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转移性去势抵抗性前列腺癌的第二次多西他赛再挑战:一例病例报告

The second docetaxel rechallenge for metastatic castration-resistant prostate cancer: a case report.

作者信息

Ning Wei, Chang Pengkang, Zheng Ji, He Fan

机构信息

Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing, China.

Urology Department, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

Front Oncol. 2023 Sep 27;13:1185530. doi: 10.3389/fonc.2023.1185530. eCollection 2023.

Abstract

BACKGROUND

Docetaxel combined with prednisone plus androgen deprivation therapy (ADT) is the preferred treatment option for metastatic hormone-sensitive prostate cancer (mHSPC) or metastatic castration-resistant prostate cancer (mCRPC). With the development of next-generation hormonal agents (NHAs) and poly (ADP-ribose) polymerase (PARP) inhibitors, more aggressive first-line or later-line treatment strategies have been added to the treatment of mHSPC and mCRPC. However, docetaxel rechallenge (DR) has special clinical significance in patients with "docetaxel-sensitive" prostate cancer. There are no reports on the efficacy and safety of the second DR in mCRPC patients.

CASE PRESENTATION

We report one patient diagnosed with mCRPC who showed progression-free survival (PFS) and overall survival (OS) benefits and safety and good lower urinary tract function after the second DR.

CONCLUSION

The second DR as a potential alternative later-line treatment strategy should be considered for patients with mCRPC who worry about the high economic burden of multigene molecular testing and PARP inhibitors as well as repeated prostate needle biopsy.

摘要

背景

多西他赛联合泼尼松加雄激素剥夺疗法(ADT)是转移性激素敏感性前列腺癌(mHSPC)或转移性去势抵抗性前列腺癌(mCRPC)的首选治疗方案。随着新一代激素药物(NHA)和聚(ADP-核糖)聚合酶(PARP)抑制剂的发展,mHSPC和mCRPC的治疗增加了更积极的一线或二线治疗策略。然而,多西他赛再挑战(DR)在“多西他赛敏感”前列腺癌患者中具有特殊的临床意义。目前尚无关于mCRPC患者第二次DR疗效和安全性的报道。

病例报告

我们报告1例诊断为mCRPC的患者,第二次DR后显示无进展生存期(PFS)和总生存期(OS)获益,且安全性良好,下尿路功能正常。

结论

对于担心多基因分子检测和PARP抑制剂经济负担重以及反复前列腺穿刺活检的mCRPC患者,应考虑将第二次DR作为一种潜在的替代二线治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bea9/10565221/a1eddf56eefd/fonc-13-1185530-g001.jpg

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