在转移性割敏感前列腺癌中,阿帕胺诱导的皮疹和相对剂量强度:一个多中心的日本队列研究
Fumihiko Urabe1,2, Hajime Onuma1,2, Kojiro Tashiro1,3
1Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
Translational andrology and urology
|December 10, 2025
概括
高龄和低BMI预测在转移性割敏感前列腺癌 (mCSPC) 患者中出现阿帕胺诱导的皮疹. 对皮疹的剂量修改不会对无进展生存率 (PFS) 产生负面影响,这表明对管理副作用的安全策略.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 皮肤病学 皮肤病学
背景情况:
- 雄激素受体信号抑制剂 (ARSI) 是转移性割敏感前列腺癌 (mCSPC) 的标准治疗方法.
- 与西方人群相比,日本患者的阿帕胺诱导皮肤不良事件发生率更高.
- 确定阿帕胺诱导皮疹的预测因子和治疗修改的影响至关重要.
研究的目的:
- 在mCSPC患者中确定阿帕胺诱导皮疹的临床决定因素.
- 评估治疗修改 (剂量减少/中止) 对相对剂量强度 (RDI) 的影响.
- 评估RDI对瘤结果的影响,特别是无进展生存期 (PFS).
主要方法:
- 对95名mCSPC患者的回顾性分析,这些患者接受了阿帕胺加上雄激素剥夺疗法 (ADT).
- 排除那些以降低剂量开始治疗的患者.
- 主要终点:阿帕胺诱导皮疹的发病率和预测因素;次要终点:RDI对PFS的影响,使用Cox比例危险模型和ROC分析.
主要成果:
- 发疹发生在40%的患者中,其中13.7%的患者经历了3级事件.
- 皮疹的独立预测因素包括年龄较大 (≥68岁) 和较低的体重指数 (BMI;≤19.7 kg/m2).
- 由于剂量修改而减少的RDI并没有影响PFS,并且RDI不是进展的独立预测指标.
结论:
- 高龄和低BMI是mCSPC中阿帕胺诱导皮疹的重要危险因素.
- 及时调整剂量来管理不良事件是一种安全有效的策略.
- 治疗修改似乎不会影响mCSPC. apalutamide的瘤疗效.
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