Real-World Overall Survival Comparison of Enzalutamide and Abiraterone In First- and Second-Line Setting of Metastatic Castration-Resistant Prostate Cancer.

BACKGROUND

While their indications overlap, no clinical trials have compared abiraterone and enzalutamide for overall survival (OS) in mCRPC.

METHODS

A large, country-wide health insurance database (2013-2023) was assessed for the OS comparison between abiraterone and enzalutamide.

RESULTS

Overall, 3497 patients were identified with first- (n = 2215) or second-line (n = 1282) abiraterone or enzalutamide treatment (only 66 received both drugs sequentially). Enzalutamide-treated patients had longer OS both in the first- (HR:0.84; 95%CI:0.74-0.96; p = 0.008) and the second-line setting (HR:0.88; 95%CI:0.78-0.99; p = 0.043), respectively.

CONCLUSIONS

This health insurance-registry-based study suggests that, in the real-world mCRPC setting, enzalutamide is superior to abiraterone in terms of OS.