Department of Urology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
Department of Urology, University of the Ryukyus, Graduate School of Medicine, Nishihara, Okinawa, Japan.
PLoS One. 2021 Oct 1;16(10):e0258160. doi: 10.1371/journal.pone.0258160. eCollection 2021.
There was no clear evidence whether the initial dose of enzalutamide affects the incidence of adverse events (AEs), and oncological outcome in patients with castration-resistant prostate cancer (CRPC).
The clinical charts of 233 patients with CRPC treated with enzalutamide were reviewed retrospectively. After 1:3 propensity score matching (PSM), 124 patients were divided into a reduced dose group and a standard dose group, and the prostate specific antigen (PSA) response and the incidence of AEs were compared.
190 patients with CRPC initiated with standard dose enzalutamide were younger and better performance status compared with 43 patients beginning with reduced dose. After PSM, the baseline characteristics were not different between the standard and the reduced dose group. In the PSM cohort, the PSA response rate was significantly lower in the reduced dose group than in the standard dose group (-66.3% and -87.4%, p = 0.02). The incidence rates of AEs were not statistically different between the groups (22.6% and 34.4%, respectively, p = 0.24).
Initiating treatment with a reduced dose of enzalutamide did not significantly decrease the incidence rate of AEs, and it showed poorer PSA response rate. There is no clear rationale for treating with a reduced initial dose of enzalutamide to reduce the incidence of AEs.
目前尚无明确证据表明恩扎卢胺的初始剂量是否会影响去势抵抗性前列腺癌（CRPC）患者不良事件（AE）的发生率和肿瘤学结局。
回顾性分析了 233 例接受恩扎卢胺治疗的 CRPC 患者的临床资料。经过 1:3 倾向评分匹配（PSM）后，将 124 例患者分为低剂量组和标准剂量组，比较前列腺特异抗原（PSA）应答率和 AE 发生率。
与 43 例起始剂量为低剂量的患者相比，190 例起始剂量为标准剂量的 CRPC 患者更年轻，表现状态更好。PSM 后，标准剂量组和低剂量组的基线特征无差异。在 PSM 队列中，低剂量组的 PSA 应答率明显低于标准剂量组（-66.3%和-87.4%，p=0.02）。两组的 AE 发生率无统计学差异（分别为 22.6%和 34.4%，p=0.24）。
起始剂量为低剂量的恩扎卢胺治疗不会显著降低 AE 的发生率，且 PSA 应答率较低。没有明确的理由使用低初始剂量的恩扎卢胺来降低 AE 的发生率。
