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

Shore, Neal;Higano, Celestia S;George, Daniel J;Sternberg, Cora N;Sartor, Oliver;et.al.
(2020) Prostate Cancer and Prostatic Diseases — Vol. 23, n° 4, p. 680-688 (2020)

Files

Shore-2020inpress-Concurrentorlayeredtreatment.pdf
  • Open Access
  • Adobe PDF
  • 853.94 KB
Download
Shore-2020-Concurrentorlayeredtreatment.pdf
  • Open Access
  • Adobe PDF
  • 841.53 KB
Download

Details

Authors
  • Shore, Neal
    Author
  • Higano, Celestia S
    Author
  • George, Daniel J
    Author
  • Sternberg, Cora N
    Author
  • Tombal, Bertrandorcid-logoUCLouvain
    Author
  • Sartor, Oliverorcid-logo
    Author
Show more
Abstract
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). 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. 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. 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.
Affiliations

Citations

  • APA
  • Chicago
  • FWB

Shore, N., Higano, C. S., George, D. J., Sternberg, C. N., Saad, F., Tombal, B., Miller, K., Kalinovsky, J., Jiao, X., Tangirala, K., & Sartor, O. (2020). Concurrent or layered treatment with radium-223 and enzalutamide or abiraterone/prednisone: real-world clinical outcomes in patients with metastatic castration-resistant prostate cancer. Prostate Cancer and Prostatic Diseases, 23(4), 680-688. https://doi.org/10.1038/s41391-020-0236-0 (Original work published 2020)