Efficacy and safety of abiraterone acetate plus prednisone and androgen deprivation therapy +/- docetaxel in older patients (≥70 years), with de novo metastatic-castration sensitive prostate cancer, compared to younger patients (<70 years): The PEACE-1 trial.

• DOI: 10.1200/jco.2023.41.6_suppl.20
• Publication Date: 2023-03-14T15:22:32Z
• Authors: Loic Mourey; Helen Jane Boyle; Guilhem Roubaud; Raymond S. McDermott; Stephane Supiot; Bertrand F. Tombal; Aude Flechon; Dominik R. Berthold; Philippe Ronchin; Gabriel Kacso; Jean Francois Berdah; Fabio Calabro; Gwenaelle Gravis; Samuel Palumbo; Thierry Gil; Brigitte Vie; Hélène Ribault; Karim Fizazi; Stéphanie Foulon; Joan Carles
• Keywords: Abiraterone acetate; Discontinuation

20 Background: Metastatic castration-sensitive prostate cancer (mCSPC) primarily affects older men (OM). In this post-hoc analysis we investigated the safety and efficacy of abiraterone acetate + prednisone (AAP) in (≥ 70 years) younger (&lt; patients PEACE-1. Methods: Men with de novo mCSPC were allocated to standard care (SOC), SOC AAP, radiotherapy (RXT), or AAP RXT 2x2 design phase 3 trial. was initially androgen deprivation therapy (ADT) alone, then from Oct 2015 onwards, use docetaxel (D) authorized as part (at investigator’s discretion until 2017, then, following publication LATITUDE STAMPEDE trials, accrual restricted receiving ADT+ D). Efficacy OM included PEACE-1 analyzed same methods used overall trial (Lancet 2022; 399: 1695-1707). Results: A total 741 (YM) (63%) 431 (37%) randomized. presented more altered PS (ECOG 1-2) (36% vs 26% p=0.0003) less frequent (66% 51% p&lt;0.0001) than YM. Hypertension (56,5% 38,2%, p&lt;0,001) diabetes mellitus type 2 (15,5% 11%, p=0,029) significantly OM. Median time discontinuation shorter (30.0 months [95%CI= 22.1; 35.4] 41.4 31.5; 54.0] independently D frequently due adverse events death population. The benefit on radiographic progression-free survival (rPFS) tended decrease age population: (HR 0.65, 95%CI 0.42-1.01) 0.49, 0.35-0.69) for trend observed (OS): 0.95, 0.72-1.25) (HR: 0.73, 0.58-0.92) On other hand, fit receive composed ADT+D, rPFS comparable 0.55, 0.29-1.04) YM 0.5, 0.33-0.78). OS was: 0.80, 0.53-1.2) 0.71, 0.52-0.95) YM, respectively. Safety data show that severe (grade 3-5) comparison (69% 61%) while there no difference between not (48% 47%). Conclusions: This suggests that, population, derive a lower benefit, both terms OS, adding versus decreased is likely toxicity leading earlier drug discontinuation. Importantly, enough Clinical information: NCT01957436 .