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多中心随机 II 期研究比较多西他赛联合姜黄素与多西他赛联合安慰剂一线治疗转移性去势抵抗性前列腺癌。

Multicenter randomized phase II study comparing docetaxel plus curcumin versus docetaxel plus placebo in first-line treatment of metastatic castration-resistant prostate cancer.

机构信息

Centre Jean Perrin, Clermont-Ferrand, France.

Université Clermont Auvergne, Centre Jean Perrin INSERM U1240, Imagerie Moléculaire et Stratégies Théranostiques, Clermont-Ferrand, France.

出版信息

Cancer Med. 2021 Apr;10(7):2332-2340. doi: 10.1002/cam4.3806. Epub 2021 Mar 5.

Abstract

BACKGROUND

Metastatic castration-resistant prostate cancer (mCRPC) patients have a poor prognosis, and curcumin is known to have antineoplastic properties. On the basis of previous phase I and phase II studies, we investigated whether the association of curcumin with docetaxel could improve prognosis among mCRPC patients.

METHODS

A total of 50 mCRPC patients (included from June 2014 to July 2016) treated with docetaxel in association with oral curcumin (6 g/d for 7 days every 3 weeks) versus placebo were included in this double-blind, randomized, phase II study. The primary endpoint was to evaluate the time to progression. Among the secondary endpoints, compliance, overall survival, prostate-specific antigen (PSA) response, safety, curcumin absorption, and quality of life were investigated. An interim analysis was planned in the modified intention-to-treat population with data at 6 months (22 patients per arm).

RESULTS

Despite good compliance and a verified absorption of curcumin, no difference was shown for our primary endpoint: progression-free survival (PFS) between the placebo and curcumin groups was, respectively, 5.3 months versus 3.7 months, p = 0.75. Similarly, no difference was observed for the secondary objectives: PSA response rate (p = 0.88), overall survival (p = 0.50), and quality of life (p = 0.49 and p = 0.47).

CONCLUSION

Even though our previous studies and data in the literature seemed to support an association between curcumin and cancer therapies in order to improve patient outcome and prognosis, the results from this interim analysis clearly showed that adding curcumin to mCRPC patients' treatment strategies was not efficacious. The study was discontinued on the grounds of futility.

摘要

背景

转移性去势抵抗性前列腺癌(mCRPC)患者预后较差,姜黄素具有抗肿瘤特性。基于之前的 I 期和 II 期研究,我们研究了姜黄素与多西他赛联合应用是否能改善 mCRPC 患者的预后。

方法

本双盲、随机、II 期研究共纳入 50 例 mCRPC 患者(纳入时间为 2014 年 6 月至 2016 年 7 月),接受多西他赛联合口服姜黄素(6g/d,每 3 周连用 7 天)或安慰剂治疗。主要终点为无进展生存期。次要终点包括依从性、总生存期、前列腺特异性抗原(PSA)反应、安全性、姜黄素吸收和生活质量。在改良意向治疗人群中进行了中期分析,数据截止时间为 6 个月(每组 22 例患者)。

结果

尽管姜黄素的依从性良好且吸收得到验证,但我们的主要终点——无进展生存期(PFS)在安慰剂组和姜黄素组之间没有差异:分别为 5.3 个月和 3.7 个月,p=0.75。同样,次要终点也没有差异:PSA 反应率(p=0.88)、总生存期(p=0.50)和生活质量(p=0.49 和 p=0.47)。

结论

尽管我们之前的研究和文献中的数据似乎支持姜黄素与癌症治疗联合应用以改善患者结局和预后,但中期分析结果清楚地表明,在 mCRPC 患者的治疗策略中添加姜黄素并不有效。该研究因无效而终止。

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