Early abiraterone acetate treatment is beneficial in Japanese castration-resistant prostate cancer after failure of primary combined androgen blockade.
Early abiraterone acetate treatment is beneficial in Japanese castration-resistant prostate cancer after failure of primary combined androgen blockade.
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DOI：
10.1016/j.prnil.2017.07.001
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发表时间：
2018-03
影响因子：
3
通讯作者：
Yasui T
中科院分区：
文献类型：
--
作者：
Nagai T;Naiki T;Iida K;Etani T;Ando R;Hamamoto S;Sugiyama Y;Akita H;Kubota H;Hashimoto Y;Kawai N;Yasui T
靶向雄激素轴的新型药物的开发已导致去势抵抗性前列腺癌（CRPC）的总生存率提高。本研究旨在研究在日本患者中使用一种此类药物醋酸阿比特龙（AA）治疗的最佳时机。2014年7月至2016年2月期间，106例CRPC患者在初次联合雄激素阻断（CAB）失败后，在日本名古屋的名古屋市立大学医院和4家附属医院接受AA治疗。其中，69例患者的化疗前治疗的记录进行了回顾性分析。患者被分为两个AA治疗组：（1）CRPC诊断后的一线或二线治疗，称为早期组，（2）三线治疗后的治疗，称为延迟组。比较两组患者的前列腺特异性抗原（PSA）缓解率、治疗后PSA下降率≥ 50%、无进展生存期（PFS）和总生存期（OS）。使用美国国家癌症研究所不良事件通用术语标准4.0版对不良事件进行分类。在早期组的24例患者和延迟组的45例患者中，未观察到组间基线参数的显著差异。早期组的PSA缓解率、≥ 50% PSA下降率和PFS（但非OS）均显著优于延迟组。血清天冬氨酸氨基转移酶/丙氨酸氨基转移酶升高是最常见的3级治疗相关毒性，在临床上可管理。在早期组的亚组分析中，氟替卡松治疗后一线AA与二线AA的比较显示PSA缓解率、PFS或OS无变化。本研究表明，CAB失败后日本化疗初治CRPC患者中一线或二线AA治疗的有利结局改善;这种改善的统计学证实对于PFS是明显的，但对于OS不是。此外，早期AA治疗显示出可接受的安全性特征。
Development of novel agents targeting the androgen axis has led to improved overall survival in castration-resistant prostate cancer (CRPC). This study aimed to investigate the optimal timing of treatment with one such agent, abiraterone acetate (AA), in Japanese patients. Between July 2014 and February 2016, 106 CRPC patients were administered AA in Nagoya City University Hospital, Nagoya, Japan and in four affiliated hospitals following failure of primary combined androgen blockade (CAB). Of these, records of 69 patients treated before chemotherapy were retrospectively analyzed. Patients were divided into two AA treatment groups: (1) first- or second-line after diagnosis of CRPC, designated the Early Group, and (2) third-line onwards, designated the Deferred Group. Prostate-specific antigen (PSA) response rate, ≥ 50% PSA decline rate with treatment, progression-free survival (PFS), and overall survival (OS) were compared between the two groups. National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0 was used to classify adverse events. In 24 patients in the Early Group and 45 patients in the Deferred Group, no significant differences in baseline parameters were observed between groups. PSA response rate, ≥ 50% PSA decline rate and PFS (but not OS) were significantly better in the Early Group than in the Deferred Group. Serum aspartate aminotransferase/alanine aminotransferase elevations were the most common Grade 3 treatment-related toxicities, and were clinically manageable. In subgroup analyses of the Early Group, comparison of first-line AA with second-line AA after flutamide treatment showed no changes in PSA response rate, PFS, or OS. This study suggests improved favorable outcomes of first- or second-line AA treatment in Japanese chemotherapy-naïve CRPC patients after failed CAB; statistical confirmation of such improvement was evident for PFS, but not OS. In addition, early AA treatment exhibited an acceptable safety profile.
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影响因子：
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作者：
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通讯作者：
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影响因子：
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