Survival outcomes of enzalutamide and abiraterone acetate treatments in patients with castration-resistant metastatic prostate cancer

Objective: In this study, it was aimed to evaluate the overall survival (OS) and progression-free survival (PFS) outcomes, as well as the prognostic factors affecting these outcomes, in patients with metastatic castration-resistant prostate cancer (mCRPC) who received treatment with enzalutamide or abiraterone acetate. Materials and Methods: This retrospective study included 83 mCRPC patients treated with enzalutamide or abiraterone. Clinical, laboratory, and imaging data were analyzed. Relationships between OS and PFS and factors such as age, Gleason score, serum ALP and LDH levels, presence of bone and visceral metastases, lymph node involvement, PSMA PET SUVmax values, and treatment type were assessed. Statistical analyses included Kaplan-Meier estimates, the log-rank test, and Cox regression models. Results: High Gleason score, elevated ALP, and elevated LDH levels were identified as significant predictors of shorter OS. Visceral metastasis was the only factor significantly associated with PFS. There was no statistically significant difference in OS or PFS between patients treated with enzalutamide versus abiraterone. Conclusion: In this study, Gleason score, ALP, and LDH levels were identified as key prognostic indicators for OS, while visceral metastasis was predictive for PFS in mCRPC patients. Considering these parameters in clinical decision-making may provide therapeutic benefit. As this was a single-center retrospective study, further prospective studies with larger patient populations are warranted.