Enzalutamide Prior to Radium-223 Is Associated with Better Overall Survival in Metastatic Castration-Resistant Prostate Cancer Patients Compared to Abiraterone—A Retrospective Study

Author:

Chen Hao Xiang1ORCID,Tsai Li-Hsien1ORCID,Chang Chao-Hsiang12,Wu Hsi-Chin123,Lin Ching-Chan45,Lin Che-Hung4,Yeh Chin-Chung1,Yang Chi-Rei1,Lien Chi-Shun1,Chang Yi-Huei16,Liang Ji-An27,Chen Guan-Heng8,Hsiao Po-Jen1ORCID,Hsieh Po-Fan12,Huang Chi-Ping12

Affiliation:

1. Department of Urology, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan

2. School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan

3. Department of Urology, China Medical University Beigang Hospital, Beigang, Yunlin 651012, Taiwan

4. Department of Internal Medicine, Division of Hematology and Oncology, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan

5. Division of Hematology and Oncology, Department of Internal Medicine, An Nan Hospital, China Medical University, Tainan 70965, Taiwan

6. Department of Public Health, College of Public Health, China Medical University, Taichung 406333, Taiwan

7. Department of Radiation Oncology, China Medical University Hospital, Taichung 40402, Taiwan

8. Department of Urology, China Medical University Hsinchu Hospital, Hsinchu 30272, Taiwan

Abstract

Metastatic castration-resistant prostate cancer (mCRPC) is a progressive stage of prostate cancer that often spreads to the bone. Radium-223, a bone-targeting radiopharmaceutical, has been shown to improve the overall survival in mCRPC in patients without visceral metastasis. However, the impact of prior systemic therapy on the treatment outcome of mCRPC patients receiving radium-223 remains unclear. This study aimed to investigate the optimal choice of systemic therapy before radium-223 in mCRPC patients. The study included 41 mCRPC patients who received radium-223 therapy, with 22 receiving prior enzalutamide and 19 receiving prior abiraterone. The results showed that the median overall survival was significantly longer in the enzalutamide group than in the abiraterone group (25.1 months vs. 14.8 months, p = 0.049). Moreover, the number of patients requiring blood transfusion was higher in the abiraterone group than in the enzalutamide group (9.1% vs. 26.3%, p = 0.16). The study also found that the number of doses of Radium-223 received was significantly associated with overall survival (≥5 vs. <5, HR 0.028, 95%CI 0.003–0.231, p = 0.001). Our study provides insights into the optimal treatment choice for mCRPC prior to radium-223, indicating that enzalutamide prior to radium-223 administration may have better outcomes compared to abiraterone in mCRPC patients without visceral metastasis.

Publisher

MDPI AG

Subject

Cancer Research,Oncology

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