[Cabazitaxel, abiraterone and enzalutamide in metastatic castration-resistant prostate cancer not responding to docetaxel]

Oubiña M, García Martí S, Pichon-Riviere A, Augustovski F, Alcaraz A, Bardach A, Ciapponi A, López A, Rey-Ares L
Record ID 32015001165
Authors' objectives: To assess the available evidence on the efficacy, safety and coverage policy related aspects on the use of cabazitaxel, enzalutamide and abiraterone in metastatic castration-resistant prostate cancer not responding to docetaxel. Prostate cancer is the most commonly diagnosed non-cutaneous malignant neoplasm in males. At early stages, management includes surgery and radiotherapy, but if the disease is locally advanced or there are metastases, patients are treated with antiandrogen therapy. If there is progression after receiving treatment, it is known as metastatic castration-resistant prostate cancer (MCRPC). Docetaxel is the standard therapy for MCRPC. For those patients who have presented progression after receiving docetaxel, drugs like cabazitaxel, abiraterone and enzalutamide have been developed as well as a technique based on leukapheresis called T-sipuleucel and a radiopharmaceutical called radium-223. In this document, only antiandrogen or chemotherapy drugs will be assessed. The use of cabazitaxel, abiraterone and enzalutamide is proposed for the treatment of MCRPC, which progresses after receiving docetaxel, since it might increase overall survival. Cabazitaxel is an antineoplastic drug from the taxane class. It is intravenously administered in six cycles. Abiraterone is an orally administered androgen inhibitor. Enzalutamide is an androgen receptor signal inhibitor which reduces the prostatic neoplastic cell proliferation and is orally administered.
Authors' recommendations: The evidence found is of high quality. Treatment with cabazitaxel, enzalutamide or abiraterone in patients with metastatic castration-resistant prostate cancer whose disease progressed after receiving docetaxel showed an increase in survival of approximately three to five months. The health technology assessments and the clinical practice guidelines consulted recommend the use of the three drugs alike and the American health sponsors cover them in the reference population.
Project Status: Completed
Year Published: 2015
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Argentina
MeSH Terms
  • Androgen Receptor Antagonists
  • Androstenols
  • Male
  • Prostatic Neoplasms, Castration-Resistant
  • Taxoids
Organisation Name: Institute for Clinical Effectiveness and Health Policy
Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name: info@iecs.org.ar
Contact Email: info@iecs.org.ar
Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.