Myint Zin W, Allison Derek B, Ellis Carleton S
Department of Internal Medicine, Division of Medical Oncology, University of Kentucky, Lexington, KY, United States.
Markey Cancer Center, University of Kentucky, Lexington, KY, United States.
Front Oncol. 2021 Sep 23;11:731002. doi: 10.3389/fonc.2021.731002. eCollection 2021.
The treatment landscape of metastatic castration-resistant prostate cancer (mCRPC) has dramatically improved over the last decade; however, patients with visceral metastases are still faced with poor outcomes. Phosphatase and tensin homolog () loss is observed in 40%-60% of mCRPC patients and is also associated with a poor prognosis. Several PI3K/AKT/mTOR pathway inhibitors have been studied, with disappointing anti-tumor activity. Here, we present a case of a patient with heavily treated mCRPC who had a modest tumor response to concurrent carboplatin, abiraterone acetate/prednisone, and liver-directed radiation therapy. We discuss the potential rationale supporting the use of this combination therapy and its safety in mCRPC. While the underlying basic mechanism of our patient's anti-tumor response remains uncertain, we suggest that further prospective studies are warranted to evaluate whether this combination therapy is effective in this population of patients with pre-treated mCRPC and loss.
在过去十年中,转移性去势抵抗性前列腺癌(mCRPC)的治疗格局有了显著改善;然而,有内脏转移的患者仍然面临着较差的预后。在40%-60%的mCRPC患者中观察到磷酸酶和张力蛋白同源物(PTEN)缺失,这也与预后不良相关。已经研究了几种PI3K/AKT/mTOR通路抑制剂,但其抗肿瘤活性令人失望。在此,我们报告一例接受过大量治疗的mCRPC患者,该患者对同时使用卡铂、醋酸阿比特龙/泼尼松和肝脏定向放射治疗有适度的肿瘤反应。我们讨论了支持使用这种联合治疗的潜在理论依据及其在mCRPC中的安全性。虽然我们患者抗肿瘤反应的潜在基本机制仍不确定,但我们建议有必要进行进一步的前瞻性研究,以评估这种联合治疗对这群接受过治疗的mCRPC和PTEN缺失患者是否有效。