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開催概要
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第56回・2018年・横浜
 

去勢抵抗性前立腺癌に対する新規ホルモン剤の臨床的検討

演題番号 : P43-8

[筆頭演者]
演者)引地 克:1 
[共同演者]
高原 健:1、深谷 孝介:1、深見 直彦:1、市野 学:1、佐々木 ひと美:1、日下 守:1、白木 良一:1

1:藤田保健衛生大学・腎泌尿器外科

 

After the introduction of Androgen receptor targeted agents (ARTAs) since 2014, the prognosis of castration refractory prostate cancer improved dramatically. However, there are many cases in which treatment is required after 2nd line, and there is no conclusion as to the timing of drug selection and change of sequential therapy.

To evaluate and compare the clinical outcomes, We conducted a retrospective analysis of Enzalutamide (ENZ) · Abiraterone (ABI) for castration resistant prostate cancer (CRPC).

From June 2014 to June 2017, 61 patients who received initial ENZ and 20 patients who received initial ABI.
As a prognostic factor, PSA, Hb, Alb, ALP, LDH, PSA change rate, Time to CRPC, Gleason score, presence of metastasis in COX proportional hazard model, PSA progression free survival (pPFS), Overall survival (OS)is Kaplan -Meier method.
The age (median) at the time of introduction of ENZ / ABI group was 76 years / 74 years, PSA (median) was 23/150 ng / ml, PSA (30% / 50%) reduction rate was ENZ group 68.9 % / 55.7%, ABI group 55% / 55%. The median time to PSA 30% decline was 28 days in both groups.
The pPFS of the ENZ / ABI first dose group was 6 months / 5 months, OS was 24 months / 15 months. Effect predicting factors common to both groups were pretreatment Alb and PSA change rates, and in PSA 30% lower group, pPFS and OS significantly increased in both groups.

The rate of decrease in PSA at 4 weeks after the beginning of ARTAs became a prognostic factor and seemed to help change to an indicator of treatment course and 2nd line.

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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