Optimal Sequencing of Docetaxel and Abiraterone Acetate in Patients with Metastatic Prostate Cancer

Conference Correspondent - ESMO 2014 - Prostate Cancer


Docetaxel (D) and abiraterone acetate (AA) are each approved as a first-line therapy for patients with metastatic castrate-resistant prostate cancer (mCRPC), but the optimal sequencing of these 2 agents is as yet not well defined. A study presented at ESMO 2014 by Zafeiriou and colleagues evaluated whether sequencing of AA and D has an effect on overall survival (OS) in patients with mCRPC (Zafeiriou Z, et al. ESMO 2014: Abstract 791P).

In this retrospective analysis, the authors evaluated patients who had been treated with D after AA therapy (DàAA) or with AA after D therapy (AAàD), excluding patients who had been treated with D in the noncastrate setting, or those who had received enzalutamide before D or AA. Patients who had received cabazitaxel either before or after the second treatment were allowed to enroll.

In this study, 161 patients with mCRPC who received DàAA and 37 patients who received AàD were identified. After a mean follow-up of 2.7 years, 11.2% of the patients in the DàAA group and 5.4% of those in the AAàD group were alive, with a mean OS of 31.4 months in the DàAA group and 38.6 months in the AAàD group (P = .60). Although this retrospective analysis did not identify a significant difference in mean OS between patients treated with DàAA or AAàD, prospective studies to evaluate the optimal treatment sequencing are clearly warranted.