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2019 ASCO Annual Meeting!

Session: Genitourinary (Prostate) Cancer

Type: Poster Session

Time: Saturday June 1, 1:15 PM to 4:15 PM

Location: Hall A

Concurrent or layered treatment with radium-223 (Ra-223) and enzalutamide (Enza) or abiraterone plus prednisone/prednisolone (Abi/pred): A retrospective study of real-world clinical outcomes in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC).

Advanced Disease

Genitourinary (Prostate) Cancer

2019 ASCO Annual Meeting

Abstract No:

Poster Board Number:
Poster Session (Board #138)

J Clin Oncol 37, 2019 (suppl; abstr 5026)

Author(s): Neal D. Shore, A. Oliver Sartor, Cora N. Sternberg, Fred Saad, Bertrand F. Tombal, Kurt Miller, Jan Kalinovsky, XiaoLong Jiao, Krishna Tangirala, Celestia S. Higano; Carolina Urologic Research Center, Myrtle Beach, SC; Tulane Medical School, New Orleans, LA; Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY; Centre Hospitalier de l’Université de Montréal/CRCHUM, Montréal, QC, Canada; Université Catholique de Louvain, Brussels, Belgium; Department of Urology, Charité Berlin, Berlin, Germany; Bayer HealthCare Pharmaceuticals, Inc., Basel, Switzerland; Bayer HealthCare Pharmaceuticals, Whippany, NJ; Bayer HealthCare Pharmaceuticals, Inc., Whippany, NJ; University of Washington and Fred Hutchinson Cancer Research Center, Seattle, WA

Abstract Disclosures


Background: In clinical practice, Ra-223 is often combined with Enza or Abi/pred. ERA 223 (NCT02043678) showed increased fracture risk with concurrent Ra-223+Abi/pred. We assessed real-world symptomatic skeletal events (SSEs) and overall survival (OS) of pts with mCRPC who received concurrent or layered Ra-223+Enza or Abi/pred. Methods: Patients with mCRPC treated with Ra-223 in US cancer clinics from 1/01/2013 to 6/30/2017 were identified from a Flatiron prostate cancer registry of electronic health records. Treatment initiation defined subgroups: concurrent (both started within 30 days) or layered (1 started ≥30 days after the other). Baseline (BL) was the first dose of Ra-223. Descriptive analysis was performed for BL characteristics, SSEs, and OS (Kaplan–Meier). Results: Of 625 pts treated with Ra-223, 48% received Ra-223+Enza or Abi/pred. Layered treatment was more common (73%) than concurrent (27%). BL characteristics and clinical outcomes were summarized [Table]. Conclusions: In a real-world setting, Ra-223+Enza or Abi/pred treatment was mainly layered. SSE rates with layered vs concurrent Ra-223+Abi/pred varied between subgroups; results must be treated cautiously given small pt numbers and a non-randomized study. The ongoing PEACE III trial is investigating concurrent Ra-223+Enza; a Phase III study (ESCALATE) exploring layered Ra-223+Enza is planned.

(n = 44)
(n = 123)
Ra-223 +Abi/pred
(n = 39)
Ra-223 +Abi/pred
(n = 97)
All pts
(N = 625)
Time from CRPC to BL (mo), median51431011
Prior therapy, n (%)15 (34)60 (49)NANA344 (55)
Abi/predNANA12 (31)31 (32)335 (54)
Enza10 (23)23 (19)12 (31)24 (25)164 (26)
Any concomitant BHA, n (%)29 (66)71 (58)24 (62)59 (61)343 (55)
Prior SSE, n (%)19 (43)71 (58)20 (51)47 (48)314 (50)
Prior pathologic fractures, n (%)8 (18)22 (18)4 (10)13 (13)110 (18)
Any SSE, n (%)9 (20)35 (28)14 (36)22 (23)168 (27)
Pathologic fractures, n (%)4 (9)15 (12)7 (18)8 (8)61 (10)
OS from mCPRC (mo), median28.126.928.334.528.1

Other Abstracts in this Sub-Category:


1. Overall survival (OS) results of a phase III randomized trial of standard-of-care therapy with or without enzalutamide for metastatic hormone-sensitive prostate cancer (mHSPC): ENZAMET (ANZUP 1304), an ANZUP-led international cooperative group trial.

Meeting: 2019 ASCO Annual Meeting Abstract No: LBA2 First Author: Christopher Sweeney
Category: Genitourinary (Prostate) Cancer - Advanced Disease


2. Impact of darolutamide (DARO) on pain and quality of life (QoL) in patients (Pts) with nonmetastatic castrate-resistant prostate cancer (nmCRPC).

Meeting: 2019 ASCO Annual Meeting Abstract No: 5000 First Author: Karim Fizazi
Category: Genitourinary (Prostate) Cancer - Advanced Disease


3. Interest of short hormonotherapy (HT) associated with radiotherapy (RT) as salvage treatment for metastatic free survival (MFS) after radical prostatectomy (RP): Update at 9 years of the GETUG-AFU 16 phase III randomized trial (NCT00423475).

Meeting: 2019 ASCO Annual Meeting Abstract No: 5001 First Author: Christian Carrie
Category: Genitourinary (Prostate) Cancer - Advanced Disease