Eur Urol:之前接受雄激素剥夺疗法(加或不加用多西紫杉醇)的转移未去势前列腺癌患者, 进展后再治疗的抗癌活性和耐受性研究。

2017-10-31 fengxiangxin MedSci原创

本研究的目的是探讨之前接受过化学-激素治疗的未去势前列腺癌(mCNPC)患者,在后续治疗中因治疗选择的不同,治疗效果和耐受性的差异。

根据GETUG-AFU 15,CHAARTED和STAMPEDE的研究结果,对于未去势前列腺癌(mCNPC)患者,雄激素剥夺治疗(ADT)+多西紫杉醇是标准护理手段。但是,对于之前接受ADT+多西紫杉醇的转移性去势抵抗性前列腺癌(mCRPC)患者,尚没有疗效研究数据。

本研究的目的是探讨之前接受过化学-激素治疗的未去势前列腺癌(mCNPC)患者,在后续治疗中因治疗选择的不同,治疗效果和耐受性的差异。

研究者在GETUG-AFU 15期3期试验的回顾性资料中收集了mCRPC患者接受的相应治疗。并调查了mCRPC患者前三线救助治疗的生化无进展生存期,前列腺特异性抗原(PSA)最大下降值,总生存期和耐受性。

总体而言,245名患者接受了至少一项针对mCRPC的治疗。当多西他赛应用于一线治疗中时,在之前单独接受ADT组和之前接受ADT+多西他赛组中分别观察到25/66例(38%)和4/20例(20%)患者的PSA降低≥50%(p = 0.14)。中位生化无进展生存期分别为6.0月(95%置信区间:3.6-7.7)和4.1 月(95%置信区间:1.3-4.9)。

当多西他赛应用于一线或二线治疗时,在之前单独接受ADT组和之前接受ADT+多西他赛组中分别观察到36/80例(45%)和4/29例(14%)患者的PSA降低≥50%(p = 0.07)。

在之前单独接受ADT组和之前接受ADT+多西他赛组中,使用比卡鲁胺分别观察到12/28例(43%)和4/23例(17%)患者的PSA降低≥50%。

在之前接受过ADT+多西紫杉醇治疗,接受阿比特龙或恩杂鲁胺的mCRPC患者中,有10/19例(53%)的PSA降低≥50%。治疗中发生了为数不多的3-4级事件。

研究局限性包括该分析的观察设计和回顾性特征、没有标准化的治疗救助方案以及部分治疗亚组患者数量有限。

结论:对于在前期使用ADT+多西他赛针对mCNPC治疗,之后进展至mCRPC的患者,疾病发生进展之后再使用多西紫杉醇时,其疗效仅在有限的患者中观察到。针对此项研究中设置的患者,阿比特龙和恩杂鲁胺保持了其疗效。对于进展的mCRPC患者,由于缺乏标准化的治疗方案,患者之间的可比性也因此受到限制。

原始出处:


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    2017-11-02 whmdzju
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    2017-10-31 清风拂面

    很好的文章谢谢分享

    0

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    2017-10-31 1ddf0692m34(暂无匿称)

    学习了.涨知识

    0

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    2017-10-31 1e0f8808m18(暂无匿称)

    学习了.谢谢分享.

    0

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