Lambert E, Hollebosch S, van Praet C, Van Bruwaene S, Duck L, De Roock W, van Wambeke S, Ghysel C, Ameye F, Schatteman P, Vandenbroucke F, Sautois B, Baekelandt F, Ost D, Fransis K, Filleul B, Remondo C, Wynendaele W, Bamelis B, Logghe P, Vergauwe E, Denies E, Joniau S, Lumen N
Uz Gent, Department of Urology Ghent, Belgium.
Az Groeninge Kortrijk, Department of Urology.
Acta Clin Belg. 2022 Dec;77(6):897-905. doi: 10.1080/17843286.2021.2001999. Epub 2021 Nov 18.
Abiraterone acetate + prednisone (AAP) and docetaxel have proven their efficacy in the treatment of patients with newly diagnosed metastatic hormone-sensitive prostate cancer (mHSPC) in clinical trials. However, real-world data are scarce. The goal of this study is to evaluate real-world data on the efficacy and safety of these therapies in mHSPC patients.
Records of 93 patients from 21 different centres were retrospectively reviewed. Primary and secondary endpoints were radiographic and PSA progression-free survival (RPFS - PSA-PFS) and cancer specific and overall survival (CSS - OS), respectively. Adverse events (AEs) were evaluated according to the Common Terminology Criteria for Adverse Events version 5.0. Differences in oncological outcome and AEs were evaluated between three treatment groups: ADT only (N=26) - ADT + AAP (N=48) - ADT + docetaxel (N=19). Survival analysis was performed using Kaplan-Meier statistics.
Median RPFS was 13 months (95% confidence interval [CI]: 9-17) for ADT only, 21 months (95% CI: 19-23) for ADT + AAP and 12 months (95% CI: 11-14) for ADT + docetaxel (p = 0.004). The 1-year PSA-PFS, CSS and OS were 73.5%, 90.7% and 88.7%, respectively, with no significant differences between the three groups. Adverse events of grade 3 or higher were not observed more frequently.
Retrospective real-world data show a significantly longer RPFS for mHSPC patients treated with ADT + AAP compared to ADT only or ADT + docetaxel at short-term follow-up. This can aid in counselling of mHSPC patients in daily clinical practice.
醋酸阿比特龙+泼尼松(AAP)和多西他赛在临床试验中已证明其对新诊断的转移性激素敏感性前列腺癌(mHSPC)患者的治疗效果。然而,真实世界的数据却很匮乏。本研究的目的是评估这些疗法在mHSPC患者中的疗效和安全性的真实世界数据。
回顾性分析了来自21个不同中心的93例患者的记录。主要和次要终点分别是影像学和PSA无进展生存期(RPFS - PSA - PFS)以及癌症特异性生存期和总生存期(CSS - OS)。根据不良事件通用术语标准第5.0版评估不良事件(AE)。在三个治疗组之间评估肿瘤学结局和AE的差异:单纯雄激素剥夺治疗(ADT)组(N = 26) - ADT + AAP组(N = 48) - ADT +多西他赛组(N = 19)。使用Kaplan - Meier统计进行生存分析。
单纯ADT组的中位RPFS为13个月(95%置信区间[CI]:9 - 17),ADT + AAP组为21个月(95% CI:19 - 23),ADT +多西他赛组为12个月(95% CI:11 - 14)(p = 0.004)。1年的PSA - PFS、CSS和OS分别为73.5%、90.7%和88.7%,三组之间无显著差异。未观察到3级或更高等级不良事件的发生频率更高。
回顾性真实世界数据显示,在短期随访中,与单纯ADT或ADT +多西他赛相比,接受ADT + AAP治疗的mHSPC患者的RPFS显著更长。这有助于在日常临床实践中为mHSPC患者提供咨询。