轉移性去勢抗性攝護腺癌的雄性素阻斷期間長短可用以預測化療後澤珂治療
的療效與病患存活----臺中榮總經驗
李建儀1、裘坤元1、王賢祥、陳卷書、楊晨洸1、楊啟瑞2、歐宴泉1
臺中榮民總醫院 外科部 泌尿外科；1中國醫藥大學附設醫院 泌尿部，2
Androgen deprivation therapy duration is associated with abiraterone acetate efficacy in metastatic castration resistance prostate cancer
Jian-Ri Li1, Kun-Yuan Chiu1, Shian-Shiang Wang1, Chuan-Shu Chen1, Cheng-Kuang Yang1, Chi-Rei Yang2, Yen-Chuan Ou1
Divisions of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Urology1, China Medical University Hospital, Taichung, Taiwan
Purpose: We performed a retrospective study in our metastatic castration resistance prostate cancer (mCRPC) patients who received at abiraterone acetate(AA) as conjunctive treatment after docetaxel.
Materials and Methods: From 2012 to 2017, 83 patients with mCRPC who received AA after docetaxel were included. Clinical parameters including first line androgen deprivation therapy (ADT) duration, add-on anti-androgen duration, docetaxel treatment duration, docetaxel treatment cycles, CRPC PSA, and pre-abiraterone PSA were analyzed.
Results: The mean follow-up period was 12.2 months. 40 patients (48.2%) reached PSA response after AA treatment. The mean docetaxel cycles used was 7. The median progression free survival was 4.6 months and the median overall survival was 24.3 months. Among 83 patients, all used LH-RH agonists or orchiectomy as ADT therapies. Add on anti-androgen was given after biochemical failure. The add-on anti-androgen duration and the first line ADT duration were associated with progression free survival of AA treatment (HR=0.95, 95% CI 0.91-0.99; HR=0.98, 95% CI 0.97-0.998, respectively). First line ADT duration was associated with overall survival (HR=0.97, 95% CI 0.95-1.00).
Conclusions: We showed our real world data that first line ADT duration and add-on anti-androgen duration could work as pre-AA treatment predictors for efficacy and overall survival. Our result also suggested possible benefit of add-on anti-androgen after first line ADT failure.