@article{3123183,
    title = "Results of the FLAC European Database of Metastatic Castration-Resistant Prostate Cancer Patients Treated With Docetaxel, Cabazitaxel, and Androgen Receptor–Targeted Agents",
    author = "Angelergues, A. and Efstathiou, E. and Gyftaki, R. and Wysocki, P.J. and Lainez, N. and Gonzalez, I. and Castellano, D.E. and Ozguroglu, M. and Carbonero, I.G. and Flechon, A. and Borrega, P. and Guillot, A. and Balea, B.C. and Le Moulec, S. and Esteban, E. and Munarriz, J. and Rubio, G. and Birtle, A.J. and Delanoy, N. and Bellmunt, J. and Oudard, S.",
    journal = "Clinical Genitourinary Cancer",
    year = "2018",
    volume = "16",
    number = "4",
    pages = "e777-e784",
    publisher = "HANLEY & BELFUS-ELSEVIER INC",
    issn = "1558-7673",
    doi = "10.1016/j.clgc.2018.02.016",
    keywords = "androgen receptor antagonist;  cabazitaxel;  docetaxel;  prostate specific antigen;  androgen receptor;  antineoplastic agent;  AR protein, human;  cabazitaxel;  docetaxel;  taxoid, adult;  aged;  androgen deprivation therapy;  Article;  cancer combination chemotherapy;  cancer growth;  cancer survival;  castration resistant prostate cancer;  Gleason score;  human;  major clinical study;  male;  middle aged;  overall survival;  retrospective study;  treatment planning;  treatment response;  cancer grading;  castration resistant prostate cancer;  clinical trial;  disease exacerbation;  factual database;  metabolism;  molecularly targeted therapy;  multicenter study;  pathology;  procedures;  prospective study;  survival analysis;  treatment outcome;  very elderly, Adult;  Aged;  Aged, 80 and over;  Antineoplastic Combined Chemotherapy Protocols;  Databases, Factual;  Disease Progression;  Docetaxel;  Humans;  Male;  Middle Aged;  Molecular Targeted Therapy;  Neoplasm Grading;  Prospective Studies;  Prostatic Neoplasms, Castration-Resistant;  Receptors, Androgen;  Retrospective Studies;  Survival Analysis;  Taxoids;  Treatment Outcome",
    abstract = "Several agents have demonstrated an overall survival (OS) benefit in metastatic castration-resistant prostate cancer (mCRPC); however, optimal sequencing is unknown. Retrospective analysis of data from 574 mCRPC patients showed increasing OS with the number of therapies provided; a sequence including docetaxel, cabazitaxel (CABA), and an androgen receptor–targeted agent (ART) provided the greatest benefit. Prior administration of ART did not appear to influence CABA activity. These findings will help guide treatment decisions in daily practice. Background: Several agents have demonstrated an overall survival (OS) benefit in patients with metastatic castration-resistant prostate cancer (mCRPC); however, the optimal sequencing of these therapies is unknown as a result of a lack of prospective randomized controlled trials. This retrospective study aimed to identify clinical factors influencing outcomes and to determine optimal treatment sequencing in patients with mCRPC treated with cabazitaxel (CABA) and/or androgen receptor–targeted agents (ART) after androgen-deprivation therapy (ADT) and docetaxel (DOC). Patients and Methods: Records of 574 consecutive patients treated (2012−2016) at 44 centers in 6 countries were retrospectively examined. Results: A total of 267 patients received ADT → DOC → CABA (group 1), 183 patients ADT → DOC → ART → CABA (group 2), and 124 patients ADT → DOC → CABA → ART (group 3), with respective median OS from diagnosis of mCRPC of 38.3, 44.45, and 53.9 months (P =.012 for group 3 vs. group 1). Multivariate analysis showed response to first ADT ≤ 12 months, Gleason score of 8 to 10, clinical progression, and high prostate-specific antigen levels at mCRPC diagnosis were associated with worse OS. Prior receipt of ART did not influence activity of CABA. Conclusion: OS appeared to increase with the number of life-extending therapies, with a sequence including DOC, CABA, and an ART providing the greatest OS benefit. © 2018 Elsevier Inc."
}