Cabazitaxel增進轉移性去勢抗性攝護腺癌病人的臨床結果

吳芃諺、洪晟鈞、裘坤元、李建儀、王賢翔、楊晨洸、陳卷書、盧嘉文、陳正哲、王樹吉、林嘉彥、張瓈文、程千里、歐宴泉

台中榮民總醫院外科部泌尿科、童綜合醫院泌尿部

Cabazitaxel Improves Clinical Outcomes in Patients with Metastatic Castration-Resistant Prostate Cancer

Peng-Yen Wu, Sheng-Chun Hung, Kun-Yuan Chiu, Jian-Ri Li, Shian-Shiang Wang, Cheng-Kuang Yang, Chuan-Shu Chen, Kevin Lu, Cheng-Che Chen, Shu-Chi Wang, Chia-Yen Lin, Li-Wen Chang, Chen-Li Cheng, Yen-Chuan Ou

Division of Urology, Department of Surgery, Taichung Veterans General Hospital; Department of Urology, Tungs' Taichung MetroHarbor Hospital

Purpose:

The purpose of this study was to evaluate the treatment efficacy of chemotherapy with cabazitaxel among patients with metastatic castration–resistant prostate cancer (mCRPC).

Materials and Methods:

We retrospectively reviewed the data of patients with mCRPC who received the chemotherapy with cabazitaxel (at a dose of 20mg per square meter of body-surface area every 3 weeks and daily steroid). The survival, response and adverse events were assessed.

Results:

From 2010 to 2018, thirty-nine patients with mCRPC who ever received cabazitaxel in Taichung Veterans General Hospital were included in the study. The median overall survival (OS) from cabazitaxel administration was 24.25 months. Seventeen patients achieved PSA decline > 50% (43.58%) and 29 patients achieved overall PSA decline (74.35%). The Uni-Multi variant analysis for OS, the visceral metastasis (Hazard Ratio [HR] = 5.62, 95% Confidence Interval [CI] 1.95~16.17, p = 0.001) and nadir PSA after treatment (HR = 1.001, 95% CI 1.0003~1.003, p = 0.011) were recognized as independent predictive factors in OS. Twenty-eight patients who received cabazitaxel after docetaxel had the median OS 23.96 months and the progression-free survival (PFS) 5.07 months. All the patients had an adverse event of any grade. Adverse events of grade 3 or higher was observed in 19 of 39 patients (48.71%), including 18 patients that suffered from neutropenia and one with elevated liver enzymes.

Conclusions:

Cabazitaxel improved the clinical outcomes, including OS, PFS and PSA response rate, in patients with mCRPC who had been treated with docetaxel, with manageable adverse events. Independent predictive factors for overall survival included visceral metastasis and nadir PSA after treatment.