Efficacy and safety of enzalutamide, abiraterone and cabazitaxel in post-docetaxel treatment of castration-resistant prostate cancer: meta-analysis data

Background. Castration-resistant prostate cancer (CRPC) is wide-spread severe disease in many regions of the world. Enzalutamide, abiraterone and cabazitaxel have been recently registered for the treatment of this condition.

Objective: to perform indirect comparison of enzalutamide, abiraterone and cabazitaxel efficacy and safety in 2nd line “post-docetaxel” treatment of CRPC according to published clinical data.

Materials and methods. Indirect comparison was undertaken to extract efficacy and safety parameters of enzalutamide, abiraterone and cabazitaxel from integrated registration pivotal trials and independent retrospective studies. 13 articles were selected: enzalutamide – 2, abiraterone – 7, cabazitaxel – 3 and orteronel 1 article.

Results. Enzalutamide had highest chances of prostatic specific antigen response (50 % and more decline from baseline) and highest chances of Response Evaluation Criteria In Solid Tumors (RECIST) soft-tissue objective response. Chances of enzalutamide and abiraterone adverse effects did not have serious difference from control groups in pivotal trials. Cabazitaxel increased adverse effects chances, mostly hematological adverse effects.

Conclusion. Treatment with enzalutamide of CRPC in 2nd line “post-docetaxel” provided best parameters of prostatic specific antigen response. Enzalutamide is safer than cabazitaxel and does not have several adverse events typical for abiraterone.

enzalutamide, abiraterone, cabazitaxel, castration-resistant prostate cancer, indirect comparisson, meta-analysis, overall survival

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