Treatment of metastatic castration-resistant prostate cancer in thefirst-line setting with docetaxel, enzalutamide, and abiraterone: Real-world data

Ozay, G. Treatment of Metastatic Castration-Resistant Prostate Cancer in the First-Line Setting with Docetaxel, Enzalutamide, and Abiraterone: Real-World Data. Eskisehir Osmangazi University Faculty of Medicine, Department of Internal Medicine, Eskisehir, 2025. Prostate cancer ranks among the most common malignancies in men worldwide. The aim of our study is to investigate treatment efficacy and adverse effects, and to obtain real-world data from patients receiving docetaxel, enzalutamide, or abiraterone as first-line therapy for metastatic castration-resistant prostate cancer (mCRPC). A total of 135 patients who presented to the ESOGÜ Faculty of Medicine Medical Oncology outpatient clinic between January 2010 and 2023 and who received docetaxel, enzalutamide, or abiraterone as first-line treatment for mCRPC were included in the study.By reviewing pathology reports and imaging results of patients meeting the study criteria, the following parameters were evaluated: age, performance score, Gleason score, history of prostatectomy or orchiectomy, neural invasion (NI), presence of metastasis, accompanying chronic diseases, hematologic and non-hematologic adverse effects following docetaxel, enzalutamide, and abiraterone therapy, progression-free and overall survival times, and mortality status.Among the 135 patients included in the study, 74 (54.8%) received docetaxel, 30 (22.2%) received enzalutamide, and 31 (23.0%) received abiraterone as first-line therapy. In first-line treatment, progression-free survival (PS) was 15.718±1.783 months for docetaxel, 20.285±2.687 months for enzalutamide, and 18.774±2.769 months for abiraterone (p=0.290). Overall survival (OS) was 27.666±3.190 months for docetaxel, 34.339±8.048 months for enzalutamide, and 20.797±2.933 months for abiraterone (p=0.546). Hematologic and non-hematologic adverse effects were observed in all patients. In univariate analysis, absence of visceral metastasis (p=0.044), absence of liver metastasis (p=0.025), having fewer metastatic sites (p=0.043), and achieving a PSA response (p=0.002) were statistically associated with longer PS. Higher Gleason score was significantly associated with both PS (p=0.007) and OS (p=0.047). Achieving a PSA response was also significantly associated with both PS (p=0.002) and OS (p=0.000).