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Background: We investigated our institution’s mCRPC enzalutamide or abiraterone patients examining PSA responses and impact of sequencing of these drugs. Methods: All enzalutamide / abiraterone mCRPC patients (2011-2018) were included. Rates of PSA >50% response (PSA50) were compared. Time to treatment failure (TTF) and overall survival (OS) was analysed as per lines of previous therapy and timing of chemotherapy. Results: 363 patients included (Enza n=236, Abi n=127), with 15.6 months median follow-up. PSA50 was greater in enzalutamide group (58% vs 31% p<0.0005) but TTF was similar for both groups (median Abi 4.2m vs Enza 6m, p=0.965). There was no significant median OS difference between the groups (Enza 13.8m vs Abi 12.5m p=0.065). Number of lines of prior therapy (p=0.735) or timing of chemotherapy before or after Abi/Enza (p=0.21) had no significant OS impact. Conclusion: Enzalutamide showed higher PSA50 response than abiraterone. Previous lines of therapy or sequencing of chemotherapy with abiraterone / enzalutamide showed no significant survival differences indicating no detriment in either treatment sequence.

Real World Patterns of PSA Response and Survival with Abiraterone and Enzalutamide in Metastatic Castrate Resistant Prostate Cancer (mCRPC)