Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan.
Department of Urology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
Med Oncol. 2019 Feb 28;36(4):32. doi: 10.1007/s12032-019-1257-1.
This multi-institutional study aimed to investigate the efficacy and safety profiles of cabazitaxel after prior docetaxel chemotherapy in patients with castration-resistant prostate cancer (CRPC). This study included 63 Japanese patients with CRPC who were treated with cabazitaxel from 2014 to 2017. The oncological outcomes and adverse events (AEs) were documented, and prognostic factors for oncological outcomes and predictive factors for AEs were analysed. PSA decline was observed in 68.3% of patients, including 25.4% who achieved a ≥ 50% decline. The median progression-free survival, treatment failure-free survival, and overall survival were 4.3, 4.1, and 9.0 months, respectively. More cycles of prior docetaxel therapy was identified as common favourable prognostic factors for progression-free survival, treatment failure-free survival, and overall survival. Severe neutropenia, febrile neutropenia, and severe non-haematological AEs were observed in 73.0%, 33.3%, and 23.8% of patients, respectively. However, > 10 cycles of docetaxel was not associated with increased incidence of AEs. In conclusion, cabazitaxel chemotherapy was still active in Japanese CRPC patients treated with > 10 cycles of docetaxel chemotherapy, with an acceptable risk of AE burden. Treatment with cabazitaxel after > 10 cycles of docetaxel may be an appropriate option when it can be administered.
这项多机构研究旨在探讨卡巴他赛在多西他赛化疗后的疗效和安全性,纳入了 63 例 2014 至 2017 年接受卡巴他赛治疗的日本去势抵抗性前列腺癌(CRPC)患者。记录了肿瘤学结局和不良事件(AE),并分析了肿瘤学结局的预后因素和 AE 的预测因素。68.3%的患者出现 PSA 下降,其中 25.4%患者下降≥50%。中位无进展生存期、治疗失败无进展生存期和总生存期分别为 4.3、4.1 和 9.0 个月。更多周期的多西他赛治疗是无进展生存期、治疗失败无进展生存期和总生存期的共同有利预后因素。73.0%、33.3%和 23.8%的患者分别发生严重中性粒细胞减少、发热性中性粒细胞减少和严重非血液学 AE。然而,多西他赛>10 个周期与 AE 发生率增加无关。总之,卡巴他赛化疗在接受多西他赛>10 个周期治疗的日本 CRPC 患者中仍然有效,AE 负担可接受。当可以使用时,多西他赛>10 个周期后使用卡巴他赛可能是一种合适的选择。