Gómez-Veiga F, Alcaraz-Asensio A, Burgos-Revilla J, Cózar-Olmo J
Servicio de Urología, Hospital Universitario de Salamanca, Grupo de Investigación Traslacional de Urología GITUR, Instituto de Investigación Biomédica de Salamanca IBSAL, Salamanca, España.
Servicio de Urología, Hospital Clínic Universitari, Barcelona, España.
Actas Urol Esp (Engl Ed). 2018 Oct;42(8):488-498. doi: 10.1016/j.acuro.2018.06.001. Epub 2018 Jun 21.
To put forth new findings of urologic oncology with impact on clinical practice presented during 2017 in the main annual meetings.
This document reviews abstracts on prostate, kidney and bladder cancer presented at the congresses of 2016 (EAU, AUA, ASCO, ESMO and ASTRO) and publications with the highest impact in this period valued with the highest scores by the OncoForum committee.
Among patients at high risk of recurrent renal cell carcinoma after nephrectomy, adjuvant sunitinib compared to placebo showed a benefit in patients at higher risk of recurrence. In cisplatin-ineligible advanced urothelial cancer, pembrolizumab elicits clinically meaningful, durable responses. Among patients with localized prostate cancer, treatment for disease progression was less frequent (absolute difference, 26.2 percentage pontis) and adverse events was more frequent with surgery than with observation. Among patients with locally advanced or merastatic prostate cancer, androgen-deprivation therapy plus abiraterone and prednisolone resulted in fewer deaths and fewer treatment-failure events (P<.001). Among patients with metastatic castration-resistant prostate cancer previously treated with abiraterone acetate, enzalutamide median radiographic progression free survival was 8,1 months and enzalutamide median overall survival was not reached.
Among patients at high risk of recurrent renal cell carcinoma after nephrectomy, adjuvant sunitinib showed a benefit across subgroups including patients at higher risk of recurrence. Among patients with localized prostate cancer, surgery was not associated with significantly lower all-cause or porstate-cancer mortality than observation. Among patients with locally advanced or merastatic prostate cancer, androgen-deprivation therapy plus abiraterone and prednisolone was associated with significantly higher rates of overall and failure-free survival than androgen-deprivation therapy alone. In patients with metastatic castration-resistant prostate cancer previously treated with abiraterone enzalutamide remained active.
提出2017年主要年会期间展示的对临床实践有影响的泌尿肿瘤学新发现。
本文回顾了2016年大会(欧洲泌尿外科学会、美国泌尿外科学会、美国临床肿瘤学会、欧洲肿瘤内科学会和美国放射肿瘤学会)上发表的关于前列腺癌、肾癌和膀胱癌的摘要,以及在此期间OncoForum委员会评分最高、影响最大的出版物。
在肾切除术后复发风险高的肾细胞癌患者中,与安慰剂相比,辅助使用舒尼替尼对复发风险较高的患者有益。在不符合顺铂治疗条件的晚期尿路上皮癌中,帕博利珠单抗可引发具有临床意义的持久反应。在局限性前列腺癌患者中,疾病进展治疗的频率较低(绝对差异为26.2个百分点),手术的不良事件比观察更为频繁。在局部晚期或转移性前列腺癌患者中,雄激素剥夺疗法联合阿比特龙和泼尼松龙导致死亡人数和治疗失败事件减少(P<0.001)。在先前接受醋酸阿比特龙治疗的转移性去势抵抗性前列腺癌患者中,恩杂鲁胺的中位影像学无进展生存期为8.1个月,恩杂鲁胺的中位总生存期未达到。
在肾切除术后复发风险高的肾细胞癌患者中,辅助使用舒尼替尼在包括复发风险较高的患者在内的亚组中显示出益处。在局限性前列腺癌患者中,手术与全因死亡率或前列腺癌死亡率显著低于观察相比无关。在局部晚期或转移性前列腺癌患者中,雄激素剥夺疗法联合阿比特龙和泼尼松龙与单独使用雄激素剥夺疗法相比,总生存率和无失败生存率显著更高。在先前接受阿比特龙治疗的转移性去势抵抗性前列腺癌患者中,恩杂鲁胺仍然有效。