Miyake Hideaki, Matsushita Yuto, Watanabe Hiromitsu, Tamura Keita, Suzuki Takahisa, Motoyama Daisuke, Ito Toshiki, Sugiyama Takayuki, Otsuka Atsushi
Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan
Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Anticancer Res. 2018 Jul;38(7):4179-4185. doi: 10.21873/anticanres.12711.
BACKGROUND/AIM: To date, there have not been any established biomarkers predicting the efficacy of cabazitaxel in patients with metastatic castration-resistant prostate cancer (mCRPC). The objective of this study was to evaluate the significance of the aspartate aminotransaminase (AST)/alanine aminotransaminase (ALT) ratio (De Ritis ratio) as a biomarker for mCRPC patients receiving cabazitaxel.
This study included 74 consecutive docetaxel-refractory mCRPC patients treated with cabazitaxel. It assessed the impact of the pretreatment De Ritis ratio, in addition to conventional clinicopathological parameters, on the oncological outcomes in these patients.
After treatment with cabazitaxel, 22 (29.7%) of the 74 patients achieved a prostate-specific antigen (PSA) response; however, there was no significant difference in the PSA response rate between patients with a low De Ritis ratio (<1.35) and those with a high ratio (≥1.35). In this series, the median periods of PSA progression-free survival (PFS) and overall survival (OS) after the introduction of cabazitaxel were 4.2 and 14.7 months, respectively. No significant difference was noted in PSA PFS between the low and high De Ritis ratio groups, whereas OS in the high De Ritis ratio group was significantly poorer compared with that in the low De Ritis ratio group. Univariate analysis showed the significant impact of the De Ritis ratio on OS, but not PFS, in these 74 patients. Furthermore, the De Ritis ratio, in addition to the performance status and lactate dehydrogenase level, was shown to be independently associated with OS on multivariate analysis.
Assessment of the De Ritis ratio may provide useful prognostic, but not predictive, information on cabazitaxel therapy in mCRPC patients.
背景/目的：迄今为止，尚无已确立的生物标志物可预测卡巴他赛对转移性去势抵抗性前列腺癌（mCRPC）患者的疗效。本研究的目的是评估天冬氨酸转氨酶（AST）/丙氨酸转氨酶（ALT）比值（德瑞蒂斯比值）作为接受卡巴他赛治疗的mCRPC患者生物标志物的意义。
本研究纳入了74例连续接受卡巴他赛治疗的多西他赛难治性mCRPC患者。除了传统的临床病理参数外，还评估了治疗前德瑞蒂斯比值对这些患者肿瘤学结局的影响。
接受卡巴他赛治疗后，74例患者中有22例（29.7%）实现了前列腺特异性抗原（PSA）应答；然而，德瑞蒂斯比值低（<1.35）的患者与比值高（≥1.35）的患者之间的PSA应答率无显著差异。在本系列中，开始使用卡巴他赛治疗后，PSA无进展生存期（PFS）和总生存期（OS）的中位数分别为4.2个月和14.7个月。德瑞蒂斯比值低和高的两组之间在PSA PFS方面未观察到显著差异，而德瑞蒂斯比值高的组的OS明显低于德瑞蒂斯比值低的组。单因素分析显示，在这74例患者中，德瑞蒂斯比值对OS有显著影响，但对PFS无显著影响。此外，多因素分析显示，除了体能状态和乳酸脱氢酶水平外，德瑞蒂斯比值与OS独立相关。
评估德瑞蒂斯比值可能为mCRPC患者的卡巴他赛治疗提供有用的预后信息，但不是预测信息。
