How do you sequence abiraterone and enzalutamide in metastatic, castrate-resistant prostate cancer?
What determines which you select first? How do concerns about cross-resistance factor in after progression on one of these agents?
Answer from: Medical Oncologist at Academic Institution
In my experience, abiraterone is better tolerated than enzalutamide. The main difference is fatigue. Quality of life seems no different to most of my patients when I add abiraterone to a GnRH agonist. However, patients frequently complain of substantially increased fatigue with the addition of enzal...
Answer from: Medical Oncologist at Academic Institution
Both abiraterone and enzalutamide appear equally effective in delaying progression and improving survival in chemo-naive men. The choice of front line therapy therefore becomes more related to side effects, cost, and tolerability long term, as many of these men will take abi or enza for severa...
Answer from: Medical Oncologist at Academic Institution
There have been biomarker studies suggesting that it is possible to identify men who are better suited for abiraterone therapy. Charles Ryan has shown that DHEA concentration is informative as low levels suggest a lack of androgen biosynthesis drive and more strongly justify direct inhibition ...