Adding Abiraterone Acetate Plus Prednisolone to ADT for Metastatic Prostate Cancer
Posted: Monday, November 30, 2020
In the STAMPEDE trial, patients with hormone-naive prostate cancer appeared to derive a survival advantage from androgen-deprivation therapy (ADT) in combination with abiraterone acetate plus prednisolone, according to Nicholas D. James, MBBS, PhD, of The Institute of Cancer Research, London, and colleagues. The long-term results presented during the European Society for Medical Oncology (ESMO) Virtual Congress 2020 (Abstract 611O) revealed a sustained and substantial improvement in overall survival for the subset of patients with metastatic disease.
Between November 2011 and January 2014, a total of 1,917 patients were randomly assigned in a 1:1 allocation ratio to receive either ADT alone or in combination with daily abiraterone acetate plus prednisolone. Of this study population, 52% had M1 disease. Patients with M1 tumors were stratified based on tumor burden: 48% had a high burden; 44% had a low burden; 8% had an unknown tumor burden.
The median follow-up increased from 3.5 to 6.1 years; the number of deaths after ADT alone increased from 218 to 329. The investigators reported a total of 244 deaths after ADT in combination with abiraterone acetate plus prednisolone. The 5-year survival rates were 41% with ADT alone and 60% with ADT in combination with abiraterone acetate plus prednisolone. The relative effect of abiraterone seemed to be similar among patients with low-burden (hazard ratio = 0.55) and high-burden (hazard ratio = 0.54) tumors.
At 4 years after randomization, both treatment methods appeared to exhibit similar safety profiles. Toxicities of grade 3 or higher were reported in 16% of patients in each group.
Disclosure: For full disclosures of the study authors, visit oncologypro.esmo.org.
