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Chen MK, Liang ZJ, Luo DS, Xue KY, Liao DY, Li Z, Yu Y, Chen ZS, Zhao SC. Abiraterone, Orteronel, Enzalutamide and Docetaxel: Sequential or Combined Therapy? Front Pharmacol 2022; 13:843110. [PMID: 35250590 PMCID: PMC8891580 DOI: 10.3389/fphar.2022.843110] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 01/12/2022] [Indexed: 12/19/2022] Open
Abstract
Objective: To summarize the current therapeutic status using chemotherapeutic agent docetaxel and endocrine therapeutic agents (ARAT, abiraterone, orteronel or enzalutamide) for the treatment of metastatic castration-resistant prostate cancer (mCRPC), including sequential therapy and combined therapy, to promote the consensus on the optimal regimen for achieving superior treatment efficacy.Methods: Through literature search in PubMed, articles with the following relevant keywords were collected and anlyzed: CRPC, abiraterone, orteronel and enzalutamide, median survival, overall survival, prostate specific antigen (PSA), PSA response rate and median radiologic progression-free survival.Results: Fifty-eight articles were obtained and analyzed in this review. These articles included androgen axis-targeting agents after docetaxel, docetaxel after androgen axis-targeting agents, Triple sequential and combination therapy, covering four current drugs for mCRPC treatment: docetaxel, abiraterone, orteronel, and enzalutamide. It was found that there may be some cross-resistance between androgen axis-targeting agents, which will reduce the efficacy of subsequent drug treatment. Although neither of the studies of using combination therapy showed serious drug toxicity, the efficacy of sequential therapy was not as good as expected. Most adverse reactions after treatment were reported to be level 1–2.Conclusion: Based on the results of the current studies, abiraterone followed by enzalutamide treatment is the best sequential treatment for most docetaxel-naïve patients. This treatment achieves not only good OS, but also PFS and PSA response rates. In addition, for patients who have previously failed docetaxel treatment, enzalutamide is the best choice as the subsequent treatment.
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Affiliation(s)
- Ming-kun Chen
- Department of Urology, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
- Department of Urology, The Third Clinical College of Southern Medical University, Guangzhou, China
| | - Zhi-jian Liang
- Department of Urology, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
- Department of Urology, The Third Clinical College of Southern Medical University, Guangzhou, China
| | - Dao-Sheng Luo
- Dongguan Hospital, Southern Medical University, Dongguan, China
| | - Kang-yi Xue
- Department of Urology, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
- Department of Urology, The Third Clinical College of Southern Medical University, Guangzhou, China
| | - De-ying Liao
- Department of Urology, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
- Department of Urology, The Third Clinical College of Southern Medical University, Guangzhou, China
| | - Zheshen Li
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John’s University, Queens, NY, United States
| | - Yuzhong Yu
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhe-Sheng Chen
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John’s University, Queens, NY, United States
- *Correspondence: Zhe-Sheng Chen, ; Shan-Chao Zhao,
| | - Shan-Chao Zhao
- Department of Urology, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
- Department of Urology, The Third Clinical College of Southern Medical University, Guangzhou, China
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Zhe-Sheng Chen, ; Shan-Chao Zhao,
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Naito Y, Kato M, Kawanishi H, Yuguchi Y, Yuba T, Ishikawa T, Hattori K, Yamamoto A, Sano T, Matsukawa Y, Kimura T, Nishikimi T, Hattori R, Tsuzuki T, Gotoh M. The clinical benefit of sequential therapy with androgen receptor axis-targeted agents alone in patients with castration-resistant prostate cancer: A propensity score-matched comparison study. Prostate 2020; 80:1373-1380. [PMID: 32914895 DOI: 10.1002/pros.24069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 08/31/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND The optimal sequential therapy for castration-resistant prostate cancer (CRPC) remains unknown. In recent years, some doubts have emerged regarding the clinical benefit of sequential therapy with androgen receptor axis-targeted agents (ART) such as abiraterone (ABI) or enzalutamide (ENZ) for patients with CRPC. We compared the effect of