Prostate-specific antigen flare induced by cabazitaxel-based chemotherapy in patients with metastatic castration-resistant prostate cancer
Prostate-specific antigen flare induced by cabazitaxel-based chemotherapy in patients with metastatic castration-resistant prostate cancer
复制标题
DOI：
10.1016/j.ejca.2014.03.015
复制
发表时间：
2014-06-01
影响因子：
8.4
通讯作者：
Oudard, Stephane
中科院分区：
文献类型：
--
作者：
Angelergues, Antoine;Maillet, Denis;Oudard, Stephane
背景资料：在接受多西他赛治疗的转移性去势抵抗性前列腺癌（mCRPC）患者中，约15%发生前列腺特异性抗原（PSA）发作。这种耀斑没有标准定义。其对治疗效果的影响尚不清楚。我们试图评估的发病率和特点的PSA耀斑卡巴他赛，其对survival.Methods的影响：多中心回顾性审查连续患者卡巴他赛二线化疗mCRPC。收集卡巴他赛治疗前和治疗期间的基线特征、病史和PSA水平。总生存期（OS）和放射学/临床无进展生存期（PFS）的患者组相应的不同定义的PSA耀斑估计的Kaplan-Meier方法和比较使用log-rank test.Results：总体上，125例患者被纳入。中位PFS和OS分别为6.5和13.3个月。根据使用的定义，耀斑发生率范围为8.3%至30.6%。发作持续≥ 50%的减少与中位PFS和OS分别为11.2和25.2个月相关。下降>= 30%而非>= 50%的中位PFS和OS分别为10.4和16.5个月。这些结果与PSA较基线即刻下降>= 50%或>= 30%的患者无显著差异，但显著优于PSA未下降的患者（OS分别为p = 0.006和0.015）。结论：卡巴他赛的PSA反应，无论是否有初始发作，均与较强的生存获益相关。在评价PSA应答时，可忽略治疗前12周内紫杉烷诱导的发作。(C)2014爱思唯尔有限公司版权所有。
Background: A prostate-specific antigen (PSA) flare occurs in about 15% of metastatic castration-resistant prostate cancer (mCRPC) patients receiving docetaxel. This flare has no standard definition. Its impact on treatment efficacy is unclear. We sought to evaluate the incidence and characteristics of PSA flare on cabazitaxel, and its impact on survival.Methods: Multicentre retrospective review of consecutive patients treated with cabazitaxel second-line chemotherapy for mCRPC. Collection of baseline characteristics, disease history and PSA levels before and during cabazitaxel therapy. Overall survival (OS) and radiological/clinical progression-free survival (PFS) for patient groups corresponding to different definitions of PSA flare estimated by the Kaplan-Meier method and compared using the log-rank test.Results: Overall, 125 patients were included. Median PFS and OS were 6.5 and 13.3 months, respectively. Depending upon the definition used, flare incidence ranged from 8.3% to 30.6%. The flare lasted = 50% decrease was associated with a median PFS and OS of 11.2 and 25.2 months, respectively. Median PFS and OS for a >= 30% rather than >= 50% decrease were 10.4 and 16.5 months. These outcomes were not significantly different from those in patients with immediate PSA decreases of >= 50% or >= 30% from baseline, but were significantly better than in patients experiencing no PSA decrease ( p = 0.006 and 0.015, respectively, for OS).Conclusion: The PSA response to cabazitaxel, with or without initial flare, was associated with a strong survival benefit. The taxane-induced flare during the first 12 weeks of therapy can be ignored when evaluating PSA response. (C) 2014 Elsevier Ltd. All rights reserved.