Mita Koji, Izumi Kouji, Goriki Akihiro, Tasaka Ryo, Hatayama Tomoya, Shima Takashi, Kato Yuki, Kamiyama Manabu, Inoue Shogo, Tanaka Nobumichi, Hoshi Seiji, Okamura Takehiko, Yoshio Yuko, Enokida Hideki, Chikazawa Ippei, Kawai Noriyasu, Hashimoto Kohei, Fukagai Takashi, Shigehara Kazuyoshi, Takahara Shizuko, Kadono Yoshifumi, Mizokami Atsushi
Department of Urology, Hiroshima City North Medical Center Asa Citizens Hospital, 1-2-1 Kameyama-Minami, Asakita-ku, Hiroshima 731-0293, Japan.
Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan.
Cancers (Basel). 2024 Jan 24;16(3):508. doi: 10.3390/cancers16030508.
Enzalutamide (ENZ) and abiraterone plus prednisolone (ABI) can improve the survival of patients with castration-resistant prostate cancer (CRPC). However, the agent that is more effective against nonmetastatic CRPC remains unclear. To evaluate the agent that can be used as the first-line treatment for CRPC, an investigator-initiated, multicenter, randomized controlled trial (ENABLE Study for PCa) including both metastatic and nonmetastatic CRPC was conducted in Japan. The prostate-specific antigen (PSA) response rate, overall survival, some essential survival endpoints, and safety of patients with nonmetastatic CRPC were also analyzed. In this subanalysis, 15 and 26 patients in the ENZ and ABI arms, respectively, presented with nonmetastatic CRPC. There was no significant difference in terms of the PSA response rate between the ENZ and ABI arms (80% and 64%, respectively; = 0.3048). The overall survival did not significantly differ between the two arms (HR: 0.68; 95% CI: 0.22-2.14, = 0.5260). No significant differences were observed in terms of radiographic progression-free survival and cancer-specific survival between the ENZ and ABI arms (HR: 0.81; 95% CI: 0.35-1.84; = 0.6056 and HR: 0.72; 95% CI: 0.19-2.73; = 0.6443, respectively). Only four and six patients in the ENZ and ABI arms, respectively, had ≥grade 3 adverse events. ABI and ENZ had similar efficacy and safety profiles in patients with nonmetastatic CRPC.
恩杂鲁胺(ENZ)以及阿比特龙联合泼尼松龙(ABI)可提高去势抵抗性前列腺癌(CRPC)患者的生存率。然而,对于非转移性CRPC更有效的药物仍不明确。为评估可作为CRPC一线治疗的药物,在日本开展了一项由研究者发起的、多中心、随机对照试验(前列腺癌ENABLE研究),纳入了转移性和非转移性CRPC患者。还分析了非转移性CRPC患者的前列腺特异性抗原(PSA)缓解率、总生存期、一些重要的生存终点以及安全性。在这项亚组分析中,ENZ组和ABI组分别有15例和26例患者表现为非转移性CRPC。ENZ组和ABI组的PSA缓解率无显著差异(分别为80%和64%;P = 0.3048)。两组的总生存期无显著差异(HR:0.68;95%CI:0.22 - 2.14,P = 0.5260)。ENZ组和ABI组在影像学无进展生存期和癌症特异性生存期方面也未观察到显著差异(HR分别为:0.81;95%CI:0.35 - 1.84;P = 0.6056和HR:0.72;95%CI:0.19 - 2.73;P = 0.6443)。ENZ组和ABI组分别仅有4例和6例患者发生≥3级不良事件。ABI和ENZ在非转移性CRPC患者中具有相似的疗效和安全性。