ART-to-ART (AA) sequential therapy after castration resistance with that of docetaxel (DTX)-combined sequential therapy (ART to DTX or DTX to ART) in patients with CRPC. METHODS We retrospectively identified and analyzed the data of 315 patients with CRPC treated in our seven affiliated institutions between 2009 and 2019. All patients received either DTX or ART (ABI or ENZ) as the first- or second-line therapy after castration resistance. We compared the overall survival (OS) and the second progression-free survival (PFS2), calculated from the initiation of first-line therapy after castration resistance, between the AA sequence group and the DTX-combined sequence group. PFS2 was defined as the period from the start of first-line treatment after castration resistance to progression on second-line treatment. To minimize selection bias from possible confounders, we performed propensity score matching using one-to-one nearest neighbor matching without replacement. RESULTS Overall, 106 and 209 patients were administered the AA sequential therapy and DTX-combined sequential therapy, respectively. The clinicopathological variables of patients were well balanced after propensity score matching, and there were no significant differences between the two groups. In the propensity score-matched cohort, OS was not significantly different between the two groups (median, 37.9 vs. 45.4 months; hazard ratio [HR], 1.10; 95% confidence interval [CI], 0.68-1.79; p = .701), while PFS2 was significantly shorter in the AA group than in the DTX-combined group (median, 12.9 vs. 21.6 months; HR, 1.70; 95% CI, 1.16-2.48; p = .007). CONCLUSIONS Certain patients with CRPC can benefit from ART-to-ART sequential therapy in a daily clinical setting.
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Affiliation(s)
- Yushi Naito
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masashi Kato
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hideji Kawanishi
- Department of Urology, Aichi Medical University Hospital, Nagakute, Japan
| | - Yuri Yuguchi
- Department of Urology, Chukyo Hospital, Nagoya, Japan
| | - Takuma Yuba
- Department of Urology, Kariya Toyota General Hospital, Kariya, Japan
| | | | | | - Akiyuki Yamamoto
- Department of Urology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Tomoyasu Sano
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshihisa Matsukawa
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toru Kimura
- Department of Urology, Chukyo Hospital, Nagoya, Japan
| | - Toshinori Nishikimi
- Department of Urology, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan
| | - Ryohei Hattori
- Department of Urology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan
| | - Toyonori Tsuzuki
- Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Japan
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Chung DY, Kang DH, Kim JW, Kim DK, Lee JY, Hong CH, Cho KS. Comparison of Oncologic Outcomes Between Two Alternative Sequences with Abiraterone Acetate and Enzalutamide in Patients with Metastatic Castration-Resistant Prostate Cancer: A Systematic Review and Meta-Analysis. Cancers (Basel) 2019; 12:cancers12010008. [PMID: 31861415 PMCID: PMC7017207 DOI: 10.3390/cancers12010008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 12/15/2019] [Indexed: 01/03/2023] Open
Abstract
Sequential treatment of androgen receptor axis targeted agents (ARAT), abiraterone acetate (ABI) and enzalutamide (ENZA), in metastatic castration-resistant prostate cancer (mCRPC) demonstrated some positive effects, but cross-resistances between ABI and ENZA that reduce activity have been suggested. Therefore, we conducted a meta-analysis to compare oncologic outcomes between the treatment sequences of ABI-ENZA and ENZA-ABI in patients with mCRPC. The primary endpoint was a combined progression-free survival (PFS), and the secondary endpoint was overall survival (OS). A total of five trials on 553 patients were included in this study. Each of the included studies was retrospective. In two studies including both chemo-naïve and post-chemotherapy mCRPC patients, for ABI-ENZA compared with ENZA-ABI, pooled hazard ratios (HRs) for PFS and OS were 0.37 (p < 0.0001; 95% confidence intervals (CIs), 0.23–0.60) and 0.64 (p = 0.10; 95% CIs, 0.37–1.10), respectively. In three studies with chemo-naïve mCRPC patients only, for ABI-ENZA compared with ENZA-ABI, pooled HRs for PFS and OS were 0.57 (p = 0.02; 95% CIs, 0.35–0.92) and 0.86 (p = 0.39; 95% CIs, 0.61–1.21), respectively. The current meta-analysis revealed that ABI-ENZA had a significantly more favorable oncological outcome, but the level of evidence was low. Therefore, large-scale randomized trials may be needed.
