Beer Tomasz M, Bergenstock Misty, Birt Karlee, Higano Celestia S
Department of Medicine, Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland, OR 97239, USA.
Clin Genitourin Cancer. 2007 Jun;5(5):329-33. doi: 10.3816/CGC.2007.n.012.
Anemia is a common morbidity of advanced prostate cancer, and prostate cancer treatment and has been associated with a worse overall survival and reduced quality of life in patients with prostate cancer. We sought to determine if infrequent dosing of darbepoetin alfa is safe and effective in treating anemia in patients receiving systemic therapy for prostate cancer.
Sixteen patients with histologically confirmed prostate cancer with bone metastases on androgen deprivation therapy with or without chemotherapy; and a baseline hemoglobin (Hb) < or = 12 g/dL (amended to < or = 11 g/dL) were enrolled. The primary endpoints were the proportion of patients who had a baseline Hb > or = 12.5 g/dL and the proportion whose baseline Hb increased by > or = 1 g/dL. Patients were initially treated with 300 microg of darbepoetin alfa every 4 weeks. The dose was increased to 500 microg, 800 microg, and 1000 microg at each subsequent visit if the baseline Hb was not at target and had not increased by > or = 1 g/dL during the previous 4 weeks. Treatment was planned for 6 months.
Treatment was well tolerated with no grade > or = 3 toxicities. Fourteen patients were assessable. The median Hb at study entry was 10.7 g/dL (range, 8.4-12). Serum Hb increased by > or = 1 g/dL in 10 patients (71%; 95% confidence interval, 42%-92%) and 7 patients (50%; 95% confidence interval, 23%-77%) reached an Hb of > or = 12.5 g/dL after treatment with doses that ranged from 300 microg to 1000 microg.
Darbepoetin alfa administration every 4 weeks is feasible and well tolerated. Target Hb increases were achieved in approximately half of the patients and required doses that ranged from 300 microg to 1000 microg.
贫血是晚期前列腺癌的常见并发症,与前列腺癌治疗相关,且与前列腺癌患者较差的总生存期及生活质量下降有关。我们旨在确定较少剂量的阿法达贝泊汀治疗接受前列腺癌全身治疗患者的贫血是否安全有效。
16例经组织学确诊为前列腺癌且伴有骨转移的患者,接受雄激素剥夺治疗,部分患者联合化疗;基线血红蛋白(Hb)≤12 g/dL(修订为≤11 g/dL)。主要终点为基线Hb≥12.5 g/dL的患者比例以及基线Hb升高≥1 g/dL的患者比例。患者最初每4周接受300μg阿法达贝泊汀治疗。若基线Hb未达目标且在前4周内未升高≥1 g/dL,则在每次后续访视时将剂量增加至500μg、800μg和1000μg。治疗计划为期6个月。
治疗耐受性良好,无≥3级毒性反应。14例患者可进行评估。研究入组时的中位Hb为10.7 g/dL(范围8.4 - 12)。10例患者(71%;95%置信区间,42% - 92%)的血清Hb升高≥1 g/dL,7例患者(50%;95%置信区间,23% - 77%)在接受300μg至1000μg剂量治疗后Hb≥12.5 g/dL。
每4周给予阿法达贝泊汀是可行的且耐受性良好。约一半的患者达到了目标Hb升高,所需剂量范围为300μg至1000μg。