性能状况对前列腺癌全身疗法的疗效的影响:元分析
Takafumi Yanagisawa1,2, Tatsushi Kawada1,3, Keiichiro Mori2
1Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
BJU international
|July 3, 2023
概括
系统疗法可以改善前列腺癌患者的整体存活率,而不管他们的表现状况如何 (PS). 更糟糕的PS不应该阻止任何疾病阶段的治疗强化.
科学领域:
- 在瘤学瘤学.
- 临床试验 临床试验
- 前列腺癌研究 研究前列腺癌
背景情况:
- 关于表现状态 (PS) 对接受全身治疗的前列腺癌 (PCa) 患者瘤结局的影响的数据有限.
- 评估新型全身疗法在PS恶化的患者中的有效性,在各种PCa阶段至关重要.
研究的目的:
- 评估前列腺癌 (PCa) 系统治疗在不同疾病阶段表现状况 (PS) 更差的患者中的有效性.
- 为了比较PCa患者之间的瘤结局,具有良好的PS和更差的PS接受组合全身疗法.
主要方法:
- 系统审查和随机对照试验 (RCT) 的元分析,公布至2022年6月.
- 包括的RCT分析了系统性疗法,如与受体剥夺疗法 (ADT) 结合的雄激素受体信号抑制剂 (ARSIs) 或多赛 (DOC).
- 癌症结局,包括总生存 (OS),无转移生存 (MFS) 和无进展生存,基于PS (ECOGPS ≥1定义为更差的PS) 进行了分析.
主要成果:
- 综合系统疗法在所有PCa环境中,在良好的和更糟糕的PS组中显著改善了OS.
- 在非转移性割抗性PCa (nmCRPC) 中,ARSI对无转移性存活的益处在具有良好的PS的患者中更为明显.
- 在转移性荷尔蒙敏感PCa (mHSPC) 患者中,三合一疗法显示,无论PS如何,改善OS的可能性最高,达洛胺加DOC+ADT在更糟糕的PS患者中显示出最大的OS益处.
结论:
- 新的全身疗法似乎有利于前列腺癌患者的整体存活率,无论他们的表现状况如何.
- 更糟糕的表现状态不应该成为强化治疗前列腺癌所有阶段的威.
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