• World journal of urology · May 2016

    Review

    What do we know about treatment sequencing of abiraterone, enzalutamide, and chemotherapy in metastatic castration-resistant prostate cancer?

    • Souhil Lebdai, Victor Basset, Julien Branchereau, Alexandre de La Taille, Vincent Flamand, Thierry Lebret, Thibaut Murez, Yann Neuzillet, Guillaume Ploussard, and François Audenet.
    • Department of Urology, University Hospital of Angers, 4, rue Larrey, 49933, Angers, France. souhil.lebdai@gmail.com.
    • World J Urol. 2016 May 1; 34 (5): 617-24.

    PurposeTo present a systematic review of the different therapeutic sequences in metastatic castration-resistant prostate cancer (mCRPC).MethodsEvidence acquisition on therapeutic sequences in mCRPC was performed by a MEDLINE search using combination of the following key words: "prostate cancer," "metastatic," "castration resistant," "enzalutamide," "abiraterone," "treatment sequencing," "cabazitaxel," "docetaxel." A total of 17 studies were included for analysis.ResultsDifferent sequences have been reported for the treatment of mCRPC: docetaxel after abiraterone, cabazitaxel after docetaxel and abiraterone, abiraterone after cabazitaxel and docetaxel, abiraterone after docetaxel and enzalutamide, and enzalutamide after docetaxel and abiraterone. There are arguments from the preclinical observations suggesting a cross-resistance between docetaxel and abiraterone, and between abiraterone and enzalutamide in mCRPC. Despite limitations, several retrospective clinical reports support these data.ConclusionNo study of high level of evidence is available to support any recommendation on sequential treatment for mCRPC. There are only clues that prospective clinical studies need to confirm.

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