Abiraterone acetate for treatment of metastatic castration-resistant prostate cancer in chemotherapy-naive patients: an Italian multicentre “real life” 1 year study
To better understand the “real life” experience with abiraterone acetate (AA) in men with chemotherapy-naïve metastatic castration-resistant prostate cancer (mCRPC), we present an Italian multicentre real life analysis with a mid-term follow-up.
Materials and Methods
A consecutive series of patients with mCRPC in 8 Italian tertiary centres treated with AA was collected. Demographics, clinical parameters, treatment outcomes and toxicity were recorded. The Brief Pain Inventory scale Q2 was recorded and patient treatment satisfaction was evaluated. Univariate and multivariate analyses were performed to identify factors for treatment satisfaction. Kaplan-Meier curves were estimated.
We included 145 patients (mean age 76.5y). All patients were on androgen deprivation therapy. Patients had prior radiotherapy, radical prostatectomy, both treatments or exclusive androgen deprivation therapy in 17%, 33%, 9% and 40%, respectively. The Gleason score >7 at diagnosis was 57%. Asymptomatic patients were 62%. The median serum total PSA at AA start was 17ng/mL (range 0,4-2100). Overall the median exposure to AA was 10m (range 1-35). Among the patients that had ≥ 3 months of AA the proportion of patients achieving a ≥50% PSA decline was 49%. Patient satisfaction was 31% “greatly improved”, 37% “improved”, 24% “not changed”, 7% “worsened”; and significantly correlated at multivariable analysis with baseline PSA (OR 1.43 95%CI 1.03-1.98 p0.033), pain (OR 9.3 95%CI 3.33-26.09 p<0.0001), duration of ADT>12months (OR 5.5 95%CI 1.43-21.57 p0.014). With a median follow-up of 13months, median progression free and overall survival were 17 and 26.5months, respectively, and correlated with patient satisfaction, pain, PSA decline (all p <0.001).
we study an Italian real life esperience to evaluate which parameters can influence patients' satisfation.
The AA is effective and well tolerated in asymptomatic or slightly symptomatic mCRPC in a real life setting. These preliminary data should be confirmed after longer follow-up, nevertheless the baseline PSA, the presence of pain and the duration of ADT are predictors of patient satisfaction. The survival outcomes depend on patient satisfaction, pain, and PSA decline.Argomenti: