A real-world evaluation of radium-223 in combination with abiraterone or enzalutamide for the treatment of metastatic castration-resistant prostate cancer
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Kim, S.I, et al. A Real-world Evaluation of Radium-223 In Combination with Abiraterone Or Enzalutamide for the Treatment of Metastatic Castration-resistant Prostate Cancer. Public Library of Science, 2021. https://doi.org/10.17615/ka8r-c759APA
Kim, S., Szeto, A., Morgan, K., Brower, B., Dunn, M., Khandani, A., Godley, P., Rose, T., Basch, E., Milowsky, M., Whang, Y., & Crona, D. (2021). A real-world evaluation of radium-223 in combination with abiraterone or enzalutamide for the treatment of metastatic castration-resistant prostate cancer. Public Library of Science. https://doi.org/10.17615/ka8r-c759Chicago
Kim, S.I., A.H Szeto, K.P Morgan, B Brower, M.W Dunn, A.H Khandani, P.A Godley et al. 2021. A Real-World Evaluation of Radium-223 In Combination with Abiraterone Or Enzalutamide for the Treatment of Metastatic Castration-Resistant Prostate Cancer. Public Library of Science. https://doi.org/10.17615/ka8r-c759- Creator
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Kim, S.I.
- Affiliation: Eshelman School of Pharmacy, Division of Pharmacotherapy and Experimental Therapeutics
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Szeto, A.H.
- Affiliation: Eshelman School of Pharmacy, Division of Pharmacotherapy and Experimental Therapeutics
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Morgan, K.P.
- Affiliation: Eshelman School of Pharmacy
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Brower, B.
- Affiliation: School of Medicine, Department of Medicine
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Dunn, M.W.
- Affiliation: School of Medicine, Department of Medicine
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Khandani, A.H.
- Affiliation: School of Medicine, Department of Radiology
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Godley, P.A.
- Affiliation: School of Medicine, Department of Medicine
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Rose, T.L.
- Affiliation: School of Medicine, Department of Medicine
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Basch, E.M.
- Affiliation: School of Medicine, Department of Medicine
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Milowsky, M.I.
- Affiliation: School of Medicine, Department of Medicine
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Whang, Y.E.
- Affiliation: School of Medicine, Department of Medicine
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Crona, D.J.
- Affiliation: Eshelman School of Pharmacy, Division of Pharmacotherapy and Experimental Therapeutics
- Abstract
- Introduction Radium-223, abiraterone, and enzalutamide have each been shown to significantly improve survival as monotherapy in patients with metastatic castration-resistant prostate cancer. However, effects of combination radium-223 plus abiraterone or enzalutamide on survival and safety remain unclear. Patients and methods This single-center retrospective cohort study used electronic health record data of patients with metastatic castration-resistant prostate cancer and bone metastases who were treated with radium-223 between April 1, 2014 and February 19, 2019. Patients who received radium-223 monotherapy were compared to patients who received a combination of radium-223 plus either abiraterone or enzalutamide. The primary endpoint was overall survival. Secondary endpoints included progression-free survival, time to symptomatic skeletal event, symptomatic skeletal event-free survival, and incidence of drug-related adverse events. Time-to-event analyses were estimated by log rank tests using Kaplan-Meier curves. Hazard ratios and 95% confidence intervals were derived from Cox proportional hazards models. Chi-square tests evaluated difference in serious adverse events between the two arms. Results A total of 60 patients met inclusion criteria (n = 41 in the monotherapy arm, n = 19 in the combination arm). Differences in median overall survival were not observed (12.7 vs. 12.8 months; HR 1.15, 95% CI 0.59-2.23; P = 0.68), but median progression-free survival was significantly longer in the combination arm (7.6 vs. 4.9 months; HR 1.94, 95% CI 1.11-3.40; P = 0.02). Significant differences were not observed in time to first SSE (P = 0.97), SSE-free survival (P = 0.16), or in the overall incidence of serious adverse events (P = 0.45). Conclusion Combination radium-223 plus abiraterone or enzalutamide did not improve overall survival, but prolonged progression-free survival without increasing the incidence of serious adverse events in metastatic castration-resistant prostate cancer patients with bone metastases. However, these results are limited by small numbers and patient selection inherent in retrospective analysis.
- Date of publication
- 2021
- Keyword
- DOI
- Identifier
- PMID 34153052
- https://dx.doi.org/10.1371/journal.pone.0253021
- Resource type
- Article
- Rights statement
- In Copyright
- License
- Attribution 4.0 International
- Journal title
- PLoS ONE
- Journal volume
- 16
- Journal issue
- 6-Jun
- Language
- English
- Version
- Publisher
- ISSN
- 1932-6203
- Publisher
- Public Library of Science
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