演題抄録

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開催概要
開催回
第56回・2018年・横浜
 

去勢抵抗性前立腺癌に対するエンザルタミドのPSA再発に関する危険因子の検討

演題番号 : P43-5

[筆頭演者]
演者)中井 康友:1 
[共同演者]
岡 利樹:1、奥田 洋平:1、朝倉 寿久:1、波多野 浩士:1、中山 雅志:1、垣本 健一:1、西村 和郎:1

1:大阪国際がんセンター・泌尿器科

 

Objective
To clarify risk factors for PSA progression in patients who received enzalutamide for the treatment of castration resistant prostate cancer (CRPC).

Materials and Methods
We retrospectively reviewed clinical records of CRPC patients who initiated enzalutamide treatment between Nov/2011 and Dec/2017 in our institution. PSA progression was defined as the date that a 25% or greater increase and an absolute increase of 2 ng/ml or more from the nadir. Risk factors for PSA progression were analyzed by a Cox regression model.

Results
Seventy CRPC patients received enzalutamide for the treatment of CRPC. Their median age was 73 (56-88) and the median PSA level was 14.7 ng/ml (1.0-3087.2 ng/ml). The metastatic site was bone (61.4%), lymph node (10.0%), and viscera (11.4%). Sixteen patients had no metastasic foci on imaging at initiation of enzalutamide. Twenty-nine patients had prior docetaxel treatment and 11 patients had prior abiraterone treatment.
PSA decline was observed in 53 patients (77.9%) and mean PSA reduction rate was 54.8±9.8% (95% confidence interval [CI]).The median PSA progression free period was 7months.Response duration of primary androgen deprivation therapy (ADT) less than 20 months (hazard ratio [HR] 2.70, 95% CI 1.47-5.23), prior docetaxel use (HR 3.05, 95% CI 1.62-5.74), prior abiraterone use (HR 2.88, 95% CI 1.20-6.21), presence of metastasis at the initiation of enzalutamide (HR 3.00, 95% CI 1.40-7.43), Neutrophil-lymphocyte ratio ≧3 (HR 1.98, 95% CI 1.49-6.67), and simultaneous steroid use (HR 4.69, 95% CI 2.46-9.90) revealed to be risk factors for PSA progression by univariate analysis. By multivariate analysis, response duration of primary ADT less than 20 months (HR 3.13, 95% CI 1.49-6.67) and simultaneous steroid use (HR 7.73, 95% CI 10.30-30.41) were independent risk factors for PSA progression.

Summary
Duration of primary ADT and simultaneous steroid use were risk factors for PSA progression in the treatment of enzalutamide for CRPC.

キーワード

臓器別:前立腺・男性生殖器

手法別:内分泌・ホルモン療法

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