Efficacy and safety of enzalutamide (ENZ) vs placebo (PL) in chemotherapy- naïve patients (pts) with progressive metastatic castration-resistant prostate cancer (mCRPC): Taiwan subgroup analysis of an Asian multiregional study
Hsi-Chin Wu,1,* Shu-Pin Huang,2,* Yen-Hwa Chang,3 Yen-Chuan Ou,4 See-Tong Pang,5 Yuh- Shyan Tsai,6 Kun-Hung Shen,7 Tai-Lung Cha,8 Yeong-Shiau Pu9,†
 
*Co-lead author; †Corresponding author
 
1China Medical University Hospital, Taichung, Taiwan; 2Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; 3Taipei Veterans General Hospital, Taipei, Taiwan; 4Taichung Veterans General Hospital, Taichung, Taiwan; 5Chang-Gung Memorial Hospital, Linkou, Taiwan; 6National Cheng Kung University Hospital, Tainan, Taiwan; 7Chi Mei Medical Center, Tainan, Taiwan; 8Tri-Service General Hospital, Taipei, Taiwan; 9National Taiwan University Hospital, Taipei, Taiwan
 
Purpose: ENZ significantly improved time to prostate-specific antigen (PSA) progression (TTPP) vs PL in chemotherapy-naïve pts with progressive mCRPC in an Asian multiregional study (NCT02294461). This subgroup analysis assessed whether the effect of ENZ vs PL on the efficacy and safety observed in the entire pt population was consistent in Taiwanese (TW) pts.
 
Materials and methods: Pts with asymptomatic/mildly symptomatic progressive mCRPC were randomized 1:1 to ENZ (160 mg/day) or PL. The primary endpoint was TTPP (time from randomization to PSA progression). Secondary endpoints included overall survival (OS; time from randomization to death) and radiographic progression-free survival (rPFS; time from randomization to radiographic progression or death). Safety assessments included recording adverse events (AEs). Subgroup analyses were performed at the pre-specified interim analysis to determine whether treatment effect was consistent among regions.
 
Results: Of the 409 randomized pts from China, Korea, Taiwan, and Hong Kong (ENZ 209; PL 200), 84 were from Taiwan (ENZ 42; PL 42). Baseline characteristics were generally balanced among treatment groups, except median baseline PSA (ENZ 25.3 µg/L [range 3.0–461.2]; PL 59.8 µg/L [range 2.4–1383.0]). Median TTPP was 10.2 months for ENZ vs 2.9 for PL (HR 0.44; 95% CI 0.24, 0.82; p=0.0059). Due to the small number of deaths (ENZ 2; PL 6), median OS was not yet reached (NYR) in either treatment group (HR 0.25; 95% CI 0.05, 1.22; p=0.0633). Median rPFS was NYR for ENZ and was 11.3 months for PL (HR 0.29; 95% CI 0.12, 0.71; p=0.0040). Median time on treatment was 7.9 months for ENZ and 4.1 months for PL. Although slightly more ENZ than PL pts reported ≥1 AE (83.3% vs 78.6%), fewer ENZ than PL pts reported ≥1 serious AE (19.0% vs 35.7%), AEs ≥ grade 3 (28.6% vs 40.5%), and AEs leading to treatment discontinuation (14.3% vs 19.0%). No seizures or convulsions were reported in either group.
 
Conclusion: The results of this subgroup analysis demonstrate that the effect of ENZ vs PL on the efficacy and safety of TW pts was consistent with that observed in the entire pt population.
 
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    TUA秘書處
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    台灣泌尿科醫學會
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    2017-06-01 20:06:23
    最近修訂
    2017-06-08 21:28:15
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