在非转移性化抵抗性前列腺癌患者中使用雄激素受体抑制剂
Daniel J George1, Alicia K Morgans2, Niculae Constantinovici3
1Duke University Cancer Institute, Durham, North Carolina.
JAMA network open
|August 27, 2024
概括
与恩扎胺和阿帕胺相比,达洛胺在非转移性抵抗割的前列腺癌 (nmCRPC) 患者中表现出更好的耐受性和有效性. 需要进一步的比较研究来指导nmCRPC的治疗决策.
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:
- 新型雄激素受体抑制剂 (ARI),如达罗胺,恩扎胺和阿帕胺是治疗非转移性抵抗割的前列腺癌 (nmCRPC) 的标准治疗方法.
- 仅有有限的数据可以比较这些ARI的临床使用和耐受性.
研究的目的:
- 在被诊断为nmCRPC的患者中比较达罗胺,恩扎胺和阿帕胺的临床使用和结果.
- 评估停止治疗和进展到转移性CRPC (mCRPC) 作为主要终点.
主要方法:
- 追溯性队列研究分析了美国泌尿病实践的电子病历.
- 包括870名nmCRPC患者,他们在2019年8月至2022年3月期间开始新型ARI治疗.
- 在三个ARI中比较了复合终点事件 (停止或进展到mCRPC),停止率和进展率.
主要成果:
- 与恩扎胺和阿帕胺相比,达洛胺与复合终点事件 (37.0%),中止 (30.4%) 和进展到mCRPC (17.7%) 的比例较低.
- 经过调整后的分析显示,达洛胺的复合事件,停止治疗和进展到mCRPC的风险明显较低,而不是恩扎胺和阿帕胺.
- 对于研究的结果,在恩扎胺和阿帕胺之间没有发现显著差异.
结论:
- 在nmCRPC患者中,达洛胺似乎提供了更好的耐受性和潜在的临床有效性优势,而不是恩扎胺和阿帕胺.
- 这些发现表明达罗胺可能是首选的治疗选择,但需要进行比较性临床研究来证实这些结果并指导临床决策.
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