Abiraterone or Enzalutamide in Advanced CRPC.

[pjoshea13]

New study below.

"We found weak evidence that enzalutamide {Xtandi} outperforms AA {abiraterone acetate - Zytiga} with prednisone in terms of OS {overall survival} in the pre-docetaxel and post-docetaxel settings. However, we found strong evidence that enzalutamide outperforms AA with prednisone in terms of radiographic PFS, time until PSA progression, and PSA response rate in both the pre- and post-docetaxel settings. Rates of grade 3 or worse adverse events were broadly similar between treatment (enzalutamide or AA) and control arms (placebo or placebo with prednisone) in all included randomized studies.

CONCLUSIONS:

There is strong evidence that enzalutamide outperforms AA with prednisone in terms of radiographic PFS and PSA progression and PSA response rate but not OS in the pre and post-docetaxel settings. These results may further guide clinicians in making treatment recommendations for patients with advanced prostate cancer."

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/281...

Prostate. 2017 Jan 19. doi: 10.1002/pros.23309. [Epub ahead of print]

Abiraterone or Enzalutamide in Advanced Castration-Resistant Prostate Cancer: An Indirect Comparison.

Chopra A1, Georgieva M2, Lopes G3, Yeo CM1, Haaland B2.

Author information

1Department of Medical Oncology, Johns Hopkins Singapore International Medical Centre, Singapore.

2H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Georgia.

3Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida.

Abstract

BACKGROUND:

To perform a comparative effectiveness analyses between enzalutamide and abiraterone acetate in both the pre-docetaxel and post-docetaxel settings based on published phase III randomized trials.

METHODS:

The primary measure of efficacy was the posterior probability that enzalutamide outperforms abiraterone acetate (AA) with prednisone in terms of overall survival (OS) on average. Indirect meta-estimates were generated from four randomized studies in the context of a Bayesian hierarchical model with study-specific efficacy estimates meta-analyzed on the log scale.

RESULTS:

We found weak evidence that enzalutamide outperforms AA with prednisone in terms of OS in the pre-docetaxel and post-docetaxel settings. However, we found strong evidence that enzalutamide outperforms AA with prednisone in terms of radiographic PFS, time until PSA progression, and PSA response rate in both the pre- and post-docetaxel settings. Rates of grade 3 or worse adverse events were broadly similar between treatment (enzalutamide or AA) and control arms (placebo or placebo with prednisone) in all included randomized studies.

CONCLUSIONS:

There is strong evidence that enzalutamide outperforms AA with prednisone in terms of radiographic PFS and PSA progression and PSA response rate but not OS in the pre and post-docetaxel settings. These results may further guide clinicians in making treatment recommendations for patients with advanced prostate cancer. Prostate © 2017 Wiley Periodicals, Inc.

© 2017 Wiley Periodicals, Inc.

KEYWORDS:

abiraterone; advanced prostate cancer; castrate-resistant; enzalutamide

PMID: 28101887 DOI: 10.1002/pros.23309

[PubMed - as supplied by publisher]

[BigRich]

Patrick,

What are the median OS times for each drug? Of course a PCa victum would want to beat the median times.

Brothers: if you are reading my question, remenber there are no expiration dates stamped on our foreheads. Why can't you be the exception to the median rule? No matter the answer to my question; it is are journey to beat the statistics.

Patrick, you are providing a valuable service to the brotherhood.

Rich

[pjoshea13 in reply to BigRich]

Rich,

I have long felt that a patient group such as this, should have free access to the full text of papers that might be useful. But since we do not, you will have to pay for the OS data.

My view is that we can each jockey for a better place on the bell curve. Which is why I post on supplements & other topics.

There is no need to be fatalistic about medians & standard deviations. They are useful for understanding what happens to the group, but an individual should not be passive.

-Patrick

[BigRich in reply to pjoshea13]

"There is no need to be fatalistic about medians & standard deviations. They are useful for understanding what happens to the group, but an individual should not be passive."

As stated in my comments, I agree 100% with your above words.

Rich

[Neal-Snyder in reply to pjoshea13]

Thank you as always, Patrick, for informing us and for encouraging us to be active in improving our own prospects.

From my own experiences & from many others I've read about, alleged ranges of added survival time on one treatment or another are surpassed by many of us, to the extent that they've long since vanished from the rear view mirror.

I'll just throw out some other things I'm sure you agree with:

1. Optimism--a positive attitude--increases overall survival.

2. Having fun increases OS.

3. Stress reduction increases OS.

Cheers!

Neal

[Scruffybut1 in reply to Neal-Snyder]

15 months ago my guessed prognosis was given as 67 months median. Like so many of us I got fed up living a median life whatever that is and at the start if this week I told my partner the same. As a nurse she worries. What will you do? My simple answer 'I have decided to live 10 years from diagnosis because I don't feel ill, I don't look ill, I refuse to be ill. My life from now is a holiday. Enjoy it with me.

So your comments and positivity drive us all no matter what. God bless

[Neal-Snyder]

That's the spirit, Scruffy! An oncologist told me 11 years ago that I had a year or 2 to live. I said he was so far off that I wanted my $ back for the appointment. He gave it to me, & I never saw him again. Now, about a decade after my "death," I'm on vacation with my wife in Thailand. Best wishes for a loooong & wonderful holiday, Scruffy!