Igarashi Atsushi, Fukagai Takashi, Morita Masashi, Hayashi Keiichiro, Koshikiya Atsushi, Ogawa Yoshio, Fuji Kohzo, Naoe Michio, Morita Jun, Oshinomi Kazuhiko, Nakazato Takehiko, Ogawa Yu, Matsui Yuki, Shimada Makoto, Inoue Katsuki, Saito Katsuyuki, Ogawa Yuichiro, Matsumoto Yuki, Sasaki Haruaki, Ota Michiya, Yamamoto Kenro, Shimoyama Hideaki, Imamura Yuichiro, Yamagishi Motoki, Tanifuji Satoru, Ishihara Masahiro, Shichijyo Takeshi, Sato Naoya, Omori Kei, Matsubara Eiji
Department of Urology, Showa University Koto Toyosu Hospital.
Department of Urology, Showa University School of Medicine.
Nihon Hinyokika Gakkai Zasshi. 2016;107(3):155-161. doi: 10.5980/jpnjurol.107.155.
(Objective) Enzalutamide is an oral androgen-receptor inhibitor that prolongs survival in men with castration-resistant prostate cancer (CRPC). We retrospectively evaluated clinical efficacy and safety of enzalutamide in CRPC. (Patients and methods) We reviewed clinical records of 73 patients who had received enzalutamide for the CRPC at Showa University and affiliated 7 hospitals. Enzalutamide was given at a dose of 160 mg/day, but some patients were treated at lower dose because of there age or poor performance status. Prostrate-specific antigen (PSA) response, prior docetaxel use and the previously administered agents were evaluated retrospectively. (Results) The median patients age was 77 years, the median Gleason score was 9 and the median PSA level at baseline was 26.9 ng/ml. The patients who had prior docetaxel use were 29 (39.7%) and the median of total docetaxel dose was 460 mg/body. The median number of total prior treatments (anti-androgens, Estramustine and steroid) was 3. Twenty seven (61.4%) patients with docetaxel-naïve achieved over 50% reduction of PSA level from baseline, but only 7 (24.1%) in patients previously treated with docetaxel. The most common adverse events included fatigue (24.7%), anorexia (24.7%) and the nausea (16.4%). We found a small proportion of responders to enzalutamide experienced a PSA flare. (Conclusion) Our results of the use of Enzaltamide for CRPC were similar with previous reports. PSA flare was found in some patients with CRPC who responded to enzaltamide. It should be noted that this possible PSA flare phenomenon.
（目的）恩杂鲁胺是一种口服雄激素受体抑制剂，可延长去势抵抗性前列腺癌（CRPC）男性患者的生存期。我们回顾性评估了恩杂鲁胺在CRPC中的临床疗效和安全性。（患者和方法）我们回顾了昭和大学及其附属7家医院中73例接受恩杂鲁胺治疗CRPC的患者的临床记录。恩杂鲁胺的给药剂量为160mg/天，但一些患者由于年龄或身体状况不佳而接受较低剂量治疗。回顾性评估前列腺特异性抗原（PSA）反应、既往多西他赛使用情况和先前使用的药物。（结果）患者的中位年龄为77岁，中位Gleason评分为9分，基线时的中位PSA水平为26.9ng/ml。既往使用多西他赛的患者有29例（39.7%），多西他赛总剂量的中位数为460mg/人。既往治疗（抗雄激素、雌莫司汀和类固醇）的总次数中位数为3次。27例（61.4%）未使用多西他赛的患者PSA水平较基线降低超过50%，但先前接受多西他赛治疗的患者中只有7例（24.1%）。最常见的不良事件包括疲劳（24.7%）、厌食（24.7%）和恶心（16.4%）。我们发现一小部分对恩杂鲁胺有反应的患者出现了PSA波动。（结论）我们使用恩杂鲁胺治疗CRPC的结果与先前报道相似。在一些对恩杂鲁胺有反应的CRPC患者中发现了PSA波动。应注意这种可能的PSA波动现象。
