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接受卡巴他赛治疗的去势抵抗性前列腺癌患者的风险分层

Risk stratification of castration-resistant prostate cancer patients treated with cabazitaxel.

作者信息

Kosaka Takeo, Hongo Hiroshi, Mizuno Ryuichi, Oya Mototsugu

机构信息

Department of Urology, Keio University School of Medicine, Tokyo 160-8582, Japan.

出版信息

Mol Clin Oncol. 2018 Dec;9(6):683-688. doi: 10.3892/mco.2018.1724. Epub 2018 Sep 19.

Abstract

Patient characteristics before administering the first cycle of cabazitaxel for metastatic castration-resistant prostate cancer (mCRPC) were collected to assess prognostic factors for overall survival (OS). Multivariate analysis revealed that prostate-specific antigen (PSA) ≥100 ng/ml prior to cabazitaxel treatment, visceral metastasis, and low absolute monocyte count were independent prognostic indicators for OS. The aim of the present study was to investigate prognostic biomarkers in patients treated with cabazitaxel among Japanese metastatic castration-resistant prostate cancer (mCRPC) patients. In this retrospective study, 45 patients with mCRPC treated with cabazitaxel were reviewed retrospectively. Clinicopathological factors and laboratory data before administering the first cycle of cabazitaxel were collected to assess the prognostic factors for overall survival (OS). Treatment was generally well tolerated, with a median of 5 cycles (range, 1-26). Median OS from the start of cabazitaxel treatment was 16.1 months (95% confidence interval 6.8-25.5). Univariate analysis revealed that poor performance status, visceral metastasis, hemoglobin <11 mg/dl, absolute monocyte count <400/µl, and prostate-specific antigen ≥100 ng/ml prior to cabazitaxel treatment (P=0.002) were significantly associated with shorter OS. Multivariate analysis revealed that PSA ≥100 ng/ml prior to cabazitaxel treatment, visceral metastasis, and absolute monocyte count <400/µl were independent prognostic indicators for OS. Based on the relative risk of death, patients with mCRPC before cabazitaxel therapy were divided into three risk groups: Low, intermediate, and high (P<0.001). In conclusion, the practical implications of our results may assist in tailoring the introduction of cabazitaxel.

摘要

收集转移性去势抵抗性前列腺癌(mCRPC)患者在接受第一周期卡巴他赛治疗前的患者特征,以评估总生存期(OS)的预后因素。多变量分析显示,卡巴他赛治疗前前列腺特异性抗原(PSA)≥100 ng/ml、内脏转移和绝对单核细胞计数低是OS的独立预后指标。本研究的目的是调查日本转移性去势抵抗性前列腺癌(mCRPC)患者中接受卡巴他赛治疗患者的预后生物标志物。在这项回顾性研究中,对45例接受卡巴他赛治疗的mCRPC患者进行了回顾性分析。收集卡巴他赛第一周期治疗前的临床病理因素和实验室数据,以评估总生存期(OS)的预后因素。治疗总体耐受性良好,中位周期数为5个周期(范围1 - 26)。从卡巴他赛治疗开始的中位OS为16.1个月(95%置信区间6.8 - 25.5)。单变量分析显示,体能状态差、内脏转移、血红蛋白<11 mg/dl、绝对单核细胞计数<400/µl以及卡巴他赛治疗前前列腺特异性抗原≥100 ng/ml(P = 0.002)与较短的OS显著相关。多变量分析显示,卡巴他赛治疗前PSA≥100 ng/ml、内脏转移和绝对单核细胞计数<400/µl是OS的独立预后指标。根据死亡相对风险,卡巴他赛治疗前的mCRPC患者分为三个风险组:低、中、高(P<0.001)。总之,我们结果的实际意义可能有助于调整卡巴他赛的引入。

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