Abiraterone及類固醇轉換用於轉移性荷爾蒙抗性前列腺癌的化療前病患：
單一醫學中心經驗
江佩璋、陳進利、高建璋、吳勝堂
三軍總醫院 外科部 泌尿外科
Steroid switch with abiraterone acetate in chemotherapy-naïve patients with metastatic castration-resistant prostate cancer: A single-center experience
Pei-Jhang Chiang, Chin-Li Chen, Chien-Chang Kao, Sheng-Tang Wu
Division of Urology, Department of Surgery
Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Purpose: Abiraterone acetate (AA), a second-generation androgen deprivation therapy (ADT), improves survival in metastatic castration-resistant prostate cancer (mCRPC). Prednisone (P) is the most commonly used steroid with AA recommended by current guideline. The recent phase II prospective SWITCH trial demonstrated that patients with mCRPC treated with AA + P could benefit from a ‘steroid switch’ from P to dexamethasone (D). Herein, we share our experience of using different steroid regimen combined with abiraterone acetate.
Materials and Methods: Retrospective analysis among 32 consecutive asymptomatic and chemotherapy-naïve patients with mCRPC undergoing treatment with AA between September 2017 and October 2019 in our institution. All patients were monitored for PSA, radiological tumor progression and side effects.
Results: All mCRPC patients were chemotherapy-naïve. A total of 15 patients (46.9%) were AA + P group and 17 patients were switch group (53.1%). Mean time to PSA progression was 12.95 months in AA + P group, and 18.39 months in switch group, respectively (p = 0.241). Treatment was well tolerated, with no grade 3 and grade 4 adverse events.
Conclusions: Durable safety and PSA response were found when steroid switch from P to D. ‘Steroid switch’ could help prolong the treatment duration of chemotherapy-naïve mCRPC patients whom received treatment with AA.