Continuing enzalutamide with docetaxel in castration-resistant prostate cancer
Mené dans plusieurs pays européens sur 271 patients atteints d'un cancer de la prostate résistant à la castration et de stade métastatique, cet essai multicentrique de phase IIIB évalue l'efficacité, du point de vue de la survie sans progression, et la toxicité de la poursuite du traitement par enzalutamide après l'échec d'un traitement par docétaxel et prednisolone
In metastatic prostate cancer, several life-prolonging therapeutics, such as novel androgen receptor pathway inhibitors, abiraterone acetate and second-generation antiandrogens, and the chemotherapeutic agent docetaxel, are available for both metastatic castration-sensitive prostate cancer and metastatic castration-resistant prostate cancer (mCRPC). Similarly, cabazitaxel, radioisotopes, and poly(ADP-ribose) polymerase inhibitors are available for the treatment of mCRPC. There is currently no evidence of a survival benefit of combination therapy in mCRPC, and life-prolonging drugs are administered sequentially for patients with mCRPC. However, the potential ability of combination therapy to delay progression has been shown in the CHEIRON (adding enzalutamide to docetaxel), ACIS (adding apalutamide to abiraterone plus prednisone), IPATential150 (adding ipatasertib to abiraterone plus prednisone or prednisolone), and PROpel (adding olaparib to abiraterone plus prednisone or prednisolone) trials. Additionally, the survival benefit of combinations of androgen receptor pathway inhibitors, including the addition of abiraterone or the second-generation antiandrogen darolutamide to castration plus docetaxel, was shown in the PEACE-1 (adding abiraterone plus prednisone to docetaxel) and ARASENS (adding darolutamide to docetaxel) trials.
The Lancet Oncology , commentaire, 2021