A real-world comparison of docetaxel versus abiraterone acetate for metastatic hormone-sensitive prostate cancer.
BACKGROUND
Docetaxel (D) or secondary hormonal therapy (SHT) each combined with androgen deprivation therapy (ADT) represent possible treatment options in males with metastasized hormone-sensitive prostate cancer (mHSPC). Real-world data comparing different protocols are lacking yet. Thus, our objective was to compare the efficacy and safety of abiraterone acetate (AA)+ADT versus D+ADT in mHSPC.


METHODS
In a retrospective multicenter analysis including males with mHSPC treated with either of the aforementioned protocols, overall survival (OS), progression-free survival 1 (PFS1), and progression-free survival 2 (PFS2) were assessed for both cohorts. Median time to event was tested by Kaplan-Meier method and log-rank test. The Cox-proportional hazards model was used for univariate and multivariate regression analyses.


RESULTS
Overall, 196 patients were included. The AA+ADT cohort had a longer PFS1 in the log-rank testing (23 vs. 13 mos., p < 0.001), a longer PFS2 (48 vs. 33 mos., p = 0.006), and longer OS (80 vs. 61 mos., p = 0.040). In the multivariate analyses AA+ADT outperformed D+ADT in terms of PFS1 (HR = 0.34, 95% CI = 0.183-0.623; p = 0.001) and PFS2 (HR = 0.33 95% CI = 0.128-0.827; p = 0.018), respectively, while OS and toxicity rate were similar between both groups.


CONCLUSIONS
AA+ADT is mainly associated with a similar efficacy and overall toxicity rate as D+ADT. Further prospective research is required for validation of the clinical value of the observed benefit of AA+ADT for progression-free end-points.
['Tsaur|Igor|I|https://orcid.org/0000-0001-5107-3523', 'Heidegger|Isabel|I|', 'Bektic|Jasmin|J|', 'Kafka|Mona|M|', 'van den Bergh|Roderick C N|RCN|', 'Hunting|Jarmo C B|JCB|', 'Thomas|Anita|A|', 'Brandt|Maximilian P|MP|', 'Höfner|Thomas|T|', 'Debedde|Eliott|E|', 'Thibault|Constance|C|', 'Ermacora|Paola|P|', 'Zattoni|Fabio|F|', 'Foti|Silvia|S|', 'Kretschmer|Alexander|A|', 'Ploussard|Guillaume|G|https://orcid.org/0000-0002-6004-2152', 'Rodler|Severin|S|', 'von Amsberg|Gunhild|G|', 'Tilki|Derya|D|', 'Surcel|Christian|C|', 'Rosenzweig|Barak|B|', 'Gadot|Moran|M|', 'Gandaglia|Giorgio|G|', 'Dotzauer|Robert|R|', '|||']
hormone-sensitive prostate cancer hormonal therapy chemotherapy metastasis