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Affiliation(s)
- Doo Yong Chung
- Department of Urology, Inha University School of Medicine, Incheon 22212, Korea; (D.Y.C.); (D.H.K.)
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Dong Hyuk Kang
- Department of Urology, Inha University School of Medicine, Incheon 22212, Korea; (D.Y.C.); (D.H.K.)
| | - Jong Won Kim
- Department of Urology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea; (J.W.K.); (C.H.H.)
| | - Do Kyung Kim
- Department of Urology, Soonchunhyang University Medical College, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea;
| | - Joo Yong Lee
- Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea;
| | - Chang Hee Hong
- Department of Urology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea; (J.W.K.); (C.H.H.)
| | - Kang Su Cho
- Department of Urology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea; (J.W.K.); (C.H.H.)
- Correspondence: ; Tel.: +82-2-2019-3471
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Koo KC, Lee JS, Ha JS, Han KS, Lee KS, Hah YS, Rha KH, Hong SJ, Chung BH. Optimal sequencing strategy using docetaxel and androgen receptor axis-targeted agents in patients with castration-resistant prostate cancer: utilization of neutrophil-to-lymphocyte ratio. World J Urol 2019; 37:2375-2384. [DOI: 10.1007/s00345-019-02658-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 01/29/2019] [Indexed: 01/04/2023] Open
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Guan W, Hu J, Yang L, Tan P, Tang Z, West BL, Bollag G, Xu H, Wu L. Inhibition of TAMs improves the response to docetaxel in castration-resistant prostate cancer. Endocr Relat Cancer 2019; 26:131-140. [PMID: 30400004 PMCID: PMC6226051 DOI: 10.1530/erc-18-0284] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 09/11/2018] [Indexed: 02/05/2023]
Abstract
For men with castration-resistant prostate cancer (CRPC), androgen-deprivation therapy (ADT) often becomes ineffective requiring the addition of docetaxel, a proven effective chemotherapy option. Tumor-associated macrophages (TAMs) are known to provide protumorigenic influences that contribute to treatment failure. In this study, we examined the contribution of TAMs to docetaxel treatment. An increased infiltration of macrophages in CRPC tumors was observed after treatment with docetaxel. Prostate cancer cells treated with docetaxel released more macrophage colony-stimulating factor (M-CSF-1 or CSF-1), IL-10 and other factors, which can recruit and modulate circulating monocytes to promote their protumorigenic functions. Inhibition of CSF-1 receptor kinase signaling with a small molecule antagonist (PLX3397) in CRPC models significantly reduces the infiltration of TAMs and their influences. As such, the addition of PLX3397 to docetaxel treatment resulted in a more durable tumor growth suppression than docetaxel alone. This study reveals a rational strategy to abrogate the influences of TAMs and extend the treatment response to docetaxel in CRPC.
