Department of Urology, Fukui University, Fukui, Japan.
Department of Urology, Miyazaki University, Miyazaki, Japan.
Int J Urol. 2023 Feb;30(2):227-234. doi: 10.1111/iju.15097. Epub 2022 Nov 14.
This study investigated the efficacy of docetaxel (DOC) and cabazitaxel (CBZ) and examined the factors associated with the prognosis of patients with castration-resistant prostate cancer (CRPC) receiving DOC-CBZ sequential treatment in Japanese real-world data.
We retrospectively evaluated data for 146 patients who received DOC followed by CBZ. The correlations of prostate specific antigen (PSA) decrease rate and time to progression between DOC and CBZ treatment were examined. Combined progression-free survival (PFS) of DOC-CBZ and overall survival (OS) from the initiation of DOC and the diagnosis of CRPC were evaluated and compared between patients with high and low PSA levels at the start of DOC and CBZ treatment.
No correlations of PSA decrease rate and time to progression were observed between DOC and CBZ. The patients for whom DOC was started in higher PSA levels had significantly shorter combined PFS (p = 0.003) and OS from the initiation of DOC (p = 0.002). In patients who started DOC at high PSA levels, those who switched to CBZ at low PSA levels had longer OS than those who switched at high PSA levels (p = 0.048). The OS from CRPC of patients who started DOC at low PSA levels was significantly longer than those that started at high PSA levels (p = 0.030).
For patients for whom DOC was not effective, sequential CBZ might have change to be effective. The PSA levels at the start of DOC and CBZ might be a potential prognostic biomarker.
本研究旨在探讨多西他赛(DOC)和卡巴他赛(CBZ)的疗效,并分析日本真实世界数据中接受 DOC-CBZ 序贯治疗的去势抵抗性前列腺癌(CRPC)患者的预后相关因素。
我们回顾性评估了 146 例接受 DOC 序贯 CBZ 治疗的患者数据。考察了 DOC 和 CBZ 治疗之间前列腺特异性抗原(PSA)下降率和进展时间的相关性。评估并比较了 DOC 和 CBZ 起始时 PSA 水平较高和较低的患者的 DOC-CBZ 联合无进展生存期(PFS)和从 DOC 起始到 CRPC 诊断的总生存期(OS)。
DOC 和 CBZ 之间 PSA 下降率和进展时间无相关性。DOC 起始时 PSA 水平较高的患者,联合 PFS(p=0.003)和从 DOC 起始到 OS(p=0.002)均显著缩短。在 PSA 水平较高的患者中,DOC 起始时 PSA 水平较高的患者,将 CBZ 转换为 PSA 水平较低时,OS 长于将 CBZ 转换为 PSA 水平较高时(p=0.048)。PSA 水平较低的患者从 CRPC 开始的 OS 明显长于 PSA 水平较高的患者(p=0.030)。
对于 DOC 无效的患者,序贯 CBZ 可能会有效。DOC 和 CBZ 起始时的 PSA 水平可能是潜在的预后生物标志物。