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開催概要
開催回
第56回・2018年・横浜
 

IDC-P を有するCRPC患者に対するアビラテロンの有用性と安全性の検討

演題番号 : P43-7

[筆頭演者]
演者)服部 恭介:1 
[共同演者]
加藤 真史:2、山本 晃之:3、弓場 拓真:4、川西 秀治:5、石川 智啓:6、鈴木 晶貴:7、錦見 俊徳:1、服部 良平:5、都築 豊徳:8

1:名古屋第二赤十字病院・泌尿器科、2:名古屋大学・泌尿器科、3:豊橋市民病院・泌尿器科、4:刈谷豊田総合病院・泌尿器科、5:名古屋第一赤十字病院・泌尿器科、6:中京病院・泌尿器科、7:名古屋医療センター・泌尿器科、8:愛知医科大学病院・病理診断科

 

Background
Abiraterone showed survival outcomes in the recent studies. But there are no report about efficacy of abiraterone in castration-resistant prostate cancer (CRPC) patients with IDC-P.

Patients and Method
This retrospective study aimed to apparent efficacy and safety of abiraterone in CRPC patients. We identified 42 patients treated with abiraterone after diagnosis of CRPC from June 2002 to February 2016. All needle biopsy slides were reviewed by a single genitourinary pathologist (TT). We evaluated overall survival from the time of CRPC diagnosis, progression-free survival (PFS) from the administration of aviraterone, prostate-specific antigen (PSA) response and safety. The Cox regression model was used to confirm whether IDC-P would act as independent factors for prognosis.

Result
The median age was 70.5 years (59 to 85), the median serum PSA level before administration of abiraterone was 17.8 ng/ml (0.15 to 2449). The number of patients who had previously been treated with docetaxel was 11. IDC-P was found in 17 of 42 patients. The median OS in the IDC-P present group was 45.0 months versus 92.8 months in the IDC-P absent group (HR, 5.76; 95% CI, 1.68 to 19.7; P = 0.005). The median PFS in patients previously treated with docetaxel was 2.3 months and not treated was 6.3 months, respectively (p=0.65).In patients not previously treated with docetaxel, the median PFS was 6.9 months with IDC-P and 4.6 months without IDC-P, respectively (p=0.09). Treatment-related adverse events occurred in 3 of 42 patients; grade 3 or 4 events occurred in 1 patient. Univariate analysis demonstrated that the presence of IDC-P, initial serum PSA level and the presence of distant metastases at first visit were independent prognostic factors for OS.

Conclusion
The presence of IDC-P would make worse the prognosis of CRPC patients. Regarding PFS, the efficacy of abiraterone may not be affected by the presence of IDC-P.

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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