As we all know there are now a number of new drugs available to treat castrate resistant metastatic prostate cancer (mCRPC). The availability of these new drugs (abiraterone acetate aka Zytiga, cabazitaxel aka Jevtana, and enzalutamide aka Xtandi) for use in men with mCRPC after the failure of chemotherapy (with docetaxel) has opened a number of questions about possible survival advantages offered by these drugs. One of the questions that have been asked is figuring out the best sequencing of these drugs to obtain a cumulative survival benefit.
An Italian multicenter study provided clinical outcome data relating to a large cohort of mCRPC men who received a third-line new drug after the failure of docetaxel and another of the new drugs(sequencing).
The trial was a retrospective review the clinical records of men who had received at least two successive new drugs after the failure of docetaxel.
The researchers assessed 260 men who received one third-line new drug between January 2012 and December 2013, including 38 who received a further new drug as a fourth-line therapy.
The researchers concluded that they were unable to demonstrate a difference in the clinical outcomes of third-line new drugs regardless of previous new drug therapy. Therefore, in this study it did not matter which sequence of treatments was superior after the failure of docetaxel.
Eur Urol. 2014 Oct 25. pii: S0302-2838(14)01022-7.
Joel T. Nowak, M.A., M.S.W.