CRPC: enzalutamide maintains HRQoL in PROSPER

  • Tombal B & et al
  • Lancet Oncol
  • 12 Feb 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • In patients with nonmetastatic, castration-resistant prostate cancer (CRPC), enzalutamide maintains low baseline pain and health-related QoL (HRQoL) scores.
  • Enzalutamide delays pain progression, worsening of urinary and bowel symptoms.

Why this matters

  • Enzalutamide prolonged metastasis-free survival in PROSPER study.

Study design

  • Patient-reported outcomes from PROSPER study.
  • 1401 men with nonmetastatic CRPC, PSA doubling time ≤10 months received androgen deprivation therapy with either enzalutamide or placebo.
  • Funding: Astellas Pharma, Inc.

Key results

  • Median follow-up: enzalutamide group, 18.5 months; placebo group, 15.1 months.
  • Brief Pain Inventory Short Form:
    • Mean scores remained stable and similar at all timepoints.
    • Time to pain progression was longer with enzalutamide (P=.028).
  • European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire:
    • Mean symptom scores remained stable and similar except at weeks 65 and 81, where urinary symptom score was significantly better with enzalutamide (P=.028 and .0251, respectively).
  • Functional Assessment of Cancer Therapy-Prostate:
    • Mean scores were similar (P=.184).
  • EuroQoL 5-Dimensions 5-Levels health questionnaire visual analogue scale:
    • Mean scores remained stable and similar between groups except at weeks 65 and 81 (P=.024 and .022, respectively, favoring enzalutamide).
    • Time to worsening of urinary and bowel symptoms was significantly longer with enzalutamide.

Limitations

  • Lack of data after treatment discontinuation.

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