Enzalutamide Shows Efficacy in Prostate Cancer With Visceral Mets


“Patients with metastatic castration-resistant prostate cancer (mCRPC) and visceral metastases (liver and lung) fare better with the androgen receptor inhibitor enzalutamide than placebo, according to a new analysis from the phase III AFFIRM trial. There were differences in response based on which of those two sites had metastases, suggesting they should be considered differently for treatment.

” ‘Visceral metastases are identified in approximately 22% to 30% of patients with mCRPC and are associated with unfavorable outcomes,’ wrote study authors led by Yohann Loriot, MD, PhD, of Université Paris-Saclay in Villejuif, France.”

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ASCO: Visceral Spread Guts Prostate Ca Survival Odds

“Lung, liver, and other visceral metastases are associated with the poorest survival in advanced hormone-refractory prostate cancer, according to results from a meta-analysis that sets the benchmark for prognosis.

“Lung metastases were associated with 30% higher adjusted odds of death compared with bone metastases (median survival 17 versus 20 months, P<0.002), Susan Halabi, PhD, of Duke University, and colleagues found.

“Liver metastases were even worse, with 40% higher adjusted odds of death compared with lung metastases after adjustment for performance status, prostate specific antigen (PSA), and age (median 12 months, P<0.001), the group reported here at the American Society of Clinical Oncology meeting.”

Site of Visceral Metastases Can Dictate Prognosis in Prostate Cancer

“A pooled analysis of five phase III clinical trials suggests that the site of a metastatic castration-resistant prostate cancer (CRPC) patient’s metastases can predict overall survival following treatment with docetaxel. CRPC patients with liver metastases had the worst overall survival—a median of 12.1 months. Those patients with lung metastases fared slightly better with a median overall survival of 16.5 months. Patients with bone metastases, but no visceral metastases had relatively better outcomes—a median overall survival of 20.3 months.”