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Affiliation(s)
- Wei Guan
- Department of Urology and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Junhui Hu
- Department of Urology and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Department of Paediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California at Los Angeles CA 90095
| | - Lu Yang
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Ping Tan
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Zhuang Tang
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | | | | | - Hua Xu
- Department of Urology and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Lily Wu
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California at Los Angeles CA 90095
- Department of Urology, David Geffen School of Medicine at UCLA, University of California at Los Angeles CA 90095
- Department of Pediatrics, David Geffen School of Medicine at UCLA, University of California at Los Angeles CA 90095
- Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, University of California at Los Angeles CA 90095
- Molecular Biology Institute, University of California at Los Angeles CA 90095
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Deshayes E, Roumiguie M, Thibault C, Beuzeboc P, Cachin F, Hennequin C, Huglo D, Rozet F, Kassab-Chahmi D, Rebillard X, Houédé N. Radium 223 dichloride for prostate cancer treatment. DRUG DESIGN DEVELOPMENT AND THERAPY 2017; 11:2643-2651. [PMID: 28919714 PMCID: PMC5593411 DOI: 10.2147/dddt.s122417] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Prostate cancer is the most common malignant disease in men. Several therapeutic agents have been approved during the last 10 years. Among them, radium-223 dichloride (Xofigo®) is a radioactive isotope that induces irreversible DNA double-strand breaks and consequently tumor cell death. Radium-223 dichloride is a calcium-mimetic agent that specifically targets bone lesions. Radium-223 dichloride has been approved for the treatment of metastatic castration-resistant prostate cancer with symptomatic bone metastases, without known visceral metastases. In this review, first we summarize the interplay between prostate tumor cells and bone microenvironment; then, we discuss radium-223 dichloride mechanism of action and present the results of the available clinical trials and future developments for this new drug.
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Affiliation(s)
- Emmanuel Deshayes
- Radiobiology Unit, INSERM U1194, Institut du Cancer de Montpellier (ICM).,Department of Nuclear Medicine, Institut du Cancer de Montpellier (ICM), Montpellier
| | - Mathieu Roumiguie
- Urology Department, Andrology and Renal Transplantation, CHU Rangueil, Toulouse
| | | | | | | | | | | | | | | | | | - Nadine Houédé
- Radiobiology Unit, INSERM U1194, Institut du Cancer de Montpellier (ICM).,Medical Oncology Department, Institut de Cancérologie du Gard - CHU Caremeau, Nîmes, France
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Inhibition of the PI3K/AKT/mTOR pathway activates autophagy and compensatory Ras/Raf/MEK/ERK signalling in prostate cancer. Oncotarget 2017; 8:56698-56713. [PMID: 28915623 PMCID: PMC5593594 DOI: 10.18632/oncotarget.18082] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 04/24/2017] [Indexed: 12/19/2022] Open
Abstract
The PI3K/AKT/mTOR pathway is frequently activated in advanced prostate cancer, due to loss of the tumour suppressor PTEN, and is an important axis for drug development. We have assessed the molecular and functional consequences of pathway blockade by inhibiting AKT and mTOR kinases either in combination or as individual drug treatments. In established prostate cancer cell lines, a decrease in cell viability and in phospho-biomarker expression was observed. Although apoptosis was not induced, a G1 growth arrest was observed in PTEN null LNCaP cells, but not in BPH1 or PC3 cells. In contrast, when the AKT inhibitor AZD7328 was applied to patient-derived prostate cultures that retained expression of PTEN, activation of a compensatory Ras/MEK/ERK pathway was observed. Moreover, whilst autophagy was induced following treatment with AZD7328, cell viability was less affected in the patient-derived cultures than in cell lines. Surprisingly, treatment with a combination of both AZD7328 and two separate MEK1/2 inhibitors further enhanced phosphorylation of ERK1/2 in primary prostate cultures. However, it also induced irreversible growth arrest and senescence. Ex vivo treatment of a patient-derived xenograft (PDX) of prostate cancer with a combination of AZD7328 and the mTOR inhibitor KU-0063794, significantly reduced tumour frequency upon re-engraftment of tumour cells. The results demonstrate that single agent targeting of the PI3K/AKT/mTOR pathway triggers activation of the Ras/MEK/ERK compensatory pathway in near-patient samples. Therefore, blockade of one pathway is insufficient to treat prostate cancer in man.
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