Retrospective study of impact of concomitant antihypertensive medication on outcome of enzalutamide or abiraterone for mCRPC

The introduction of novel hormonal therapies such as enzalutamide (ENZ) and abiraterone acetate (ABI) has resulted in improvement of survival outcomes of patients with metastatic castration-resistant prostate cancer (mCRPC). The majority of mCRPC patients are elderly who may have comorbidities and use various concomitant medications. A retrospective study at the University of Pilzen (Czech Republic) investigated the impact of concomitant use of antihypertensive medication of outcomes with ENZ or ABI for mCRPC. Most concomitant antihypertensive medications were not associated with outcomes, but concomitant use of ACE inhibitors was associated with improved radiographic progression-free survival and overall survival. Median rPFS and OS for patients using ACE inhibitors were 15.5 and 32.3 months, respectively, while they were 10.7 and 24.0 months for patients not using ACE inhibitors (p=0.0053 and p=0.0238, respectively). In multivariate analysis, use of ACE inhibitors was an independent predictive factor for rPFS (HR 0.704; p=0.0364) and OS (HR 0.592; p=0.0185). The authors conclude that among patients receiving ENZ or ABI for mCRPC, concomitant use of ACE inhibitors was associated with improved outcomes.