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Metastatic Prostate Cancer: Comparing Survival Outcomes With First-Line Therapies

By: Sarah Lynch
Posted: Monday, October 23, 2023

A group of researchers aimed to look at the survival outcomes of patients with metastatic castration-resistant prostate cancer who received novel androgen receptor axis–targeted therapies such as abiraterone acetate and enzalutamide as well as prognostic factors for patient survival. In a retrospective study of more than 200 patients treated with these agents, Chao-Yuan Huang, MD, of the National Taiwan University Hospital, and colleagues found better survival in those who had a prostate-specific antigen (PSA) nadir of at least 2 ng/mL or a time to nadir of at least 7 months. These findings were published in BMC Cancer.

“Further study is needed to determine if an early switch in therapy for those in whom neither [PSA nadir of ≤ 2 ng/mL or time to nadir of ≥ 7 months] is achieved may impact overall survival,” the investigators concluded.

The study included data from 202 patients with metastatic castration-resistant prostate cancer who were administered either abiraterone acetate or enzalutamide as first-line therapy. They analyzed overall survival, as well as PSA decline, PSA nadir, and time to nadir after therapy. A total of 164 patients were treated with first-line androgen receptor axis–targeted therapies alone, and 38 received additional chemotherapy.

The patient group receiving androgen receptor axis–targeted therapies alone did not reach the median overall survival, and those given secondary chemotherapy had a median overall survival of 38.8 months. Although overall survival did not differ between the use of abiraterone and enzalutamide, treatment with enzalutamide seemed to yield a higher rate of PSA decline and a longer time to nadir. Analysis also revealed that a PSA nadir greater than 2 ng/mL and a time to nadir less than 7 months were independently associated with shorter overall survival.

Disclosure: For full disclosures of the study authors, visit

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