• Sebastian Christoph Schmid, Alexander Geith, Alena Böker, Robert Tauber, Anna Katharina Seitz, Markus Kuczyk, Christoph von Klot, Jürgen Erich Gschwend, Axel Stuart Merseburger, and Margitta Retz.
• Department of Urology, Technische Universität München, Rechts der Isar Medical Center, Ismaninger Str. 22, 81675, Munich, Germany, sebastian.schmid@lrz.tum.de.
• Adv Ther. 2014 Feb 1; 31 (2): 234-41.

IntroductionEnzalutamide is a novel antiandrogen which is approved for the treatment of metastatic, castration-resistant prostate cancer (mCRPC) after taxane-based chemotherapy. The efficacy of enzalutamide after the sequence docetaxel and abiraterone is not proven.MethodsThirty-five mCRPC patients in the German compassionate use program, who received enzalutamide after progression with taxane-based chemotherapy and abiraterone were prospectively evaluated. The endpoints of the study were overall survival, radiologic progression-free survival and safety.ResultsThe median treatment duration on enzalutamide was 2.8 months. The median overall survival was 7.5 months [95% confidence interval (CI) 4.7-10.3] while median progression-free survival assessed by imaging was 3.1 months (95% CI 1.4-4.8). The most common toxicities of all grades were anemia and weight loss.ConclusionAlthough the results are limited by a small patient number, the consecutive use of enzalutamide and abiraterone after taxane-based chemotherapy shows a modest clinical activity. Thus, sequence therapy alternating between chemotherapy and antihormonal drugs might be a more promising approach in mCRPC treatment.

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