Patients were randomly assigned 1:1 to receive cabazitaxel plus prednisone (Group A) or physician's choice of enzalutamide or abiraterone plus prednisone (Group B) at standard doses. They reported 6% of men taking enzalutamide vs 2% taking abiraterone declined (P value not reported). Methods/design: The present study is a phase III, investigator-initiated, multicenter, head-to-head, randomized controlled trial investigating enzalutamide vs. abiraterone as a first-line treatment for CRPC patients. Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Xtandi (enzalutamide) works inside the prostate cancer to prevent the prostate cancer using any testosterone it comes across in the blood. PubMed journal article: Efficacy and Safety of Cabazitaxel Versus Abiraterone or Enzalutamide in Older Patients with Metastatic Castration-resistant Prostate Cancer in the CARD Study. Patients could cross-over at progression. View This Abstract Online; AR-V7 and resistance to enzalutamide and abiraterone in prostate cancer. Abiraterone acetate and Enzalutamide are novel anti-androgens that are key treatments to improve both progression-free survival and overall survival in patients with metastatic castration-resistant prostate cancer. A total of 57 evaluable patients with mCRPC with metastases to the bone have been enrolled in the study to date. Abiraterone acetate plus prednisone and enzalutamide are both used for the treatment of metastatic castration-resistant prostate cancer. We aimed to determine the best sequence in which to use both drugs, as well as their second-line efficacy. It is not known how it will compare to abiraterone. Although it prolongs survival by a median of 4.8 months, enzalutamide carries a risk of seizures as well as numerous drug interactions. To evaluate the real-world data on the efficacy and safety of a combination therapy with radium-223 (Ra-223) and second-generation androgen-receptor targeting agents (ARTAs), including abiraterone acetate (ABI) and enzalutamide (ENZ), among Japanese patients with bone metastatic castration-resistant prostate cancer (CRPC). Moreover, PSA response rate (defined as at least 50% PSA decline from baseline) was compared between the treatment and control groups. They reported on a randomised, phase II study evaluating cabazitaxel versus abiraterone or enzalutamide in poor prognosis metastatic castration-resistant prostate cancer. 1).Of them, 135 patients were aged ≥70 yr (cabazitaxel arm, n = 66; abiraterone or enzalutamide arm, n = 69), with a median age of 76 yr. Enzalutamide-treated patients had longer median treatment duration than abiraterone-treated patients (9.93 vs 8.47 months, respectively, p = 0.0008). Treating chemotherapy-naive metastatic castration-resistant prostate cancer (mCRPC) patients with Xtandi (enzalutamide) leads to better survival outcomes and lower healthcare costs than Zytiga (abiraterone acetate), a study suggests.. In a commentary on May 29 this year we noted that the activity of abiraterone acetate + prednisone following docetaxel-based chemotherapy and enzalutamide therapy seemed to be lower than after only docetaxel-based chemotherapy in most men with metastatic, castration-resistant prostate cancer (mCRPC). The patient will use prednisone in combination with Zytiga. A study published in JAMA Oncology found that, of 6 tested systemic treatment options, abiraterone acetate and apalutamide were the likeliest to improve overall survival when combined with ADT for patients with metastatic castration-sensitive prostate cancer. For patients who remained on first line-therapy only, enzalutamide-treated patients had improved OS versus abiraterone-treated patients (HR = 0.71; 95% CI, 0.62–0.82). Each arm will contain 25 patients. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. ADT plus bicalutamide is inadequate therapy in all cases, but especially for Black patients. In gHRR carriers CBZ was not superior to ARSi in terms of rPFS (2.5 vs. 3.0 m, p=0.8), cPFS (2.5 vs. 2.4 m, p=0.8) and OS (4.5 vs. 3.7, p=0.8). METHODS: This study is an open-label, comparative study allocating castration-resistant prostate cancer patients to abiraterone or enzalutamide treatment arms (allocation factors: age <70 vs ≥70 years, and presence vs absence of metastases) and assessing the treatment results. BACKGROUND: Abiraterone acetate (AA) and enzalutamide (ENZ) are oral therapies offering survival benefit to