Docetaxel Activity in the Era of Life-prolonging Hormonal Therapies for Metastatic Castration-resistant Prostate Cancer
Docetaxel Activity in the Era of Life-prolonging Hormonal Therapies for Metastatic Castration-resistant Prostate Cancer
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DOI：
10.1016/j.eururo.2016.05.002
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发表时间：
2016-09-01
期刊：
影响因子：
23.4
通讯作者：
Sweeney, Christopher J.
中科院分区：
文献类型：
--
作者：
Francini, Edoardo;Sweeney, Christopher J.
对于>6年，多西他赛联合泼尼松是转移性去势抵抗性前列腺癌（mCRPC）唯一具有生存获益的治疗。最近，在临床实践中，通常在多西他赛之前给予醋酸阿比特龙治疗mCRPC。我们的研究旨在回顾既往阿比特龙治疗后多西他赛的活性。为此，我们分析了文献中描述既往阿比特龙治疗后接受多西他赛治疗的mCRPC患者总生存期（OS）的所有回顾性报告。观察到的平均OS为12.7个月，这表明与TAX 327研究的更新分析中观察到的19.2个月相比显著降低;然而，这些数据与13.6个月的OS非常相似（95%置信区间，12.1-15.1个月），主要在常规实践中（86.3%），在357例接受多西他赛治疗且既往无阿比特龙的mCRPC男性中进行了回顾性单机构研究。由于III期试验中招募的患者的特征往往与现实世界的情况不同，我们认为该数据集是一个相关的比较。因此，尽管回顾性交叉研究比较存在局限性，但数据表明多西他赛在阿比特龙治疗mCRPC患者后作为二线治疗时仍具有活性。患者总结：我们回顾了既往使用阿比特龙后多西他赛的活性，并根据多西他赛作为转移性去势抵抗性前列腺癌（mCRPC）一线治疗的结局考虑了结果。患者在常规治疗中我们注意到多西他赛保留了合理的活性，是阿比特龙治疗前或治疗后治疗mCRPC患者的有效药物。(C)2016年欧洲泌尿外科协会。Elsevier B. V.出版，保留所有权利。
For >6 yr, docetaxel with prednisone was the only treatment with survival benefits for metastatic castration-resistant prostate cancer (mCRPC). More recently, in clinical practice, abiraterone acetate has been commonly administered prior to docetaxel for the treatment of mCRPC. Our study aimed to review the activity of docetaxel after prior abiraterone. To this end, we analyzed all retrospective reports in the literature describing the overall survival (OS) of mCRPC patients treated with docetaxel after previous abiraterone. The mean OS observed was 12.7 mo, which suggested a significant decrement compared with the 19.2 mo seen in the updated analysis of the TAX 327 study; however, the data are quite similar to the OS of 13.6 mo (95% confidence interval, 12.1-15.1 mo) described in a retrospective single-institution study of 357 men with mCRPC treated with docetaxel with no prior abiraterone mostly in routine practice (86.3%). Because the characteristics of patients recruited in phase 3 trials tend to differ from the real-world setting, we deemed this data set a relevant comparison. Consequently, despite the limitations of retrospective cross-study comparisons, the data suggest that docetaxel retains activity when used as second-line therapy after abiraterone for mCRPC patients.Patient summary: We reviewed the activity of docetaxel after prior use of abiraterone and considered the results in the light of the outcomes of docetaxel used as firstline therapy for metastatic castration-resistant prostate cancer (mCRPC) patients in routine practice. We noted that docetaxel retains reasonable activity and is a useful agent for the treatment of mCRPC patients before or after abiraterone. (C) 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.