(Prostate Cancer) Treatment Sequence of Xtandi and Zytiga?
Medical Supporter — إشعار معلوماتي
هذه المقالة ملخص لمعلومات طبية دولية وليست نصيحة طبية، ولا يمكن أن تحل محل تشخيص طبيبك المعالج أو خطة العلاج. المعلومات المعروضة مجمّعة من منشورات عامة وبيانات رسمية لكبرى المؤسسات الطبية اليابانية؛ وتختلف ملاءمة ونتائج أي علاج من مريض لآخر ويجب أن يقيّمها طبيب مؤهل لكل حالة على حدة.
On November 11, 2019, Daniel J. Khalaf published in the medical journal The Lancet the efficacy and safety results of sequentially using androgen receptor inhibitors Xtandi (enzalutamide) and Zytiga (abiraterone acetate) in patients with metastatic castration-resistant prostate cancer in a Phase II crossover clinical trial.
This Phase II crossover trial randomized patients with metastatic castration-resistant prostate cancer (N=202) into two groups based on treatment order. The primary endpoints were PSA progression-free interval and PSA response rate during second-line treatment.
Group A (Zytiga 1000 mg once daily + Prednisone 5 mg twice daily until PSA progression, then Xtandi 160 mg once daily; N=101)
Group B (Xtandi 160 mg once daily until PSA progression, then Zytiga 1000 mg once daily + Prednisone 5 mg twice daily; N=101)
The trial was initiated because both Xtandi and Zytiga are standard treatments for metastatic castration-resistant prostate cancer, but there has been no clear guidance on which drug to use first. Against this background, a trial was conducted to evaluate the optimal sequencing of androgen receptor inhibitor therapy.
Results: The primary endpoint — median PSA progression-free interval during second-line treatment — was: Group A 19.3 months vs. Group B 15.2 months. Group A showed a 34% reduction in PSA progression risk, with a hazard ratio of 0.66. Second-line PSA response rates were: Group A 36% (N=26) vs. Group B 4%.
Regarding safety, the incidence of Grade 3/4 adverse events observed in the majority of patients was: hypertension (Group A 27% / Group B 18%), fatigue (Group A 10% / Group B 4%). Serious adverse event rates were: Group A 15% / Group B 20%. No patients died from adverse events.
Based on the Phase II trial results, Daniel J. Khalaf concluded: For patients with metastatic castration-resistant prostate cancer, in terms of clinical benefit from sequencing androgen receptor inhibitors, starting with Zytiga before Xtandi may be preferable.
Source: Optimal sequencing of enzalutamide and abiraterone acetate plus prednisone in metastatic castration-resistant prostate cancer: a multicentre, randomised, open-label, phase 2, crossover trial (Lancet Oncol. 2019 Nov 11. pii: S1470-2045(19)30688-6.)
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هل تفكر في تلقّي العلاج في اليابان؟ هل تحتاج إلى معلومات ومساعدة؟
نساعدك في تنظيم المعلومات اللازمة للسفر الطبي إلى اليابان، والتواصل مع المؤسسات الطبية اليابانية، وترتيب استشارة رأي ثانٍ.الاستشارة الأولى مجانية؛ سيساعدك المستشار على توضيح الخطوات التالية.
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