Miyake Hideaki, Sugiyama Takayuki, Aki Ryota, Matsushita Yuto, Tamura Keita, Motoyama Daisuke, Ito Toshiki, Otsuka Atsushi
Department of Urology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, 431-3192, Japan.
Med Oncol. 2017 Aug;34(8):141. doi: 10.1007/s12032-017-1005-3. Epub 2017 Jul 17.
The objective of this study was to retrospectively analyze the oncological outcomes of Japanese patients with metastatic castration-resistant prostate cancer (mCRPC) who received cabazitaxel. This study included a total of 63 consecutive Japanese mCRPC patients treated with cabazitaxel following the failure of docetaxel, and assessed the prognostic significance of cabazitaxel therapy in these patients focusing on the association of efficacies between two taxane agents. After treatment with cabazitaxel (median 5 cycles), prostate-specific antigen (PSA) decline was observed in 39 patients (61.9%), including 13 (27.0%) achieving the response defined by PSA decline ≥50%. The median progression-free survival (PFS) and overall survival (OS) periods after the introduction of cabazitaxel were 4.1 and 14.8 months, respectively. The response rate to cabazitaxel was not significantly different between responders and non-responders to prior docetaxel, and there was no significant correlation between the PFSs with docetaxel and cabazitaxel. Furthermore, univariate analyses of several parameters identified the performance status (PS) and clinical symptoms, but not the cycles of docetaxel therapy, total amount of administered docetaxel or objective response to docetaxel therapy, as significant predictors of OS on cabazitaxel therapy, of which only PS was independently associated with OS on multivariate analysis. These findings suggest that oncological outcomes in Japanese mCRPC patients receiving cabazitaxel are generally satisfactory, irrespective of the profiles related to prior treatment with docetaxel, and that it might be preferable to introduce cabazitaxel to mCRPC patients with a good PS to maximize the prognostic benefit of this agent.
本研究的目的是回顾性分析接受卡巴他赛治疗的日本转移性去势抵抗性前列腺癌(mCRPC)患者的肿瘤学结局。本研究共纳入63例连续的日本mCRPC患者,这些患者在多西他赛治疗失败后接受了卡巴他赛治疗,并重点关注两种紫杉烷类药物疗效之间的关联,评估卡巴他赛治疗在这些患者中的预后意义。在接受卡巴他赛治疗(中位5个周期)后,39例患者(61.9%)观察到前列腺特异性抗原(PSA)下降,其中13例(27.0%)达到PSA下降≥50%所定义的缓解。引入卡巴他赛后的中位无进展生存期(PFS)和总生存期(OS)分别为4.1个月和14.8个月。卡巴他赛的缓解率在先前多西他赛治疗的缓解者和非缓解者之间无显著差异,且多西他赛和卡巴他赛的PFS之间无显著相关性。此外,对多个参数的单因素分析确定了体能状态(PS)和临床症状,而非多西他赛治疗周期、多西他赛给药总量或多西他赛治疗的客观缓解,是卡巴他赛治疗OS的显著预测因素,其中只有PS在多因素分析中与OS独立相关。这些发现表明,接受卡巴他赛治疗的日本mCRPC患者的肿瘤学结局总体令人满意,与先前多西他赛治疗的情况无关,并且对于PS良好的mCRPC患者引入卡巴他赛可能更可取,以最大限度地提高该药物的预后益处。