Miyazawa Yoshiyuki, Sekine Yoshitaka, Arai Seiji, Nakamura Toshiyuki, Takezawa Yutaka, Shimizu Nobuaki, Matsuo Yasushige, Ogura Haruyuki, Takei Tomoyuki, Suzuki Kazuhiro
Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan.
Tatebayashi Kosei Hospital, Tatebayashi, Japan.
Eur Urol Open Sci. 2021 Jun 7;29:59-67. doi: 10.1016/j.euros.2021.05.003. eCollection 2021 Jul.
Enzalutamide (ENZ) is used to treat patients with castration-resistant prostate cancer (CRPC). However, the kinetics of serum androgens before and after ENZ treatment are unknown.
To elucidate the kinetics of serum androgens and explore the possibility of identifying a useful marker for predicting the effects of ENZ.
We conducted a prospective study from 2014 to 2018 at Gunma University Hospital and related facilities. Data were analyzed for 104 patients with CRPC treated with ENZ.
We measured serum androgen levels using liquid chromatography-tandem mass spectrometry. Relationships with outcomes were assessed using multivariable Cox regression and log-rank analyses.
The median age of the patients was 73 yr. Median serum testosterone, dihydrotestosterone (DHT), androstenedione, and dehydroepiandrosterone sulfate levels were 49.0, 5.8, 222.2, and 326.3 pg/ml, respectively. We performed multivariate analysis using Cox regression to predict prostate-specific antigen progression-free survival (PSA-PFS) and overall survival (OS). Hemoglobin level (≥12.5 vs <12.5 g/dl), docetaxel treatment history (no vs yes), and DHT level (≥5.9 vs <5.9 pg/ml) were significant predictors of PSA-PFS ( < 0.05). Eastern Cooperative Oncology Group performance status (0 vs. 1-2), hemoglobin level (≥12.5 vs <12.5 g/dl), presence of visceral metastasis (no vs yes), amount of bone metastasis (extent of disease 0-2 vs 3-4), and docetaxel treatment history (no vs yes) were significant predictors of OS ( < 0.05). Binomial logistic analysis of the predictors of any grade of anorexia, malaise, and fatigue showed that the presence of visceral metastasis and a low DHT level (<5.9 pg/ml) were significant.
Our results suggest that serum androgen levels before ENZ treatment may be useful for predicting efficacy, prognosis, and the incidence of adverse events.
We measured blood levels of testosterone and other male hormones before treatment with enzalutamide among men with prostate cancer resistant to castration. We found that the levels of these hormones may be useful for predicting the efficacy of enzalutamide treatment, prognosis, and the occurrence of adverse side effects.
恩杂鲁胺（ENZ）用于治疗去势抵抗性前列腺癌（CRPC）患者。然而，ENZ治疗前后血清雄激素的动力学尚不清楚。
阐明血清雄激素的动力学，并探索识别预测ENZ疗效有用标志物的可能性。
设计、设置和参与者：我们于2014年至2018年在群马大学医院及相关机构进行了一项前瞻性研究。对104例接受ENZ治疗的CRPC患者的数据进行了分析。
我们使用液相色谱-串联质谱法测量血清雄激素水平。使用多变量Cox回归和对数秩分析评估与结局的关系。
患者的中位年龄为73岁。血清睾酮、双氢睾酮（DHT）、雄烯二酮和硫酸脱氢表雄酮水平的中位数分别为49.0、5.8、222.2和326.3 pg/ml。我们使用Cox回归进行多变量分析以预测前列腺特异性抗原无进展生存期（PSA-PFS）和总生存期（OS）。血红蛋白水平（≥12.5 vs <12.5 g/dl）、多西他赛治疗史（无 vs 有）和DHT水平（≥5.9 vs <5.9 pg/ml）是PSA-PFS的显著预测因素（<0.05）。东部肿瘤协作组体能状态（0 vs. 1-2）、血红蛋白水平（≥12.5 vs <12.5 g/dl）、内脏转移的存在（无 vs 有）、骨转移量（疾病范围0-2 vs 3-4）和多西他赛治疗史（无 vs 有）是OS的显著预测因素（<0.05）。对任何级别的厌食、不适和疲劳的预测因素进行二项逻辑分析表明，内脏转移的存在和低DHT水平（<5.9 pg/ml）具有显著性。
我们的结果表明，ENZ治疗前的血清雄激素水平可能有助于预测疗效、预后和不良事件的发生率。
我们在去势抵抗性前列腺癌男性患者中测量了恩杂鲁胺治疗前血液中的睾酮和其他男性激素水平。我们发现这些激素水平可能有助于预测恩杂鲁胺治疗的疗效、预后和不良副作用的发生。
