Eur J Cancer:耄耋之年mCRPC患者采用恩杂鲁胺治疗的效果优于醋酸阿比特龙

2021-06-21 Nebula MedSci原创

转移性去势抵抗性前列腺癌老年患者采用恩杂鲁胺作一线治疗的效果优于醋酸阿比特龙

转移性去势抵抗性前列腺癌 (mCRPC) 不成比例地影响着老年人。目前,评估醋酸阿比特龙 (AA) 与恩杂鲁胺在该人群中的疗效和耐受性的数据有限。

本研究旨在比较 AA与恩杂鲁胺在80岁及以上的mCRPC患者中的临床疗效和耐受性。

这是一项回顾性倾向加权比较队列研究,招募了年满80岁的mCRPC患者,予以一线AA或恩杂鲁胺治疗。以基于倾向评分的逆概率治疗权重评估AA vs 恩杂鲁胺治疗对PSA进展时间(TTPP)、病情进展时间(TTP,首次PSA/影像学/临床进展)和总生存率的影响。

A)开始治疗到PSA进展的时间;B)任何进展前的时间;C)治疗失败前的时间;D)总生存率

共纳入了278位患者,其中153位采用AA治疗,125位采用恩杂鲁胺治疗。恩杂鲁胺治疗与更高的PSA缓解率(61.6% vs 43.8%,p<0.004)和TTP(风险比[HR] 0.66,p=0.01)相关,但与TTPP无关(HR 0.73,p=0.06)。恩杂鲁胺治疗剂量减少的患者比例明显更高(44.8% vs 22.9%,p>0.001),但两种药物的全剂量接受中位数比例与TTPP或TTP之间没有相互作用。AA和恩杂鲁胺的治疗中断率(由于进展以外的原因)也有显著差异(28.8% vs 40.8%,p=0.04)。恩杂鲁胺减剂量和中断治疗的最常见原因是疲劳(30.4%和5.6%)。

综上所述,虽然与AA相比,恩杂鲁胺治疗时下调的剂量更多,治疗中断率也更高,但恩杂鲁胺与更高的PSA缓解率和更长的进展前时间相关。鉴于临床结果不受治疗暴露减少的不利影响,剂量调整可能是平衡毒性和耐受性的有效策略

原始出处:

Soleimani Maryam,Zou Kevin,Sunderland Katherine et al. Effectiveness of first-line abiraterone versus enzalutamide among patients ≥80 years of age with metastatic castration-resistant prostate cancer: A retrospective propensity score-weighted comparative cohort study. Eur J Cancer, 2021, 152: 215-222.

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    2021-06-30 麻无赦

    学习

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    2021-06-22 rebeccajiejie
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  5. 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  6. 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    2021-06-21 JZ Yang

    方向很大有价值

    0

  7. 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createdAvatar=https://img.medsci.cn/20210606/e8b96fdba070433da10cd357c0646807/28bf16f46e314caaad8396c0c7df7a04.jpg, createdBy=adb15496357, createdName=仁术2021, createdTime=Mon Jun 21 01:34:57 CST 2021, time=2021-06-21, status=1, ipAttribution=)]
    2021-06-21 Nick Lee

    学习

    0

  8. 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createdAvatar=https://img.medsci.cn/20210606/e8b96fdba070433da10cd357c0646807/28bf16f46e314caaad8396c0c7df7a04.jpg, createdBy=adb15496357, createdName=仁术2021, createdTime=Mon Jun 21 01:34:57 CST 2021, time=2021-06-21, status=1, ipAttribution=)]
    2021-06-21 麻无赦

    学习

    0

  9. 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    2021-06-21 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

  10. 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    2021-06-21 仁术2021

    学习了不错

    0

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