to target pathways that enhance tumor growth.

The double-blind, open-label, randomized PRESIDE study enrolled 687 patients in period 1, when open-label enzalutamide was given. Patients who had no prostate-specific antigen (PSA) response or had no evidence of radiographic progression were not eligible for period 2, during which 273 patients remained and were randomized (1:1) to enzalutamide 160 mg daily, or to placebo. All patients also received docetaxel 75 mg/m2 every 3 weeks, and prednisone 10 mg daily. Treatment continued until disease progression.

The median patient ages were 71.5 years and 69 years for the enzalutamide and placebo arms, respectively. The median baseline PSA levels were 36.9 ng/mL and 28.1 ng/mL, respectively. The majority of the patients were white (97.8% and 99.3%, respectively), and 55.9% and 57% of the patients had a Gleason score of ≥8, respectively. Bone lesions were present in 41.9% of the patients in the enzalutamide arm and in 34.8% of the placebo arm, soft-tissue metastases in 21.3% and 17.8%, respectively, and lesions at both sites were present in 36.8% and 47.4% of the patients, respectively.

The median PFS was 9.53 months with enzalutamide plus docetaxel versus 8.28 months with placebo plus docetaxel (hazard ratio, 0.72; P = .027). In addition, enzalutamide treatment delayed the time to PSA progression (8.4 months vs 6.2 months with placebo).

The PFS by subgroup analysis was consistent with results from the overall study population. No significant difference in PFS was seen between the patients with a baseline ECOG performance score of 0 and 1. The PFS was also similar by disease location in bone only, tissue only, and in both locations (P = .0097).

The PSA level decreased by 37.12% from baseline to week 13 in the enzalutamide arm compared with 9.11% in the placebo arm. The objective response rate based on RECIST version 1.1 was 31.6% in the enzalutamide arm and 25.9% in the placebo arm, with complete response rates of 19.1% and 12.6%, respectively.

“These data suggest that continued treatment with enzalutamide plus docetaxel offers a clinical benefit and could be a future treatment option for some patients who progress on enzalutamide alone,” said Dr Merseburger.

The safety profile of enzalutamide was consistent with its known profile. Serious treatment-emergent adverse events were observed in 49.3% of patients who received enzalutamide versus 38.5% of the patients who received placebo. Adverse events leading to treatment discontinuation occurred in 8.8% and 6.7% of the patients, respectively, and 9.6% and 5.2% of the patients, respectively, died from any cause.

Based on these results, patients whose disease responds initially to treatment with enzalutamide, but who ultimately have disease progression within 15 months; those with ongoing clinical benefit from enzalutamide; and those who demonstrate fitness for combination therapy should be considered for continuous enzalutamide combination therapy, said Elisabeth I. Heath, MD, FACP, Hartmann Endowed Chair for Prostate Cancer Research, Karmanos Cancer Institute, Detroit, MI.

“The addition of docetaxel in men who are progressing on enzalutamide is a treatment option due to an increase in PFS in men with metastatic castration-resistant prostate cancer,” Dr Heath said.

Related Items
PD-1 Inhibition with Dostarlimab Led to Remission in All Patients with Mismatch Repair-Deficient Rectal Cancer
JHOP - August 2022 Vol 12, No 4 published on August 22, 2022 in ASCO Highlights
Black Patients with Cancer and COVID-19 More Likely Than White Patients to Have Therapy Disruptions
JHOP - August 2022 Vol 12, No 4 published on August 22, 2022 in ASCO Highlights
Trastuzumab Deruxtecan a New Standard for Patients with HER2-Low Metastatic Breast Cancer
JHOP - August 2022 Vol 12, No 4 published on August 22, 2022 in ASCO Highlights
Patients Aged ≥55 Years with Luminal A Breast Cancer Can Safely Avoid Radiation
JHOP - August 2022 Vol 12, No 4 published on August 22, 2022 in ASCO Highlights
ASCO Highlights Innovation as Key to Equitable Cancer Care
JHOP - August 2022 Vol 12, No 4 published on August 22, 2022 in ASCO Highlights
Comparing the Impact of Abiraterone and Enzalutamide Sequencing on Progression-Free Survival in Veterans with Metastatic Castration-Resistant Prostate Cancer
JHOP - August 2022 Vol 12, No 4 published on August 19, 2022 in Original Article, Prostate Cancer, Genitourinary Cancers, Targeted Therapies
Pharmacist-Driven Intervention Significantly Increases Biosimilar Adoption in Clinical Practice
JHOP - June 2022 Vol 12, No 3 published on June 16, 2022 in Biosimilars, Oncology Pharmacy Programs, ASCO Highlights
Genetic Score Makes PSA Screening More Accurate
JHOP - June 2022 Vol 12, No 3 published on June 16, 2022 in AACR Highlights, Prostate Cancer, Screening
Oncologists’ Common Misconceptions About Biosimilars Revealed in a Recent Survey
JHOP - June 2022 Vol 12, No 3 published on June 16, 2022 in Biosimilars, ASCO Highlights
Pluvicto FDA Approved for PSMA-Positive Metastatic Prostate Cancer
JHOP - April 2022 Vol 12, No 2 published on May 3, 2022 in FDA Oncology Update, Prostate Cancer
Copyright © The Lynx Group, LLC. All rights reserved.