Capivasertib Plus Chemotherapy in Metastatic Castration-Resistant Prostate Cancer
Posted: Wednesday, April 14, 2021
Research from the phase II ProCAID trial, published in the Journal of Clinical Oncology, found that adding capivasertib, a pan-AKT inhibitor, to docetaxel-based chemotherapy did not result in improved composite progression-free survival in patients with metastatic castration-resistant prostate cancer. Docetaxel resistance frequently occurs during or shortly after treatment concludes.
“Intriguingly, however, we have detected a substantial increase in the [overall survival] secondary endpoint,” noted Robert J. Jones, PhD, of Beatson West of Scotland Cancer Centre in Glasgow, and colleagues. “Data from this study do not provide a definitive explanation for why the addition of capivasertib to chemotherapy might extend [overall survival] but not [progression-free survival].
The study included 150 patients who received a maximum of 10 21-day cycles of intravenous docetaxel and oral prednisolone. In addition, participants were randomly assigned to receive either oral capivasertib or placebo until disease progression. Composite progression-free survival was determined and included prostate-specific antigen suppression events.
Among patients receiving capivasertib, the median composite progression-free survival was 7.0 months (95% confidence interval [CI] = 6.3–8.3 months), and the median overall survival was 31.2 months (95% CI = 20.1 months to not reached). In the placebo group, the median composite progression-free survival was 6.7 months (95% CI = 5.5–7.4), and the median overall survival was 20.3 months (95% CI = 17.5–24.2 months).
A patient’s P13K/AKT/PTEN pathway activation status did not appear to affect composite progression-free survival or overall survival outcomes for either group. The groups both experienced a grade 3 to 4 adverse event rate of 62.2%. Diarrhea, fatigue, nausea, and rash were the most commonly reported adverse events related to capivasertib treatment.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.
