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阿比拉酸与恩扎胺对抗全剂量诱导的化疗先天性割耐性前列腺癌
Tatsuya Shimomura1, Keiichiro Mori1, Akihiro Matsukawa1
1Urology, Jikei University School of Medicine, Tokyo, JPN.
第一线恩扎胺在接受全剂量诱导的化疗先验割耐性前列腺癌 (CRPC) 患者中显示出比阿比拉酸更高的疗效. 恩扎胺显著改善了前列腺特异性抗原反应,无进展生存率和整体生存结果.
科学领域:
- 在瘤学瘤学.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 药理学 药理学是指药理学的学科.
背景情况:
- 经过化疗治疗的前列腺癌 (CRPC) 需要有效的第一线治疗.
- 雄激素受体信号抑制剂 (ARSIs),如阿比拉酸和恩扎胺,是标准治疗方法.
- 以前的分析包括降低剂量诱导,可能会混有效性比较.
研究的目的:
- 为了评估全剂量诱导阿比拉乙酸与恩扎拉胺在化学疗法前的CRPC的第一线治疗中的比较疗效.
- 为了研究这两种ARSIs在完全诱导剂量下使用时的临床结果的真实差异.
主要方法:
- 对220名化疗先的CRPC患者进行了回顾性分析,这些患者接受了第一线全剂量ARSI诱导.
- 患者接受了阿比拉酸盐 (n=58) 或恩扎胺 (n=162) 的治疗.
- 关键结局指标包括前列腺特异性抗原 (PSA) 反应,PSA无进展生存率 (PSA-PFS),治疗无失败生存率 (TFF),癌症特异性生存率 (CSS) 和整体生存率 (OS).
主要成果:
- 与阿比拉乙酸相比,恩扎胺组的PSA应答率中位数显著更高 (-81.5%vs-65.4%) 和PSA下降≥90% (37.0%vs22.4%).
- 中位数PSA-PFS与恩扎胺显著长 (7个月与4个月相比).
- 没有治疗失败的存活率 (15个月 vs 6个月),癌症特异性存活率 (未达到 vs 45个月) 和整体存活率 (80个月 vs 34个月) 都在恩扎胺组显著优越.
结论:
- 在全诱导剂量下,一线恩扎胺在化学疗法前的CRPC中显示出与阿比拉酸相比更高的疗效.
- 恩扎胺直接抑制雄激素受体与改善的临床结果有关,包括生存益处.
- 这些发现支持恩扎胺作为这种患者群体首选的第一线选择.
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