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Tsaur, Igor; Heidegger, Isabel; Bektic, Jasmin; Kafka, Mona; Bergh, Roderick C. N. van den; Hunting, Jarmo C. B.; Thomas, Anita; Brandt, Maximilian P.; Hoefner, Thomas; Debedde, Eliott; Thibault, Constance; Ermacora, Paola; Zattoni, Fabio; Foti, Silvia; Kretschmer, Alexander; Ploussard, Guillaume; Rodler, Severin; Amsberg, Gunhild von; Tilki, Derya; Surcel, Christian; Rosenzweig, Barak; Gadot, Moran; Gandaglia, Giorgio and Dotzauer, Robert (2021): A real-world comparison of docetaxel versus abiraterone acetate for metastatic hormone-sensitive prostate cancer. In: Cancer Medicine, Vol. 10, No. 18: pp. 6354-6364

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Abstract

Background Docetaxel (D) or secondary hormonal therapy (SHT) each combined with androgen deprivation therapy (ADT) represent possible treatment options in males with metastasized hormone-sensitive prostate cancer (mHSPC). Real-world data comparing different protocols are lacking yet. Though, our objective was to compare the efficacy and safety of abiraterone acetate (AA)+ADT versus D+ADT in mHSPC. Methods In a retrospective multicenter analysis including males with mHSPC treated with either of the aforementioned protocols, overall survival (OS), progression-free survival 1 (PFS1), and progression-free survival 2 (PFS2) were assessed for both cohorts. Median time to event was tested by Kaplan-Meier method and log-rank test. The Cox-proportional hazards model was used for univariate and multivariate regression analyses. Results Overall, 196 patients were included. The AA+ADT cohort had a longer PFS1 in the log-rank testing (23 vs. 13 mos., p < 0.001), a longer PFS2 (48 vs. 33 mos., p = 0.006), and longer OS (80 vs. 61 mos., p = 0.040). In the multivariate analyses AA+ADT outperformed D+ADT in terms of PFS1 (HR = 0.34, 95% CI = 0.183-0.623;p = 0.001) and PFS2 (HR = 0.33 95% CI = 0.128-0.827;p = 0.018), respectively, while OS and toxicity rate were similar between both groups. Conclusions AA+ADT is mainly associated with a similar efficacy and overall toxicity rate as D+ADT. Further prospective research is required for validation of the clinical value of the observed benefit of AA+ADT for progression-free end-points.

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