ASCO GU 2014 - CARE Genitourinary Cancer Faculty - Androgen-deprivation therapy (ADT)

ASCO GU 2014 Abstract# 282: Duration of response to androgen-deprivation therapy (ADT) and efficacy of secondary hormone therapy, docetaxel (D), and cabazitaxel (C) in metastatic castration-resistant prostate cancer (mCRPC).
Antoine Angelergues et al.

Background: Early CRPC (<12 months, m) with 1st hormonal therapy (HT) was found to predict poor efficacy of 2nd HT, but did not seem to impair the benefit of D-based chemotherapy. We evaluated the impact of this variable in our cohort of patients (pts) treated also with second-line chemotherapy C. 

Results: All patients received first HT, D and C, and 94 of them received second HT. Time to CRPC <12 m was associated with a reduced OS and poor PSA-response and TTBP with second HT. Taxanes showed a similar PSA response whatever the time to CRPC but TTBP was slightly shorter in men with time to CRPC <12m. 

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Conclusions: This retrospective analysis of 132 pts with mCRPC suggests that rapid progression to CRPC (<12 m) is associated with a poor prognosis and a low response to second-HT. PSA response to taxanes does not seem to be affected by time to CRPC, but TTBP is shorter in men with early CRPC. Prospective randomized trials are needed to confirm these results.

The results from this study are interesting, as they may assist in informing algorithms focused on proper sequencing of treatments in men CRPC based on responses to prior treatments. In general however, it is already known that patients that have a good response to docetaxel are more likely to respond to cabazitaxel from the TROPIC study. More research evaluating the optimal sequencing of the many new treatment options available to men with CRPC is desperately needed.
— CARE Genitourinary Cancer Faculty