Abiraterone, Enzalutamide, or Apalutamide in Castrate-sensitive Prostate Cancer.
Status:
Not yet recruiting
Trial end date:
2026-06-30
Target enrollment:
Participant gender:
Summary
The investigators have used national VHA data to demonstrate real-world efficacy of
abiraterone and enzalutamide in Veterans with mCRPC. In the real-world that is the VHA, the
investigators have successfully estimated g values that accurately predict OS and the use of
this metric in other settings should now be explored. In the egalitarian system that is the
VHA the treatment of prostate cancer is excellent, uniform across the US and indifferent to
race. The choices made are clearly personalized, given not all men received all therapies and
that younger Veterans were treated more aggressively.
But with survivals that rival those in registration trials that enroll optimally fit
individuals usually not encumbered by the co-morbidities that afflict many Veterans, the
outcomes are testimony to the fact that for this common malady of older Veterans with whom VA
physicians have broad experience the care administered is unsurpassed. Importantly this care
at least as regards Veterans with mCRPC demonstrates that given equal access to health care,
African Americans with prostate cancer fared as well if not better than Caucasians and
importantly had better outcomes with abiraterone, an observation needing further exploration
as these therapies move up front.