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多西他赛每周 3 次联合泼尼松每日治疗转移性去势抵抗性前列腺癌:日本多中心、Ⅱ期、开放标签、非对照、扩展研究。

Prolonged treatment with three-weekly docetaxel plus daily prednisolone for metastatic castration-resistant prostate cancer: a multicenter, phase II, open-label, non-comparative, extension study in Japan.

机构信息

Department of Urology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan.

出版信息

Int J Clin Oncol. 2013 Apr;18(2):306-13. doi: 10.1007/s10147-012-0380-1. Epub 2012 Feb 21.

Abstract

BACKGROUND

There are few reports of long-term treatment with docetaxel in castration-resistant prostate cancer (CRPC) because of the limit of a maximum of ten cycles of treatment in TAX327 showing a survival benefit. Therefore, this study, ARD6563, was conducted to evaluate the safety of more than ten cycles of docetaxel in metastatic CRPC.

METHODS

We enrolled patients who had received ten cycles of docetaxel in the preceding study, ARD6562. For ARD6563, patients received docetaxel every 3 weeks, at the last dose (70, 60, or 50 mg/m(2)) received for cycle 10 in ARD6562, with prednisolone 5 mg orally twice daily.

RESULTS

The safety analysis set comprised 15 patients (median age, 64 years; performance status, 0 in 87%) out of 43 patients treated in ARD6562. The median initial dose of docetaxel was 60 mg/m(2), and the median number of additional cycles administered was 8 (range, 1-42). The relative dose intensity was 78.0% for docetaxel and 98.0% for prednisolone. Dose reduction was needed in 3 cycles because of grade 3 infection, febrile neutropenia, and grade 2 neuropathy. Administration delay was necessitated in 6 cycles because of grade 1-2 nonhematological toxicities. The major grade 3-4 toxicities were myelosuppression. Five patients who had an observed partial response or stable disease in ARD6562 maintained their clinical response in ARD6563. The study treatment was discontinued in 10 patients because of disease progression and in 4 patients for serious toxicities. There were no treatment-related deaths.

CONCLUSIONS

Long-term docetaxel with prednisolone is feasible in selected Japanese patients with CRPC.

摘要

背景

由于 TAX327 研究显示生存获益,限制了治疗最多十个周期,因此在去势抵抗性前列腺癌(CRPC)中很少有长期使用多西他赛的报道。因此,进行这项 ARD6563 研究,旨在评估转移性 CRPC 患者接受超过十个周期多西他赛治疗的安全性。

方法

我们纳入了在前一项研究 ARD6562 中已接受了十个周期多西他赛治疗的患者。在 ARD6563 中,患者每 3 周接受一次多西他赛治疗,剂量为 ARD6562 中第 10 个周期接受的最后一个剂量(70、60 或 50mg/m2),同时口服泼尼松龙 5mg,每日 2 次。

结果

安全性分析集包括 43 例患者中的 15 例(中位年龄 64 岁;体力状况 0 分占 87%)。多西他赛的初始中位剂量为 60mg/m2,额外治疗周期的中位周期数为 8 个(范围为 1-42)。多西他赛的相对剂量强度为 78.0%,泼尼松龙为 98.0%。由于 3 个周期的 3 级感染、发热性中性粒细胞减少症和 2 级周围神经病,需要减少剂量。由于 1-2 级非血液学毒性,需要 6 个周期延迟治疗。主要的 3-4 级毒性为骨髓抑制。在 ARD6562 中观察到部分缓解或疾病稳定的 5 例患者在 ARD6563 中保持了临床缓解。由于疾病进展,10 例患者停止了研究治疗,由于严重毒性,4 例患者停止了研究治疗。无治疗相关死亡。

结论

在选择的日本 CRPC 患者中,多西他赛联合泼尼松龙长期治疗是可行的。

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