Procopio Giuseppe, Grassi Paolo, Testa Isabella, Verzoni Elena, Torri Valter, Salvioni Roberto, Valdagni Riccardo, de Braud Filippo
Departments of *Medical Oncology ‡Urology §Prostate Programme, Fondazione IRCCS Istituto Nazionale dei Tumori †Mario Negri Institute for Pharmacological Research, Milan, Italy.
Am J Clin Oncol. 2015 Oct;38(5):479-82. doi: 10.1097/COC.0b013e3182a790ce.
The aim of this study was to evaluate the safety profile of abiraterone acetate (AA) in metastatic castration-resistant prostate cancer (mCRPC) men with cardiovascular comorbidity, as little conclusive safety data are available in this patient subset.
A retrospective analysis of mCRPC patients with controlled cardiovascular comorbidities, receiving AA 1000 mg administered orally once daily and prednisone 5 mg twice daily, between April 2011 and July 2012, was performed. All clinical and instrumental variables and toxicity data were analyzed by descriptive statistics: mean, standard deviation, minimum and maximum values for continuous variables, and absolute and relative frequencies for categorical variables.
A total of 51 mCRPC patients were evaluated. Metastatic sites included the bone (74%), lungs, and liver (26%). All patients were previously treated with at least 2 lines of hormone and 1 docetaxel-based chemotherapy. Preexisting cardiac risk factors included hypertension (41%), cardiac ischemia (12%), arrhythmias (6%), dislipidemia (18%), and hyperglycemia (30%). No grade 3-4 adverse events were observed. Grade 1-2 adverse events included fluid retention (18%), asthenia (15%), and hypertension (16%). Median progression-free survival was 5.1 months (95% confidence interval, 0.5-12). Prostate specific antigen assessment revealed a good overall disease control rate (64%).
AA appears to be safe and well tolerated even in patients with cardiovascular comorbidities or with increased risk factors for cardiovascular diseases.
本研究旨在评估醋酸阿比特龙(AA)在合并心血管疾病的转移性去势抵抗性前列腺癌(mCRPC)男性患者中的安全性,因为该患者亚组中确凿的安全性数据较少。
对2011年4月至2012年7月期间接受每日一次口服1000 mg AA和每日两次5 mg泼尼松治疗、心血管合并症得到控制的mCRPC患者进行回顾性分析。所有临床和仪器变量以及毒性数据通过描述性统计进行分析:连续变量的均值、标准差、最小值和最大值,分类变量的绝对和相对频率。
共评估了51例mCRPC患者。转移部位包括骨骼(74%)、肺和肝脏(26%)。所有患者之前均接受过至少2线激素治疗和1次基于多西他赛的化疗。既往存在的心脏危险因素包括高血压(41%)、心脏缺血(12%)、心律失常(6%)、血脂异常(18%)和高血糖(30%)。未观察到3 - 4级不良事件。1 - 2级不良事件包括液体潴留(18%)、乏力(15%)和高血压(16%)。中位无进展生存期为5.1个月(95%置信区间,0.5 - 12)。前列腺特异性抗原评估显示总体疾病控制率良好(64%)。
即使在合并心血管疾病或心血管疾病风险因素增加的患者中,AA似乎也是安全且耐受性良好的。