亞洲轉移性去勢療法無效前列腺癌於中國醫藥大學附設醫院以澤珂併用類固醇治療之預後與相關結果

蔡正晏、張議徽、王又德、蕭博任、陳冠亨、連啟舜、謝博帆、邱鴻傑、鄒頡龍、陳國樑

葉進仲、陳汶吉、張士三、黃志平、張兆祥、楊啟瑞、吳錫金

中國醫藥大學附設醫院 泌尿部

The Real-World Outcome with Abiraterone Acetate plus Prednisone in Asian Men with Metastatic Castrate-Resistant Prostate Cancer Treated in China Medical University Hospital

Cheng-Yen Tsai, Yi-Huei Chang, Yu-De Wang, Po-Jen Hsiao, Guan-Heng Chen, Chi-Shun Lien, Po-Fan Hsieh, Hung-chieh Chiu, Chieh-Lung Chou, Kuo-Liang Chen, Chin-Chung Yeh, Wen-Chi Chen, Shih-San Chang, Chi-Ping Huang, Chao-Hsiang Chang, Chi-Rei Yang, Hsi-Chin Wu   

Divisions of Urology, China Medical University Hospital, Taichung, Taiwan

Introduction: We report the cohort study of clinical outcomes in metastatic castrate-resistant prostate cancer (mCRPC) patients treated with abiraterone acetate plus prednisone in a single-center clinical setting.

Methods: A retrospective analysis of mCRPC patients treated at China Medical University Hospital, a tertiary hospital in Taiwan, from 2004 to 2021 was conducted. Disease characteristics, treatment outcomes, subsequent treatment use, and adverse events were retrieved from electronic medical records. The primary clinical endpoint was overall survival (OS). The secondary endpoints included the PSA response rate, primary resistance rate, and the analysis of adverse events.

Results: Out of 150 patients with mCRPC treated with abiraterone acetate plus prednisone, 99(66%) patients were postchemotherapy (PC) and 51 (34%) patients were chemonaïve (CN), with a median age of 75.644 (52-92) and 78.347 (60-91) years, respectively. Follow-up duration was 89.33 months for the PC group and 106.74 months for the CN group. Median OS was 32.951 (95% CI, 25.706–40.195) and 42.617 months(95% CI, 30.591–54.644) for PC and CN cohorts. The PSA response rate is 68.7 % and 68.6% in PC and CN groups within three months after starting the abiraterone therapy. Furthermore, 13 patients (8.6%) with flare phenomenon in the PC group were noted. Common side effects include fatigue (14.7%), fluid retention (8.8%), liver enzyme elevation (8.8%) and GI upset (7.3%).

Conclusions: In the reported series, we found a favored outcome of overall survival and PSA response rate of the postchemotherapy group compared to cou-aa-301. A favored outcome of overall survival compared to the chemonaïve group compared to cou-aa-302. The most common adverse effect is fatigue, elevated liver enzyme, and fluid retention.