Chen Hao Xiang, Tsai Li-Hsien, Chang Chao-Hsiang, Wu Hsi-Chin, Lin Ching-Chan, Lin Che-Hung, Yeh Chin-Chung, Yang Chi-Rei, Lien Chi-Shun, Chang Yi-Huei, Liang Ji-An, Chen Guan-Heng, Hsiao Po-Jen, Hsieh Po-Fan, Huang Chi-Ping
Department of Urology, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan.
School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan.
Cancers (Basel). 2023 Jul 6;15(13):3516. doi: 10.3390/cancers15133516.
Metastatic castration-resistant prostate cancer (mCRPC) is a progressive stage of prostate cancer that often spreads to the bone. Radium-223, a bone-targeting radiopharmaceutical, has been shown to improve the overall survival in mCRPC in patients without visceral metastasis. However, the impact of prior systemic therapy on the treatment outcome of mCRPC patients receiving radium-223 remains unclear. This study aimed to investigate the optimal choice of systemic therapy before radium-223 in mCRPC patients. The study included 41 mCRPC patients who received radium-223 therapy, with 22 receiving prior enzalutamide and 19 receiving prior abiraterone. The results showed that the median overall survival was significantly longer in the enzalutamide group than in the abiraterone group (25.1 months vs. 14.8 months, = 0.049). Moreover, the number of patients requiring blood transfusion was higher in the abiraterone group than in the enzalutamide group (9.1% vs. 26.3%, = 0.16). The study also found that the number of doses of Radium-223 received was significantly associated with overall survival (≥5 vs. <5, HR 0.028, 95%CI 0.003-0.231, = 0.001). Our study provides insights into the optimal treatment choice for mCRPC prior to radium-223, indicating that enzalutamide prior to radium-223 administration may have better outcomes compared to abiraterone in mCRPC patients without visceral metastasis.
转移性去势抵抗性前列腺癌（mCRPC）是前列腺癌的一个进展阶段，常扩散至骨骼。镭-223是一种靶向骨骼的放射性药物，已显示可改善无内脏转移的mCRPC患者的总生存期。然而，既往全身治疗对接受镭-223治疗的mCRPC患者治疗结果的影响仍不清楚。本研究旨在探讨mCRPC患者在接受镭-223治疗前全身治疗的最佳选择。该研究纳入了41例接受镭-223治疗的mCRPC患者，其中22例之前接受过恩杂鲁胺治疗，19例之前接受过阿比特龙治疗。结果显示，恩杂鲁胺组的中位总生存期显著长于阿比特龙组（25.1个月对14.8个月，P = 0.049）。此外，阿比特龙组需要输血的患者数量高于恩杂鲁胺组（9.1%对26.3%，P = 0.16）。该研究还发现，接受镭-223的剂量数与总生存期显著相关（≥5剂对<5剂，HR 0.028，95%CI 0.003 - 0.231，P = 0.001）。我们的研究为mCRPC患者在接受镭-223治疗前的最佳治疗选择提供了见解，表明在无内脏转移的mCRPC患者中，在给予镭-223之前使用恩杂鲁胺可能比阿比特龙有更好的结果。
