Phase II trial of celecoxib in prostate-specific antigen recurrent prostate cancer after definitive radiation therapy or radical prostatectomy
Phase II trial of celecoxib in prostate-specific antigen recurrent prostate cancer after definitive radiation therapy or radical prostatectomy
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DOI：
10.1158/1078-0432.ccr-05-2067
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发表时间：
2006-04-01
影响因子：
11.5
通讯作者：
Wallen, E
中科院分区：
文献类型：
--
作者：
Pruthi, RS;Derksen, JE;Wallen, E
目的：最近的证据表明，环氧化酶-2 （COX-2）抑制剂在体内和体外都有很强的抗前列腺癌活性。然而，没有人体试验。本研究评估了COX-2抑制剂塞来昔布在前列腺特异性抗原（PSA）前列腺癌放射治疗（x射线治疗或XRT）或根治性前列腺切除术后复发的疗效。方法：40例XRT或根治性前列腺切除术后生化复发患者给予塞来昔布400mg，每日2次。随访3、6、12、18个月及以后每6个月获得一次PSA水平。通过计算PSA加倍次数和计算对数曲线（PSA）随时间的斜率来评估每位患者在塞来昔布治疗前后PSA的增加率，对数据进行评估。结果：40例患者中有36例（90%）在3个月后PSA下降，其中11例PSA下降，8例PSA稳定。3个月的短期缓解持续到6、12、18个月。比较塞来昔布治疗前与治疗后PSA的增加率，每个时间点的对数斜率（PSA）与治疗前的时间相比均显着趋于平缓。睾酮水平没有明显变化，表明这是一种不依赖于雄激素的机制。结论：COX-2抑制剂可能对XRT或根治性前列腺切除术后生化进展患者的血清PSA水平有影响。这些结果表明，COX-2抑制剂可能有助于延缓或预防这些患者的疾病进展，从而有助于延长雄激素剥夺治疗的时间。
Objectives: Recent evidence has shown that cyclooxygenase-2 (COX-2) inhibitors have potent antitumor activity in prostate cancer both in vitro and in vivo. However, human trials are absent. This study evaluated the efficacy of the COX-2 inhibitor celecoxib in prostate-specific antigen (PSA) recurrent prostate cancer after radiation therapy (X-ray therapy or XRT) or radical prostatectomy.Methods: Forty patients who had biochemical relapse after XRT or radical prostatectomy were treated with celecoxib 400 mg twice per day. Follow-up PSA levels were obtained at 3, 6,12, and 18 months and subsequently every 6 months thereafter. Data were evaluated by calculating PSA doubling times and by calculating the slope of the curve of log (PSA) versus time to assess rate of PSA increase before and after celecoxib treatment for each patient.Results: Thirty-six of 40 (90%) patients had a slowing effect on their rate of PSA after 3 months, including 11 of 40 with a decline and 8 of 40 with stabilization of PSA. Short-term responses at 3 months continued at 6, 12, 18 months Comparison of rate of PSA increase before versus after celecoxib treatment showed significant flattening of slope of log(PSA) versus time from pretreatment for each of the time points. There was no significant change in testosterone levels, suggesting an androgen-independent mechanism.Conclusions: COX-2 inhibitors may have an effect on serum PSA levels in patients with biochemical progression after XRT or radical prostatectomy. These results suggest that COX-2 inhibitors may help delay or prevent disease progression in these patients and thereby help extend the time until androgen deprivation therapy.