高雄長庚單一中心及回顧文獻統合分析：去勢抗性前列腺癌患者接受Abiraterone及Enzalutamide實際臨床應用，攝護腺特定抗原下降成效比較
葉星佐、王弘仁、李維菁、莊燿吉、陳彥達、鄭元佐、康智雄、李偉嘉、陳建旭、沈元琦、柳易揚、劉惠瑛、張殷綸、楊文洲、江博暉、羅浩倫*
高雄長庚紀念醫院泌尿科
KCGMH experience and meta-analysis: Comparing PSA response of Abiraterone and Enzalutamide in metastatic castration-resistant prostate cancer in real-world practice
Hsing-Tsuo, Yeh, Hung-Jen Wang , Wei-Ching Lee, Yao-Chi Chuang, Yen-Ta Chen, Yuan-Tso Cheng, Chih-Hsiung Kang, Wei-Chia Lee, Hao-Lun Luo, Chien-Hsu Chen, Yuan-Chi Shen, Wen-Chou Yang Po-Hui Chiang, Yi Yang Liu, Hui Ying Liu, Yin Lun Chang,
Kaohsiung Chang Gung Memorial Hospital, Department of Urology
Abstract
Purpose: To investigate the efficacy of enzalutamide and abiraterone in metastatic castration-resistant prostate cancer(mCRPC) patients regarding prostate-specific antigen (PSA) response in real-world practice
Materials and Methods: 184 male patients who had received either enzalutamide or abiraterone from January, 2000 to January, 2022 were enrolled. 36 patients with hormone sensitive prostate cancer and 18 patients with incomplete data or lost follow-up were excluded. Forest plots and Funnel plots were created by RevMan 5.4 using a fixed effects analysis model to compare results with previously published cohorts as meta-analysis.
Results: Our cohort showed the proportion of patients with PSA decline ≥ 50% is similar in both group (27(64.3%) in abiraterone group and 68(77.3%)in enzalutamide group, p=0.177). However, in patients with PSA decline ≥ 90%, result favors enzalutamide (12(28.6%) in abiraterone group and 45(51.1%) in enzalutamide group, p=0.025). Pooled result from meta-analysis showed that PSA response ≥ 50% was higher for patients receiving enzalutamide than abiraterone(1322 patients, OR 2.31, 95%CI 1.83-2.91, P＜0.00001, I2=27%)
Conclusion: mCRPC patients treated with enzalutamide seemed to have a better PSA response than patients treated with abiraterone in real-world practice.