Evidence map›Paper›PMID 36104504›Full record

Observational studyProstate cancer and prostatic diseases2023

Survival of veterans treated with enzalutamide and abiraterone for metastatic castrate resistant prostate cancer based on comorbid diseases.

Martin W Schoen, Kenneth R Carson, Seth A Eisen, Charles L Bennett, Suhong Luo, Melissa A Reimers, Eric M Knoche, Alison L Whitmer, Yan Yan, Bettina F Drake and 1 more

Erratum issuedOpen access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Prostate cancer and prostatic diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 25 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 3 pooled it
5.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 36 citations in OpenAlex.

  1. Pooled it
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  4. Insights from EMBARK: guiding clinical care and trial design.Translational andrology and urology · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

Martin W SchoenSaint Louis Veterans Affairs Medical Center, Saint Louis, MO, USA. martin.schoen@health.slu.edu.ORCID 0000-0001-6388-5553
Kenneth R CarsonRush University, Chicago, IL, USA.
Seth A EisenSaint Louis Veterans Affairs Medical Center, Saint Louis, MO, USA.
Charles L BennettUniversity of South Carolina College of Pharmacy, Columbia, SC, USA.
Suhong LuoDepartment of Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
Melissa A ReimersDepartment of Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
Eric M KnocheSaint Louis Veterans Affairs Medical Center, Saint Louis, MO, USA.
Alison L WhitmerSaint Louis Veterans Affairs Medical Center, Saint Louis, MO, USA.
Yan YanDepartment of Surgery, Washington University School of Medicine, Saint Louis, MO, USA.
Bettina F DrakeDepartment of Surgery, Washington University School of Medicine, Saint Louis, MO, USA.
Kristen M SanfilippoSaint Louis Veterans Affairs Medical Center, Saint Louis, MO, USA.
Washington University in St. Louis · USSt. Louis VA Medical Center · USRush University · USUniversity of South Carolina · US

Funding

Washington University Center for Cellular ImagingP30CA091842 · NCI · WASHINGTON UNIVERSITY · PI TIMOTHY J. EBERLEIN · 2001 to 2026
$128.0M
NCI NIH HHS P30 CA091842
6 · The paper itself

Abstract

backgroundComorbid diseases influence patient outcomes, yet little is known about how comorbidities interact with treatments for metastatic castrate-resistant prostate cancer (mCRPC). No head-to-head trials have compared the efficacy of abiraterone and enzalutamide - oral androgen-receptor targeted agents (ARTAs) for mCRPC. In patients with comorbid disease, outcomes with ARTAs may differ due to disparate mechanisms of action, adverse events, and drug interactions.

methodsRetrospective observational study of US veterans initiating treatment for mCRPC with abiraterone or enzalutamide between September 2014 and June 2017. Treatment duration and overall survival (OS) was compared based on age and comorbid diseases. The association between ARTA and OS was assessed using Cox proportional hazards and propensity-score matched modeling while adjusting for potential confounders. Sensitivity analyses were performed based on patient age, comorbidities, and subsequent treatments for mCRPC.

resultsOf 5822 veterans treated for mCRPC, 43.0% initially received enzalutamide and 57.0% abiraterone. Veterans initially treated with enzalutamide versus abiraterone were older (mean 75.8 vs. 75.0 years) with higher mean Charlson comorbidity index (4.4 vs. 4.1), and higher rates of cardiovascular disease or diabetes (74.2% vs. 70.6%). In the entire population, veterans initially treated with enzalutamide had longer median OS compared to those initially treated with abiraterone (24.2 vs. 22.1 months, p = 0.001). In veterans with cardiovascular disease or diabetes, median treatment duration with enzalutamide was longer (11.4 vs. 8.6 months, p < 0.001) with longer median OS compared to abiraterone (23.2 vs. 20.5 months, p < 0.001). In a propensity score matched cohort, enzalutamide was associated with decreased mortality compared to abiraterone (HR 0.90, 95% CI 0.84-0.96).

conclusionsVeterans with cardiovascular disease or diabetes had longer treatment duration and OS with enzalutamide compared to abiraterone. Further study of ARTA selection may benefit men with metastatic castrate resistant prostate cancer and likely hormone sensitive prostate cancer, especially among patients with comorbid diseases.

Indexed as

Cardiovascular DiseasesDiabetes MellitusProstatic Neoplasms, Castration-ResistantVeteransAbiraterone AcetateAndrostenesBenzamidesHumansMaleNitrilesPhenylthiohydantoinRetrospective StudiesTreatment OutcomeabirateroneAbiraterone AcetateAndrostenesBenzamidesenzalutamideNitrilesPhenylthiohydantoin

Identifiers

PMID36104504
PMCPMC10638085
OpenAlexW4295763021

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.