Abiraterone acetate plus prednisone and androgen-deprivation therapy (ADT) is associated with improved health-related quality of life compared with ADT plus placebo among patients with metastatic castration-naïve prostate cancer, according to research published in The Lancet Oncology (online January 8, 2018; doi:10.1016/S1470-2045(17)30911-7).
An abundance of research supports the effectiveness of ADT in prostate cancer. However, ADT is also associated with numerous health-related quality of life concerns and can lead to castration-resistant disease within 12 months of treatment initiation.
Kim N Chi, MD, clinical trials unit, BC Cancer – Vancouver Center (Canada), and colleagues conducted an analysis of the phase III trial (LATITUDE) to determine the effects of ADT plus abiraterone acetate and prednisone versus ADT plus placebo on patient-reported outcomes and health-related quality of life of enrollees in the trial. The LATITUDE trial has previously demonstrated improved overall survival in patients with newly diagnosed, high-risk, metastatic castration-naïve prostate cancer receiving ADT plus abiraterone acetate and prednisone.
A total of 1199 patients randomly assigned to either treatment arm completed the Brief Pain Inventory – Short Form (BPI-SF), Brief Fatigue Inventory, Functional Assessment of Cancer Therapy Prostate scale, and the EuroQol questionnaires by electronic device at pre-defined time points.
After a median follow-up of 30.9 months, researchers reported the median time to worst pain intensity progression by BPI-SF and median time to worst fatigue intensity were not reached in either treatment arm. However, researchers acknowledged that patients in the 25th percentile of the experimental arm demonstrated a longer median time to worst pain intensity progression (11.07 months) and to worst fatigue intensity (18.40 months) compared with those in the 25th percentile of the control arm (5.62 months and 6.50 months, respectively).
Similarly, the median time to deterioration of functional status was significantly longer in the experimental arm than in the control arm ( 12.9 vs 8.3 months, respectively; HR, 0.85; 95% CI, 0.74-0.99; P = .032).
“The addition of abiraterone acetate plus prednisone to ADT in patients with newly diagnosed, high-risk metastatic castration-naive prostate cancer improved overall patient-reported outcomes by consistently showing a clinical benefit in the progression of pain, prostate cancer symptoms, fatigue, functional decline, and overall health-related quality of life,” Dr Chi and colleagues wrote. ADT plus abiraterone acetate and prednisone should be considered a new standard-of-care option for patients in this population, they added.—Zachary Bessette