Taniguchi Hisanori, Ikeda Junichi, Masuo Yuki, Kinoshita Hidefumi
Department of Urology and Andrology, Kansai Medical University, 2-3-1 Shinmachi, Hirakata, Osaka 573-1191, Japan.
Jpn J Clin Oncol. 2025 Jun 5;55(6):658-665. doi: 10.1093/jjco/hyaf034.
Cabazitaxel (CAZ) has been shown to prolong overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) following docetaxel treatment. However, the impact of the number of prior androgen receptor pathway inhibitors (ARPIs) on CAZ efficacy remains unclear. This study aimed to analyze the effectiveness of CAZ based on the number of prior ARPIs administered before CAZ treatment.
A retrospective review was conducted on mCRPC patients who received CAZ. The differences in CAZ efficacy based on the number of prior ARPIs were evaluated and prognostic factors for prostate-specific antigen (PSA) progression-free survival (PFS) and OS were analyzed.
A total of 59 patients were categorized into three groups: 12 patients with no prior ARPI, 26 with one prior ARPI, and 21 with two or more prior ARPIs. The median number of CAZ cycles and relative dose intensity were 5% and 60%, respectively. No significant differences were observed in PSA response or PFS among the three groups. Although OS from the first CAZ administration did not significantly differ among the groups, the OS from mCRPC diagnosis was shorter in the group with no prior ARPI. Multivariate analysis identified a time to mCRPC diagnosis of less than 11 months and low serum hemoglobin levels before CAZ administration as significant prognostic factors of poor OS following CAZ treatment.
PSA response, PFS, and OS after CAZ administration did not significantly differ based on the number of prior ARPIs. CAZ efficacy appears consistent regardless of the number of prior ARPI sequences.
卡巴他赛（CAZ）已被证明可延长多西他赛治疗后转移性去势抵抗性前列腺癌（mCRPC）患者的总生存期（OS）。然而，既往雄激素受体通路抑制剂（ARPI）的使用数量对CAZ疗效的影响仍不明确。本研究旨在根据CAZ治疗前使用的既往ARPI数量分析CAZ的有效性。
对接受CAZ治疗的mCRPC患者进行回顾性研究。评估基于既往ARPI数量的CAZ疗效差异，并分析前列腺特异性抗原（PSA）无进展生存期（PFS）和OS的预后因素。
共59例患者分为三组：12例未使用过ARPI，26例使用过1种ARPI，21例使用过2种或更多种ARPI。CAZ治疗周期的中位数和相对剂量强度分别为5%和60%。三组之间在PSA反应或PFS方面未观察到显著差异。虽然首次使用CAZ后的OS在各组之间无显著差异，但未使用过ARPI的组从mCRPC诊断开始的OS较短。多因素分析确定mCRPC诊断时间小于11个月以及CAZ给药前血清血红蛋白水平低是CAZ治疗后OS不良的显著预后因素。
基于既往ARPI的数量，CAZ给药后的PSA反应、PFS和OS无显著差异。无论既往ARPI序列的数量如何，CAZ疗效似乎是一致的。