metastatic castration-resistant prostate cancer (mCRPC) patients. Regarding fatigue, 28.6% of those on enzalutamide were impacted at 12 months, compared with 25% of those on abiraterone acetate (P= .033; HR 1.02). The primary endpoint is the time to prostate-specific antigen progression. We sought to evaluate the clinical activity of enzalutamide versus docetaxel in men with mCRPC who progressed on abiraterone. My notes from that visit are " "In 25% of the cases Zytiga makes prostate cancer more aggressive". Zytiga (abiraterone acetate) vs Xtandi (Enzalutamide) I remember Dr. Myers being cautious regarding Zytiga vs Xtandi. A second therapy, abiraterone, also similarly benefits these men, however it is still being appraised for this use on the NHS. In this study, we aimed to determine whether combinations of AR inhibitors with radiation are additive or synergistic, and investigated the underlying mechanisms governing this. The abiraterone comparison of STAMPEDE (arm G vs arm A) was an open-label trial comparing abiraterone plus prednisolone (5 mg once daily) with ADT alone. The primary outcome was the efficacy of abiraterone and enzalutamide on the enrolled patients, for which pooled HRs of PFS and OS were calculated using the random-effects model. Abiraterone (Zytiga) is covered when the following conditions are met: 1. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Bicalutamide, a nonsteroidal antiandrogen, is widely used to treat men with nonmetastatic or metastatic CRPC. Neither drug is a magic bullet. Rates of treatment discontinuation (for reasons other than progression) were also significantly different between AA and enzalutamide (28.8% vs 40.8%, respectively, P = 0.04). This study randomized 95 patients to either first-line therapy with cabazitaxel or an androgen antagonist (enzalutamide or abiraterone). Unlike docetaxel, which must be administered intravenously in the hospital, enzalutamide, apalutamide, and abiraterone are oral drugs that can be taken at home, so they also offer greater convenience for patients. Ultimately, abiraterone and enzalutamide provide clinical benefit across all approved settings and have higher cost when used earlier in the course … Patients could cross-over at progression. Patients will be randomly assigned to an enzalutamide or an abiraterone treatment group. In gHRR carriers CBZ was not superior to ARSi in terms of rPFS (2.5 vs. 3.0 m, p=0.8), cPFS (2.5 vs. 2.4 m, p=0.8) and OS (4.5 vs. 3.7, p=0.8). In the predocetaxel setting, enzalutamide use was associated with an increase in median OS of 5.9 months (), hazard ratio (HR) = 0.81, and an increase in median PFS of 8.3 months (), HR = 0.47 compared to abiraterone. Enzalutamide demonstrated a greater magnitude of improvement over bicalutamide, in the rate and duration of PSA response in Black patients. Patients and methods In the distant past, many prefered Bicalutamide [Casodex] monotherapy to ADT. In the abiraterone and enzalutamide arm, 53.2% received abiraterone and 46.8% received enzalutamide. After baseline comorbidity adjustment, enzalutamide-treated patients had a 16% reduced risk of death (hazard ratio [HR] = 0.84; 95% CI, 0.76-0.94; p = 0.0012). Conclusions: Detection of AR-V7 in circulating tumor cells from patients with castration-resistant prostate cancer may be associated with resistance to enzalutamide and abiraterone. We performed a single-institution retrospective analysis of consecutive mCRPC patients who had progressed on abiraterone therapy and subsequently received either enzalutamide (n = 30) or docetaxel (n = 31). appear… death by 31% vs. retreatment with enzalutamide or abiraterone (HR 0.69 [95% CI, 0.50, 0.97], p=0.0175). Each arm will contain 25 patients. N Engl J Med. Treating chemotherapy-naive metastatic castration-resistant prostate cancer (mCRPC) patients with Xtandi (enzalutamide) leads to better survival outcomes and lower healthcare costs than Zytiga (abiraterone acetate), a study suggests.. METHODS: This study is an open-label, comparative study allocating castration-resistant prostate cancer patients to abiraterone or enzalutamide treatment arms (allocation factors: age <70 vs ≥70 years, and presence vs absence of metastases) and assessing the treatment results. Both agents improve outcomes in patients previously treated with docetaxel and in those that are chemotherapy-naive. Abiraterone works via a scorched-earth attack on