Improving quality of life in metastatic castration-resistant prostate cancer: the role of androgen receptor axis-targeted agents

Abstract

Androgen receptor axis-targeted agents (ARTAs), specifically enzalutamide and abiraterone acetate, have significantly extended the survival of men with metastatic castration-resistant prostate cancer (mCRPC), making them the standard of care for mCRPC. In addition, the impact of both drugs on the health-related quality of life (HRQoL) represents an important therapeutic objective of mCRPC patients. This article aimed to review clinical evidence of HRQoL in mCRPC men treated with abiraterone acetate and enzalutamide and identify their potential benefits and correlation with overall survival or disease progression based on a literature search of randomized clinical trials, studies from real clinical practice and professional guidelines up to October 2022. The synthesized evidence showed that HRQoL of both novel hormonal therapies (NHTs) was evaluated as a secondary endpoint in pivotal trials. The results revealed that these novel agents might improve the HRQoL of mCRPC patients. However, it was difficult to compare the results between trials due to inconsistencies in trial designs and instruments. Correlation tests showed a positive correlation with HRQoL and clinical efficacy outcomes. Patient perspective was assessed only in a few comparative trials. In conclusion, both abiraterone acetate and enzalutamide improved the HRQoL of mCRPC patients. Nevertheless, further research is warranted as there was a limited number of head-to-head trials directly comparing the overall effects of ARTAs for mCRPC.

Keywords

• quality of life
• abiraterone
• enzalutamide
• castration-resistant prostate cancer