Yu Zhe, Wei Wei, Liu Hongruo, Pan Evenki, Yang Peng, Jiang Kui
Department of Medical Oncology, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China.
Nanjing Genesseq Technology Inc., Nanjing, Jiangsu, People's Republic of China.
Onco Targets Ther. 2021 Dec 8;14:5423-5428. doi: 10.2147/OTT.S334205. eCollection 2021.
Metastatic castration resistant prostate cancer (mCRPC), the advanced stage of prostate cancer (PCa), develops resistance to first line androgen deprivation therapy (ADT). Aberrant androgen receptor (AR) and PI3K-Akt-mTOR signaling pathway are responsible for the development and progression of mCRPC. We herein describe a case of a 64-year-old male mCRPC patient with somatic and mutations. The patient, who had been heavily pretreated by ADT and AR inhibitors, showed stable disease progression when he received everolimus, an mTOR inhibitor. The PSA level dropped drastically from 1493.0 ng/mL to 237.6 ng/mL, after 3 months of treatment. The overall survival (OS) was 43 months, of which the progression-free survival (PFS) with everolimus treatment was 7 months. The administration of mTOR inhibitor, everolimus, could achieve good clinical responses along with prolonging PFS for mCRPC patients harboring mutations. Technology in precision medicine, such as targeted next-generation sequencing (NGS) of cancer-relevant genes, has promising function in personalized therapy.
转移性去势抵抗性前列腺癌（mCRPC）是前列腺癌（PCa）的晚期阶段，对一线雄激素剥夺疗法（ADT）产生耐药性。异常的雄激素受体（AR）和PI3K-Akt-mTOR信号通路是mCRPC发生和进展的原因。我们在此描述一例64岁患有体细胞和 突变的男性mCRPC患者。该患者此前已接受过ADT和AR抑制剂的大量治疗，在接受mTOR抑制剂依维莫司治疗时疾病进展稳定。治疗3个月后，前列腺特异性抗原（PSA）水平从1493.0 ng/mL急剧降至237.6 ng/mL。总生存期（OS）为43个月，其中依维莫司治疗的无进展生存期（PFS）为7个月。对于携带 突变的mCRPC患者，给予mTOR抑制剂依维莫司可取得良好的临床反应并延长PFS。精准医学技术，如癌症相关基因的靶向二代测序（NGS），在个性化治疗中具有广阔前景。
