Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Urol Oncol. 2019 Mar;37(3):180.e19-180.e24. doi: 10.1016/j.urolonc.2018.10.020. Epub 2018 Nov 13.
Currently, several therapeutic options for castration-resistant prostate cancer (CRPC) are available, for which predictive biomarkers have not been established. Therefore, we aimed to reveal the association between pretreatment serum testosterone level and antitumor outcomes when treated with androgen receptor axis-targeting agents and taxane chemotherapies for CRPC.
The present study included Japanese patients with metastatic prostate cancer whose serum testosterone levels during androgen-deprivation therapy were available. The antitumor outcomes when treated with enzalutamide, abiraterone, docetaxel, and cabazitaxel with clinicopathological parameters including serum testosterone levels during androgen-deprivation therapy, as well as prognoses including progression-free survival and overall survival, were examined.
Progression-free survival among men with higher serum testosterone level was superior to that among men with lower serum testosterone level when treated with enzalutamide. On the contrary, progression-free survival and overall survival among men with higher serum testosterone level were significantly inferior to those among men with lower serum testosterone level when treated with docetaxel and cabazitaxel, respectively.
The present study indicated distinct prognostic values of serum testosterone level when treated with androgen receptor axis-targeting agent and taxane chemotherapy for CRPC, suggesting that serum testosterone level may be useful predictive biomarker to navigate the appropriate therapy in patients with CRPC.
目前，有几种治疗去势抵抗性前列腺癌（CRPC）的方法，但尚未确定预测生物标志物。因此，我们旨在揭示在接受雄激素受体轴靶向药物和紫杉烷化疗治疗 CRPC 时，治疗前血清睾酮水平与抗肿瘤疗效之间的关联。
本研究纳入了接受雄激素剥夺治疗期间血清睾酮水平可检测的转移性前列腺癌日本患者。评估了接受恩扎卢胺、阿比特龙、多西他赛和卡巴他赛治疗时，与临床病理参数（包括雄激素剥夺治疗期间的血清睾酮水平）以及预后（包括无进展生存期和总生存期）相关的抗肿瘤疗效。
与接受恩扎卢胺治疗的低血清睾酮水平的男性相比，高血清睾酮水平的男性无进展生存期更优。相反，与接受多西他赛和卡巴他赛治疗的低血清睾酮水平的男性相比，高血清睾酮水平的男性无进展生存期和总生存期明显更差。
本研究表明，在接受雄激素受体轴靶向药物和紫杉烷化疗治疗 CRPC 时，血清睾酮水平具有明显的预后价值，提示血清睾酮水平可能是指导 CRPC 患者选择合适治疗方法的有用预测生物标志物。
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