Akaza Hideyuki, Procopio Giuseppe, Pripatnanont Choosak, Facchini Gaetano, Fava Sergio, Wheatley Duncan, Leung Kwong Chuen, Butt Mohammad, Silva Alberto, Castillo Liliana, Karavasilis Vasilios, Ӧzatılgan Ayse, Hitier Simon, Ecstein-Fraisse Evelyne B, Ӧzgüroḡlu Mustafa
Hideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey.
J Glob Oncol. 2018 Sep;4:1-12. doi: 10.1200/JGO.18.00009.
There is a major clinical need to devise an optimal treatment sequence for the multiple therapy options available for patients with metastatic castration-resistant prostate cancer (mCRPC). In the absence of prospective clinical trials, sequencing information can be derived from large, real-world registry studies.
PROXIMA (Treatment Patterns in Patients With Metastatic Castration-Resistant Prostate Cancer Previously Treated With Docetaxel-Based Chemotherapy) is a large, global, prospective registry study evaluating real-world treatment patterns of patients with mCRPC who experience disease progression during or after docetaxel therapy. Patients were enrolled worldwide between 2011 and 2014. Treatments were determined by the treating physicians and recorded in categories of chemotherapy, hormonal therapy, targeted therapy, immunotherapy, and palliative therapy. Treatment sequencing patterns, response to treatment, and types of progression were recorded and analyzed. Progression-free survival and overall survival with different treatment modalities were analyzed using Kaplan-Meier method.
Treatment patterns were evaluated in 903 patients. Therapy selection was influenced by region. Hormonal therapy (57.5%) and taxane chemotherapy (26.4%) were the most frequently administered first subsequent treatments after docetaxel. Tumor responses to first subsequent treatment were observed in 22.6% of evaluable patients. Overall survival and progression-free survival did not differ significantly across different treatment modalities.
Identifying an optimal treatment sequence is vital for improving the care of patients with mCRPC. The PROXIMA registry provided a representative sample of global data on real-world treatment patterns for patients with mCRPC previously treated with docetaxel. These data can be used to devise optimal therapy sequences and inform treatment decisions.
为转移性去势抵抗性前列腺癌（mCRPC）患者现有的多种治疗方案设计最佳治疗顺序存在重大临床需求。在缺乏前瞻性临床试验的情况下，治疗顺序信息可从大型真实世界注册研究中获取。
PROXIMA（既往接受多西他赛化疗的转移性去势抵抗性前列腺癌患者的治疗模式）是一项大型、全球性、前瞻性注册研究，评估多西他赛治疗期间或之后疾病进展的mCRPC患者的真实世界治疗模式。2011年至2014年期间在全球招募患者。治疗由主治医生确定，并记录在化疗、激素治疗、靶向治疗、免疫治疗和姑息治疗类别中。记录并分析治疗顺序模式、治疗反应和进展类型。使用Kaplan-Meier方法分析不同治疗方式的无进展生存期和总生存期。
对903例患者的治疗模式进行了评估。治疗选择受地区影响。激素治疗（57.5%）和紫杉烷化疗（26.4%）是多西他赛后最常给予的首次后续治疗。在22.6%的可评估患者中观察到对首次后续治疗的肿瘤反应。不同治疗方式的总生存期和无进展生存期无显著差异。
确定最佳治疗顺序对于改善mCRPC患者的护理至关重要。PROXIMA注册研究提供了既往接受多西他赛治疗的mCRPC患者真实世界治疗模式的全球数据代表性样本。这些数据可用于设计最佳治疗顺序并为治疗决策提供参考。
