Medical Oncology, Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy.
Medical Oncology, Campus Biomedico University, Roma, Italy.
Crit Rev Oncol Hematol. 2017 Dec;120:227-233. doi: 10.1016/j.critrevonc.2017.09.008. Epub 2017 Oct 16.
Two new drugs, the CYP17 inhibitor abiraterone acetate and the androgen receptor (AR) antagonist enzalutamide, have recently shown to prolong OS prior chemotherapy or in docetaxel treated mCRPC patients, using steroidal therapy or placebo as control group. Updated analyses underlined the role of these new agents on two prostate-specific endpoints as radiographic progression-free survival (rPFS) and time to first skeletal-related event (tSRE). On the basis of these reports, we made an indirect comparison between abiraterone and enzalutamide. We obtained a clinically but not significant difference favouring enzalutamide over abiraterone in terms of rPFS (HR 0.48, 95% CI 0.22-1.02). No significant difference was shown in term of tSRE (HR 0.99, 95% CI 0.83-1.17). In conclusion, abiraterone and enzalutamide have both demonstrated to significantly delay the bone progression resulting in similar improvements in bone-related endpoints in patients with mCRPC.
两种新的药物，CYP17 抑制剂醋酸阿比特龙和雄激素受体（AR）拮抗剂恩扎鲁胺，最近在化疗前或多西他赛治疗的 mCRPC 患者中，使用甾体治疗或安慰剂作为对照组，显示出延长 OS 的作用。更新的分析强调了这些新药物在两个前列腺特异性终点（放射学无进展生存期（rPFS）和首次骨骼相关事件（tSRE）时间）上的作用。基于这些报告，我们对阿比特龙和恩扎鲁胺进行了间接比较。我们发现，在 rPFS 方面，恩扎鲁胺相对于阿比特龙具有临床意义但无统计学差异（HR 0.48，95%CI 0.22-1.02）。在 tSRE 方面没有显示出显著差异（HR 0.99，95%CI 0.83-1.17）。总之，阿比特龙和恩扎鲁胺都显著延迟了骨骼进展，从而在 mCRPC 患者的骨骼相关终点方面产生了相似的改善。
