新辅助剂达罗胺加上抗雄激素剥夺治疗高风险和局部晚期前列腺癌:多中心,开放标签,单臂,II期试验
Xuyu Zhang1,2, Feng Zhou3, Tong Lu4
1Department of Urology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
World journal of urology
|January 3, 2025
概括
新辅助剂达洛胺加上素剥夺疗法 (ADT) 在局部晚期前列腺癌 (LAPC) 方面表现有前途. 这种治疗是有效和安全的,循环瘤DNA (ctDNA) 有助于预测疾病的进展.
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:
- 局部晚期前列腺癌 (LAPC) 需要有效的新辅助治疗策略.
- 抗雄激素剥夺疗法 (ADT) 是一种标准的治疗方法,但需要新的药物.
- 达洛胺是下一代雄激素受体抑制剂,提供了一个新的治疗选择.
研究的目的:
- 在LAPC患者中评估新辅助剂达罗胺加ADT的疗效和安全性.
- 评估病理完整反应 (pCR) 或最小残留疾病 (MRD) 率.
- 为了确定无进展生存期 (PFS),手术边缘状态和安全概况.
主要方法:
- 一个单臂,多中心,开放的II期试验 (NCT05249712) 涉及30名患有高风险/非常高风险前列腺癌 (HRPCa/VHRPCa) 的患者.
- 用达洛胺和ADT进行六个月的新辅助治疗,随后进行激进前列腺切除术 (RP).
- 主要终点:pCR或MRD. 二级终点:PFS,积极的手术利率,安全性. 探索性终点:ctDNA与结果的相关性.
主要成果:
- 观察到40%的pCR或MRD率 (12/30名患者).
- 在13.3%的患者 (4/30) 中出现了积极的外科边缘.
- 12个月的PFS为90.0%;没有报告3/4级不良事件. 常见的副作用包括热和肝酶升高.
结论:
- 新辅助剂达罗胺加ADT,其次是RP,是HRPCa和LAPC的有效和安全治疗方法.
- 循环瘤DNA (ctDNA) 检测可以准确预测疾病的进展.
- 这种疗法为治疗晚期前列腺癌提供了一种有前途的方法.
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