The James Buchanan Brady Urologic Institute and Department of Urology, the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
Department of Pharmacology and Molecular Sciences, the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
Med Oncol. 2021 Jun 5;38(7):80. doi: 10.1007/s12032-021-01506-w.
The aim of the study was to evaluate the feasibility of utilizing peripheral androgen blockade in men with biochemical recurrent castrate-sensitive prostate cancer. A registration study to track outcomes of men with biochemical recurrent castrate-sensitive prostate cancer treated with peripheral androgen blockade utilizing concomitant administration of finasteride and bicalutamide. Men were on intermittent peripheral blockade for a median 20.2 months, continuous peripheral blockade for a median 6.8 months, intermittent triple dose peripheral androgen blockade for a median 10.7 months, and continuous triple dose peripheral androgen blockade for 4.4 months before failing therapy. Six men (21%) had additional therapies during treatment that included metastasis-directed therapy (5/37, 14%), systemic Lu-177 (2/37, 5%), and salvage RT (1/37, 3%). The median time to progression, which includes time from initiation through all therapies to the initiation of ADT, was 37.6 months (IQR 20-74.7). From the start of PAB, median time to castrate resistance was 49.8 months (IQR 40.9-NR). After starting ADT, median time to castrate resistance was 8.8 months (IQR 4.6-17.7). Our data support the exploration of PAB as a treatment option in carefully selected patients who present with biochemical recurrence after failure of definitive local therapy for prostate cancer.
本研究旨在评估在外周雄激素阻断治疗在生化复发性去势敏感性前列腺癌男性患者中的应用的可行性。这是一项注册研究，旨在跟踪接受非那雄胺和比卡鲁胺联合治疗的生化复发性去势敏感性前列腺癌患者的结局。患者接受间歇性外周阻断治疗中位数为 20.2 个月，连续性外周阻断治疗中位数为 6.8 个月，间歇性三倍剂量外周雄激素阻断治疗中位数为 10.7 个月，连续三倍剂量外周雄激素阻断治疗中位数为 4.4 个月后治疗失败。在治疗期间，有 6 名患者（21%）接受了额外治疗，包括转移导向治疗（5/37，14%）、全身 Lu-177（2/37，5%）和挽救性放疗（1/37，3%）。从开始 PAB 到进展的中位时间，包括从开始所有治疗到开始 ADT 的时间，为 37.6 个月（IQR 20-74.7）。从开始 PAB 到去势抵抗的中位时间为 49.8 个月（IQR 40.9-NR）。开始 ADT 后，去势抵抗的中位时间为 8.8 个月（IQR 4.6-17.7）。我们的数据支持在外周雄激素阻断治疗作为一种治疗选择，在经过局部根治性治疗后出现生化复发的精心选择的患者中进行探索。
