年轻转移性去势抵抗性前列腺癌（mCRPC）患者的治疗模式与结局：一项澳大利亚前瞻性注册研究。

Treatment patterns and outcomes for younger patients with metastatic castration-resistant prostate cancer (mCRPC); An Australian prospective registry study.

作者信息

Williams Colin, Inderjeeth Andrisha-Jade, Hong Wei, McKenzie Jane, Anton Angelyn, Weickhardt Andrew, Wong Shirley, Shapiro Jeremy, Parente Phillip, Goh Jeffrey, Torres Javier, Smith Annabel, Joshua Anthony, Brown Stephen, Steer Christopher, Johns Julie, Gibbs Peter, Tran Ben, Azad Arun A

机构信息

Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia; Medical Oncology, St Vincent's Hospital, Melbourne, Australia.

Medical Oncology, Sir Charles Gairdner Hospital, Perth, Australia; Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia.

出版信息

Clin Genitourin Cancer. 2025 Jun;23(3):102345. doi: 10.1016/j.clgc.2025.102345. Epub 2025 Apr 4.

DOI:10.1016/j.clgc.2025.102345

PMID:40319642

Abstract

INTRODUCTION AND OBJECTIVES

There is an increasing incidence of cancer in younger patients, including prostate cancer. Cancers developing in younger patients are reported to have a more aggressive phenotype. There is a need to examine younger patients with metastatic castration-resistant prostate cancer (mCRPC).

METHODS

Analysis of the prospectively collected, multisite, electronic Prostate Cancer Australian Database (ePAD) was conducted to identify all mCRPC patients enrolled between June 2016 and March 2024. We defined patients diagnosed aged < 55 years as younger patients (YP) and compared their characteristics, treatment patterns and outcomes to the other patients aged ≥ 55 years (OP).

RESULTS

Of 915 patients with mCRPC, 59 (6%) were YP. De-novo metastatic presentation, Gleason score, presence of liver metastasis and PSA doubling time at mCRPC were similar between YP and OP. In the mCRPC setting, first line treatment with docetaxel (19% YP vs. 21% OP; P = .72) and ARPI (68% YP vs. 74% OP; P = .31) was also similar. YP were more likely to receive ≥ 3 lines of therapy for mCRPC (37% YP vs. 23% OP; P = .016). There was no significant difference in overall survival from start of first line therapy (median 41.9 m YP vs. 35.1 m OP; HR 0.73; 95% CI, 0.47-1.15; P = .17) or time-to-treatment discontinuation for ARPI (median 15.8 m YP vs. 14.9 m OP; HR 0.93; 95% CI, 0.61-1.42; P = .75). Age < 55 was not independently associated with survival on multivariable analysis (HR 0.82; 95% CI, 0.52-1.29; P = .38).

CONCLUSION

Young patients with prostate cancer who go on to develop mCRPC do not appear to have distinct clinical outcomes to other patients.

摘要

引言与目的

包括前列腺癌在内，年轻患者的癌症发病率呈上升趋势。据报道，年轻患者发生的癌症具有更具侵袭性的表型。有必要对年轻的转移性去势抵抗性前列腺癌（mCRPC）患者进行研究。

方法

对前瞻性收集的多中心电子澳大利亚前列腺癌数据库（ePAD）进行分析，以确定2016年6月至2024年3月期间纳入的所有mCRPC患者。我们将诊断时年龄＜55岁的患者定义为年轻患者（YP），并将他们的特征、治疗模式和结局与其他年龄≥55岁的患者（OP）进行比较。

结果

在915例mCRPC患者中，59例（6%）为YP。YP和OP在初发转移表现、 Gleason评分、肝转移情况以及mCRPC时的PSA倍增时间方面相似。在mCRPC情况下，多西他赛一线治疗（19% YP vs. 21% OP；P = 0.72）和雄激素受体通路抑制剂（ARPI）治疗（68% YP vs. 74% OP；P = 0.31）也相似。YP更有可能接受≥3线的mCRPC治疗（37% YP vs. 23% OP；P = 0.016）。从一线治疗开始的总生存期（中位生存期41.9个月YP vs. 35.1个月OP；HR 0.73；95% CI，0.47 - 1.15；P = 0.17）或ARPI治疗中断时间（中位生存期15.8个月YP vs. 14.9个月OP；HR 0.93；95% CI，0.61 - 1.42；P = 0.75）没有显著差异。多变量分析显示年龄＜55岁与生存期无独立相关性（HR 0.82；95% CI，0.52 - 1.29；P = 0.38）。