美国退伍军人治疗转移性前列腺癌的现实世界住院治疗与组合疗法治疗
Kara Ingram1, Robert Wilson1, Jason M Doherty2
1Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis MO.
Clinical genitourinary cancer
|December 10, 2025
概括
与多塞塔塞尔或雄激素受体通路抑制剂 (ARPIs) 结合的雄激素剥夺疗法 (ADT) 在转移性激素敏感前列腺癌 (mHSPC) 患者中显示出明显的现实医院住院风险和不良事件. 医生可以将这些发现用于个性化治疗决策.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 转移性激素敏感前列腺癌 (mHSPC) 治疗通常涉及使用多塞或一种雄激素受体通路抑制剂 (ARPI) 的雄激素剥夺疗法 (ADT).
- 缺乏对这些组合疗法的住院率和不良事件 (AE) 的比较真实世界的数据.
研究的目的:
- 为了在mHSPC患者中比较ADT+docetaxel和ADT+ARPI之间的现实医院住院率和AEs.
- 确定与每个治疗方案相关的特定风险,以指导临床决策.
主要方法:
- 一项对1549名美国退伍军人 (2013-2021) 的回顾性全国性研究,比较ADT+docetaxel (n=500) 与ADT+ARPI (n=1049).
- 在治疗开始前一年和之后分析了住院病例.
- 对比了AE的基线特征和发生率差异.
主要成果:
- 治疗后住院的情况在两组中都显著增加:ADT+docetaxel的245%和ADT+ARPI的125%.
- ADT+docetaxel组经历了更高的消化和呼吸道并发症住院率.
- ADT + ARPI 组显示呼吸道,内分泌/代谢和循环并发症的住院病例增加,但急性功能衰竭入院病例减少.
结论:
- ADT+docetaxel和ADT+ARPI疗法在现实mHSPC治疗中存在明显的住院风险和副作用.
- 患有呼吸道/胃肠道并发症的患者可能面临多塞塔塞尔的更高风险.
- 更老,更脆弱的患者容易感染/代谢问题可能在ARPI的风险增加,告知个性化治疗选择.
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