Vol. 1 No. 3 (2021)
Health Technology Reviews

Treatment Sequences of Androgen Receptor–Targeted Agents for Prostate Cancer

Published March 15, 2021

Key Messages

  • No evidence was found on the treatment sequences of androgen receptor–targeted agents in patients with castration-sensitive prostate cancer.
  • Evidence from retrospective studies, including those within a systematic review, suggests that sequential treatment of abiraterone followed by enzalutamide is more favourable than enzalutamide followed by abiraterone in improving clinical outcomes such as response rate and progression-free survival, but not overall survival, in patients with castration-resistant prostate cancer.
  • Evidence from a retrospective study suggests that docetaxel-containing treatment sequences with androgen receptor–targeted agents may improve progression-free survival compared to sequential therapy with androgen receptor–targeted agents alone in patients with castration-resistant prostate cancer.
  • Evidence from a retrospective study did not reveal differences in clinical outcomes of patients with castration-resistant prostate cancer treated with sequential androgen receptor–targeted agents with or without interposed chemotherapy or radium-223.
  • These findings were in line with those observed in a 2019 CADTH report.1 However, the findings should be interpreted with caution due to low-quality evidence.
  • No comparative cost-effectiveness studies were identified.