all hormones in the steroid cascade below progesterone & pregnenolone, whereas Enzalutamide is a direct androgen receptor antagonist. Sep 17, 2020. The combination of enzalutamide and abiraterone has also been studied in arm J of STAMPEDE, which has completed recruitment but whose results are yet to be published . Abiraterone (AA) and enzalutamide (ENZA) are increasingly being used in chemotherapy-naive patients with metastatic castration-resistant prostate cancer owing to efficacy and favorable toxicity. PhilipSZacarias my dad took enzalutamide before abiraterone when his cancer metastasized to his bones.. Enzalutamide brough his PSA down over the course of 3 months, but he had the most severe, neurological side-effects from it, to the point where he … Metastatic prostate cancer is a cancer of the prostate gland that has spread to other parts of the body, such as lymph nodes. The efficacy and safety of these drugs were compared in this randomized, double-blind, phase II … The association between AR-V7 detection and therapeutic resistance was maintained after adjustment for expression of full-length androgen receptor messenger RNA. For example, Yamada et al reported that the PSA50 rate of patients receiving abiraterone after enzalutamide was 7%. Figure 3: Kaplan Meier showing Overall Survival with ARTA therapy based on number of previous lines of therapy. The trial was designed to compare cabazitaxel with either abiraterone or enzalutamide in patients with metastatic castration-resistant prostate cancer who had previously received docetaxel and who had disease progression within 12 months while they had been receiving an androgen-signaling–targeted inhibitor (abiraterone or enzalutamide). No information currently available Download Prime PubMed App to iPhone, iPad, or Android Hi . Enzalutamide-treated patients who crossed over to abiraterone had a comparable risk of death versus abiraterone-treated patients who crossed over to enzalutamide (HR = … 2014; 371(11):1028-38 (ISSN: 1533-4406). Abiraterone acetate and enzalutamide have emerged as standard therapies in metastatic castration-resistant prostate cancer (mCRPC). We identified 137 patients who prior to enzalutamide had progressed following a median of eight cycles of docetaxel and seven courses of abiraterone. Similarly, there was a modest improvement in the median on-treatment and off-treatment rPFS rate of 25.2 months for enzalutamide plus abiraterone, vs 22.4 months for enzalutamide … Purpose Enzalutamide, a potent oral androgen receptor inhibitor, improves survival in men with metastatic castration-resistant prostate cancer (CRPC) before and after chemotherapy. Of note, patients on the olaparib arm had longer duration of therapy, at a median of 7.4 months compared with 3.9 months in the physician’s choice hormonal therapy arm. Figure 2: Kaplan Meier survival curves for Overall survival comparing Enza vs Abi patient groups. Xtandi (Enzalutamide) Helps treat prostate cancer. Guidelines differ from study to study, and identify who can or cannot participate. For example, a large phase 3 study being led by the Alliance for Clinical Trials in Oncology is comparing enzalutamide plus abiraterone vs enzalutamide alone as first-line treatment of CRPC, to see whether the combination of these 2 agents will be more effective at … Ultimately, abiraterone and enzalutamide provide clinical benefit across all approved settings and have higher cost when used earlier in the course … With olaparib, 16.4% of patients discontinued treatment due to an AE compared with 8.5% of patients receiving enzalutamide or abiraterone plus prednisone. There is limited data assessing the efficacy and tolerability of abiraterone acetate (AA) versus enzalutamide in this population. An ongoing randomized phase II trial evaluating sequencing of ABI and ENZA in treatment-naïve pts with mCRPC (ClinicalTrials.gov: NCT02125357) also includes Montreal Cognitive Association (MoCA) testing for cognitive impairment and Patient Health Questionnaire (PHQ-9) for depression symptoms … Cabazitaxel vs Abiraterone or Enzalutamide in Patients With Poor Prognosis Metastatic Castration-resistant Prostate Cancer. Today’s results show that enzalutamide, which is already licenced and available on the NHS for men who are resistant to hormone therapy, could be another treatment option for this group of men. 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