Prostate-specific Antigen Response Patterns During Cabazitaxel Therapy in Patients With Metastatic Castration-Resistant Prostate Cancer
Prostate-specific Antigen Response Patterns During Cabazitaxel Therapy in Patients With Metastatic Castration-Resistant Prostate Cancer
复制标题
转移性去势抵抗性前列腺癌患者卡巴他赛治疗期间前列腺特异性抗原反应模式
DOI：
10.1093/jjco/hyz110
复制
发表时间：
2019
期刊：
影响因子：
2.4
通讯作者：
Makoto Sumitomo
中科院分区：
文献类型：
--
作者：
Kent Kanao;Toshiki Ito;Kiyoshi Takahara;Ryosuke Ando;Takahiro Yasui;Ryoichi Shiroki;Hideaki Miyake;Makoto Sumitomo
BackgroundThe本研究的目的是将转移性去势抵抗性前列腺癌（mCRPC）患者在卡巴他赛治疗期间的前列腺特异性抗原（PSA）反应归类为不同的模式，并调查PSA反应模式对预后的影响。MethodsWe回顾了来自mCRPC患者的数据，这些患者在属于东海泌尿肿瘤研究研讨会的四个机构接受了卡巴他赛治疗。符合本研究条件的患者已接受至少三个周期的卡巴他赛治疗，间隔三周或四周。PSA反应模式分为原发抵抗（PR）、反应（RE）、稳定（ST）和波动（FL）。总生存期（OS）之间的patterns.ResultsData从共50例患者进行了分析。PR型18例（36%），RE型14例（28%），ST型12例（24%），FL型6例（12%）。PR和RE模式患者的中位OS（95%CI）分别为10.7（5.6-15.9）和14.9（6.8-23.0）个月，ST和FL模式患者未达到。FL型患者的OS明显优于PR型（P= 0.012）和RE型（P= 0.010）。由于此类患者的预后相对较好，PSA升高后下降时应谨慎判断是否停止卡巴他赛治疗。
BackgroundThe objective of this study was to categorize prostate-specific antigen (PSA) response during cabazitaxel therapy in patients with metastatic castration-resistant prostate cancer (mCRPC) into different patterns and to investigate the prognostic impact of the PSA response patterns.MethodsWe reviewed data from patients with mCRPC who had been treated with cabazitaxel therapy at four institutions belonging to Tokai Urologic Oncology Research Seminar. Patients eligible for this study had received at least three cycles of cabazitaxel treatment at three- or four-week intervals. The PSA response patterns were categorized as primary resistance (PR), response (RE), stabilization (ST), and fluctuating (FL). The overall survival (OS) was compared among the patterns.ResultsData from a total of 50 patients were analyzed in this study. The number of patients exhibiting PR, RE, ST and FL patterns were 18 (36%), 14 (28%), 12 (24%) and 6 (12%), respectively. The median (95% CI) OS of patients with PR and RE patterns was 10.7 (5.6–15.9) and 14.9 (6.8–23.0) months, respectively, and was not reached for patients with ST and FL patterns. The OS of patients with the FL pattern was significantly better than that of patients with PR (P= 0.012) and RE (P= 0.010) patterns.ConclusionThere were some patients whose PSA were fluctuating during cabazitaxel therapy in patients with mCRPC. Because the prognosis of such patients was relatively good, the judgment to discontinue the cabazitaxel therapy after PSA rise followed by decrease should be made prudently.