Yasukawa Hitomi, Ikehata Yoshinori, Tsuboi Yasumasa, Nishiyama Naotaka, Watanabe Akihiko, Fujiuchi Yasuyoshi, Kitamura Hiroshi
The Department of Urology, University of Toyama.
Hinyokika Kiyo. 2020 Dec;66(12):427-432. doi: 10.14989/ActaUrolJap_66_12_427.
Abiraterone acetate plus prednisone/prednisolone (AAP) and androgen deprivation therapy (ADT) was approved for the treatment of high-risk metastatic hormone-sensitive prostate cancer (mHSPC) in Japan in 2018. We investigated 22 patients with mHSPC showing ≥2 of 3 high-risk factors (Gleason score ≥8, ≥3 bone lesions or measurable visceral metastases) who received AAP plus ADT at our hospital between March 2018 and October 2019. We compared outcomes between the propensity-score matched AAP plus ADT group and the combined androgen blockade (CAB) group (19 matched pairs, 38 patients) to evaluate the efficacy and safety of AAP plus ADT. Prostate-specific antigen progression-free survival (PSA-PFS) was significantly longer in the AAP group than in the CAB group (not reached vs 15.1 months, p=0.014). Time to achievement of serum PSA ≤0.2 ng/ml and ≤0.1 ng/ml was shorter in the AAP group than in the CAB group (6.4 months vs not reached, p=0.001 and 11.0 months vs not reached, p=0.004, respectively). Although no significant intergroup difference was observed in the overall survival rates and PSA-PFS2 (PSAPFS on subsequent anticancer therapy) owing to the shorter follow-up in the AAP group, our data suggest that the clinical efficacy of AAP is betterthan that of CAB in patients with mHSPC.
醋酸阿比特龙联合泼尼松/泼尼松龙（AAP）及雄激素剥夺疗法（ADT）于2018年在日本被批准用于治疗高危转移性激素敏感性前列腺癌（mHSPC）。我们调查了22例mHSPC患者，这些患者具有3项高危因素中的≥2项（ Gleason评分≥8、≥3处骨转移灶或可测量的内脏转移），于2018年3月至2019年10月在我院接受AAP联合ADT治疗。我们比较了倾向评分匹配的AAP联合ADT组与联合雄激素阻断（CAB）组（19对匹配，38例患者）的结局，以评估AAP联合ADT的疗效和安全性。AAP组的前列腺特异性抗原无进展生存期（PSA-PFS）显著长于CAB组（未达到 vs 15.1个月，p=0.014）。AAP组达到血清PSA≤0.2 ng/ml和≤0.1 ng/ml的时间短于CAB组（分别为6.4个月 vs 未达到，p=0.001和11.0个月 vs 未达到，p=0.004）。尽管由于AAP组随访时间较短，两组在总生存率和PSA-PFS2（后续抗癌治疗时的PSA-PFS）方面未观察到显著差异，但我们的数据表明，AAP对mHSPC患者的临床疗效优于CAB。
