Tombal Bertrand, Stenzl Arnulf, Cella David, Loriot Yohann, Armstrong Andrew J, Fizazi Karim, Beer Tomasz, Sternberg Cora N, Hussain Maha, Ivanescu Cristina, Ganguli Arijit, Ramaswamy Krishnan, Saad Fred
Cliniques Universitaires Saint Luc, Avenue Hippocrate, 10, B-1200 Bruxelles, Belgium.
Department of Urology, Eberhard Karls University of Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany.
Cancers (Basel). 2021 Nov 23;13(23):5872. doi: 10.3390/cancers13235872.
This review examines the impact of treatment with enzalutamide on health-related quality of life (HRQoL) in prostate cancer patients across the disease continuum based on pivotal clinical trials. We assessed the effect of enzalutamide on pain, symptom burden and overall HRQoL from randomized controlled trials. Patient experience was evaluated in men with metastatic hormone-sensitive prostate cancer (mHSPC), non-metastatic castration-resistant prostate cancer (nmCRPC) and metastatic castration-resistant prostate cancer (mCRPC) (pre-chemotherapy and post-chemotherapy). Patients across the disease continuum reported a generally positive status at baseline, with relatively low levels of pain and impairment due to cancer-related symptoms and high HRQoL. For patients with earlier-state prostate cancer, pain and symptom-related burden were low at study entry and remained so, regardless of whether patients received enzalutamide or control treatment. Patients with more advanced disease reported mitigation in pain and symptom burden while receiving treatment with enzalutamide. Enzalutamide was observed to slow deterioration of overall HRQoL most for patients with nmCRPC or mCRPC (statistical significance for between-group difference in median time to deterioration: mHSPC (confirmed) = 0.2998; nmCRPC (confirmed) = 0.0044; mCRPC (unconfirmed) < 0.0001). Across the prostate cancer continuum, enzalutamide is well-tolerated and delays the negative impact that disease progression has on quality of life.
本综述基于关键临床试验,考察了恩杂鲁胺治疗对前列腺癌患者在疾病全过程中健康相关生活质量(HRQoL)的影响。我们评估了随机对照试验中恩杂鲁胺对疼痛、症状负担和总体HRQoL的影响。在转移性激素敏感性前列腺癌(mHSPC)、非转移性去势抵抗性前列腺癌(nmCRPC)和转移性去势抵抗性前列腺癌(mCRPC)(化疗前和化疗后)患者中评估了患者体验。疾病全过程的患者在基线时报告的总体状况普遍良好,因癌症相关症状导致的疼痛和功能损害水平相对较低,HRQoL较高。对于早期前列腺癌患者,在研究开始时疼痛和症状相关负担较低,并且无论患者接受恩杂鲁胺还是对照治疗,情况均保持如此。疾病更晚期的患者在接受恩杂鲁胺治疗时报告疼痛和症状负担有所减轻。观察到恩杂鲁胺对nmCRPC或mCRPC患者的总体HRQoL恶化减缓作用最为明显(中位恶化时间组间差异的统计学显著性:mHSPC(确认)=0.2998;nmCRPC(确认)=0.0044;mCRPC(未确认)<0.0001)。在前列腺癌全过程中,恩杂鲁胺耐受性良好,并延缓了疾病进展对生活质量的负面影响。