Medical Oncology Division and Breast Unit, Sen. Antonio Perrino Hospital, S.S. 7, 72100, Brindisi, Italy.
Department of Oncology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
Med Oncol. 2019 Aug 9;36(9):80. doi: 10.1007/s12032-019-1304-y.
The aim of our study is to investigate the efficacy of metronomic cyclophosphamide plus low dose of corticosteroids in advanced or metastatic castration-resistant prostate cancer (CRPC) before, between, and after standard chemotherapy, such as docetaxel and cabazitaxel, and new hormonal treatments, such as abiraterone and enzalutamide. A retrospective analysis was performed on 37 patients. Cyclophosphamide was given orally 50 mg per day together with low dose of corticosteroids, namely dexametasone orally 1 mg per day or prednisone 10 mg per day. Seventeen patients (51%) showed a PSA decline≥ 50%. Median progression-free survival (PFS) and overall survival (OS) were 11 and 28 months, respectively. Median PFS and OS in the subgroup of patients with a PSA decline ≥ 50% were 14 and 35 months, respectively. Treatment was very well tolerated. We suggest that oral metronomic cyclophosphamide plus low dose of oral dexamethasone or prednisone may be a good and safe therapeutic option not only in those CRPC patients unfit for standard treatments but also in those heavily pre-treated patients.
我们的研究目的是调查在标准化疗（如多西他赛和卡巴他赛）和新的激素治疗（如阿比特龙和恩杂鲁胺）之前、期间和之后，采用低剂量皮质类固醇的节拍式环磷酰胺在晚期或转移性去势抵抗性前列腺癌（CRPC）中的疗效。对 37 例患者进行了回顾性分析。环磷酰胺每天口服 50mg，同时给予低剂量皮质类固醇，即每天口服地塞米松 1mg 或泼尼松 10mg。17 例患者（51%）出现 PSA 下降≥50%。中位无进展生存期（PFS）和总生存期（OS）分别为 11 个月和 28 个月。PSA 下降≥50%的患者亚组的中位 PFS 和 OS 分别为 14 个月和 35 个月。治疗耐受性良好。我们建议口服节拍式环磷酰胺联合低剂量口服地塞米松或泼尼松不仅可作为不适合标准治疗的 CRPC 患者的良好且安全的治疗选择，也可作为那些经大量预处理的患者的治疗选择。
