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Initial dose reduction of enzalutamide does not decrease the incidence of adverse events in castration-resistant prostate cancer

Author

Listed:
  • Shunsuke Tsuzuki
  • Shotaro Nakanishi
  • Mitsuyoshi Tamaki
  • Takuma Oshiro
  • Jun Miki
  • Hiroki Yamada
  • Tatsuya Shimomura
  • Takahiro Kimura
  • Nozomu Furuta
  • Seiichi Saito
  • Shin Egawa

Abstract

Background: There was no clear evidence whether the initial dose of enzalutamide affects the incidence of adverse events (AEs), and oncological outcome in patients with castration-resistant prostate cancer (CRPC). Methods: The clinical charts of 233 patients with CRPC treated with enzalutamide were reviewed retrospectively. After 1:3 propensity score matching (PSM), 124 patients were divided into a reduced dose group and a standard dose group, and the prostate specific antigen (PSA) response and the incidence of AEs were compared. Results: 190 patients with CRPC initiated with standard dose enzalutamide were younger and better performance status compared with 43 patients beginning with reduced dose. After PSM, the baseline characteristics were not different between the standard and the reduced dose group. In the PSM cohort, the PSA response rate was significantly lower in the reduced dose group than in the standard dose group (-66.3% and -87.4%, p = 0.02). The incidence rates of AEs were not statistically different between the groups (22.6% and 34.4%, respectively, p = 0.24). Conclusion: Initiating treatment with a reduced dose of enzalutamide did not significantly decrease the incidence rate of AEs, and it showed poorer PSA response rate. There is no clear rationale for treating with a reduced initial dose of enzalutamide to reduce the incidence of AEs.

Suggested Citation

  • Shunsuke Tsuzuki & Shotaro Nakanishi & Mitsuyoshi Tamaki & Takuma Oshiro & Jun Miki & Hiroki Yamada & Tatsuya Shimomura & Takahiro Kimura & Nozomu Furuta & Seiichi Saito & Shin Egawa, 2021. "Initial dose reduction of enzalutamide does not decrease the incidence of adverse events in castration-resistant prostate cancer," PLOS ONE, Public Library of Science, vol. 16(10), pages 1-10, October.
    • Handle: RePEc:plo:pone00:0258160
    DOI: 10.1371/journal.pone.0258160
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    References listed on IDEAS

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    1. Arianna Calcinotto & Clarissa Spataro & Elena Zagato & Diletta Di Mitri & Veronica Gil & Mateus Crespo & Gaston De Bernardis & Marco Losa & Michela Mirenda & Emiliano Pasquini & Andrea Rinaldi & Semin, 2018. "IL-23 secreted by myeloid cells drives castration-resistant prostate cancer," Nature, Nature, vol. 559(7714), pages 363-369, July.
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