Patterns of Cancer Progression of Metastatic Hormone-sensitive Prostate Cancer in the ECOG3805 CHAARTED Trial.
Patterns of Cancer Progression of Metastatic Hormone-sensitive Prostate Cancer in the ECOG3805 CHAARTED Trial.
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DOI：
10.1016/j.euo.2020.07.001
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发表时间：
2020-12
影响因子：
8.2
通讯作者：
Sweeney CJ
中科院分区：
文献类型：
--
作者：
Bryce AH;Chen YH;Liu G;Carducci MA;Jarrard DM;Garcia JA;Dreicer R;Hussain M;Eisenberger MA;Plimack ER;Vogelzang NJ;DiPaola RS;Harshman L;Sweeney CJ
ECOG 3805是一项在有或没有多西他赛的情况下，对转移性前列腺癌敏感性前列腺癌（mHSPC）进行睾酮抑制的随机试验。前列腺特异性抗原（PSA）抑制程度越深，预后越好。然而，之前尚未在mHSPC中检查PSA升高和放射学进展的一致性，而在转移性去势抵抗性前列腺癌中已报告了这一点。通过PSA和放射学参数确定ECOG 3805患者的进展模式。我们对ECOG 3805中的所有患者进行了回顾性分析。根据进展时的PSA水平（PSA水平是否低于2.0 ng/ml）和研究中的进展事件类型（研究定义的PSA进展伴或不伴临床进展，或仅临床进展）对患者进行分类。比较两组的基线人口统计学资料、临床结局和进展模式。八分之一的患者发生临床进展，PSA水平低于2 ng/ml，约25%的患者在未确认PSA进展的情况下发生临床进展。发生临床进展但未证实PSA进展的患者自随机化起的总生存期短于仅发生PSA进展的患者。研究入组时的患者人口统计学资料不能预测进展模式。研究局限性包括其回顾性和事后性质。PSA升高前或PSA水平较低时的临床进展是mHSPC中相对常见的现象，与总生存期较差相关。需要对这些患者进行进一步的生物学和临床研究。仅依靠前列腺特异性抗原（PSA）是监测接受转移性前列腺癌治疗的患者的不充分策略。即使PSA低和/或PSA无变化或变化很小，前列腺癌在扫描时也会恶化。PSA检测中应增加影像学检查，以监测转移性前列腺癌患者。
ECOG3805 is a randomized trial of testosterone suppression with or without docetaxel for metastatic hormone-sensitive prostate cancer (mHSPC). Deeper prostate-specific antigen (PSA) suppression is prognostic for outcome. However, the concordance of PSA rise and radiographic progression has not been examined previously in mHSPC, whereas this has been reported in metastatic castration-resistant prostate cancer. To determine the patterns of progression by PSA and radiographic parameters in patients in ECOG3805. We conducted a retrospective analysis of all patients in ECOG3805. Patients were classified according to the PSA level at progression (whether PSA level was below 2.0 ng/ml or not) and the type of progression event in the study (either PSA progression as defined by the study with or without clinical progression, or clinical progression alone). Baseline demographics, clinical outcomes, and patterns of progression were compared between the groups. One in eight patients had clinical progression below a PSA level of 2 ng/ml, and approximately 25% developed clinical progression in the absence of confirmed PSA progression. Overall survival from randomization was shorter in patients with clinical progression without confirmed PSA progression than in patients with PSA progression alone as the first progression. Patient demographics at study entry were not predictive of the pattern of progression. Study limitations include its retrospective and post hoc nature. Clinical progression prior to PSA rise or at low PSA levels is a relatively frequent phenomenon in mHSPC and is associated with poorer overall survival. Further biological and clinical studies of these patients are warranted. Reliance on prostate-specific antigen (PSA) alone is an inadequate strategy to monitor patients undergoing treatment for metastatic hormone-sensitive prostate cancer. Prostate cancer can get worse on scans even with low PSA and/or no or small changes in PSA. Imaging should be added to PSA testing to monitor patients with metastatic prostate cancer.
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DOI：
10.1056/nejmoa1503747
发表时间：
2015-08-20
期刊：
The New England journal of medicine
影响因子：
--
作者：
Sweeney CJ;Chen YH;Carducci M;Liu G;Jarrard DF;Eisenberger M;Wong YN;Hahn N;Kohli M;Cooney MM;Dreicer R;Vogelzang NJ;Picus J;Shevrin D;Hussain M;Garcia JA;DiPaola RS
通讯作者：
DiPaola RS
影响因子：
23.4
作者：
Gravis G;Boher JM;Chen YH;Liu G;Fizazi K;Carducci MA;Oudard S;Joly F;Jarrard DM;Soulie M;Eisenberger MJ;Habibian M;Dreicer R;Garcia JA;Hussain MHM;Kohli M;Vogelzang NJ;Picus J;DiPaola R;Sweeney C
通讯作者：
Sweeney C
影响因子：
4.8
作者：
Bryce, A. H.;Alumkal, J. J.;Beer, T. M.
通讯作者：
Beer, T. M.
影响因子：
45.3
作者：
Kyriakopoulos, Christos E.;Chen, Yu-Hui;Sweeney, Christopher J.
通讯作者：
Sweeney, Christopher J.
影响因子：
2.1
作者：
MOORE, SR;REINBERG, Y;ZHANG, G
通讯作者：
ZHANG, G