Corticosteroid switch from prednisone to dexamethasone in metastatic castration-resistant prostate cancer patients with biochemical progression on abiraterone acetate plus prednisone

BMC Cancer

Hao Zeng¹  Yuchao Ni¹  Zhiming Wu²  Diwei Zhao²  Jun Wang²  Yonghong Li²  Yanjun Wang²  Lijuan Jiang²  Zhenyu Yang²  Fangjian Zhou²  Dong Chen²  Yanxia Shi³  Yijun Zhang⁴  Liru He⁵ 

[1] Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 610041, Chengdu, China;Department of Urology, Sun Yat-sen University Cancer Center, 510060, Guangzhou, China;State Key Laboratory of Oncology in South China, Collaborative Innovation Cencer for Cancer Medicine, Sun Yat-sen University Cancer Center, 510060, Guangzhou, China;State Key Laboratory of Oncology in South China, Collaborative Innovation Cencer for Cancer Medicine, Sun Yat-sen University Cancer Center, 510060, Guangzhou, China;Department of Medical Oncology, Sun Yat-sen University Cancer Center, 510060, Guangzhou, China;State Key Laboratory of Oncology in South China, Collaborative Innovation Cencer for Cancer Medicine, Sun Yat-sen University Cancer Center, 510060, Guangzhou, China;Department of Pathology, Sun Yat-sen University Cancer Center, 510060, Guangzhou, China;State Key Laboratory of Oncology in South China, Collaborative Innovation Cencer for Cancer Medicine, Sun Yat-sen University Cancer Center, 510060, Guangzhou, China;Department of Radiation Oncology, Sun Yat-sen University Cancer Center, 510060, Guangzhou, China;

关键词: Abiraterone;    Castration-resistant prostate cancer;    Prednisone;    Dexamethasone;    Corticosteroid switch;   

DOI  :  10.1186/s12885-021-08670-2

来源: Springer

【 摘 要 】

BackgroundTo assess the efficacies and potential predictors of a corticosteroid switch in metastatic castration-resistant prostate cancer (mCRPC) patients with biochemical progression on abiraterone acetate plus prednisone (A + P).MethodsPatients with mCRPC treated between April 2016 and August 2020, who experienced biochemical progression on A + P and then switched to A plus dexamethasone (D), were retrospectively identified. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were PSA response, overall survival (OS), and safety.ResultsOne hundred and thirty consecutive cases were enrolled. The median PFS and OS on A + D were 5.0 and 18.7 months, respectively. The best PSA decline of ≥50% (PSA50) and ≥ 30% (PSA30) were observed in 29.2 and 46.2% patients, respectively. Lower PSA at corticosteroid switch (≤ 20 ng/mL; median PFS, HR 0.63, p = 0.019; median OS, HR 0.38, p = 0.001) and longer mCRPC-free survival (≥ 18 months; median PFS, HR 0.61, p = 0.013; median OS, HR 0.51, p = 0.015) were identified as independent prognostic predictors associated with longer PFS and OS. A risk stratification tool was developed to select candidates for corticosteroid switch based on the independent prognostic predictors of PFS and OS.ConclusionsA corticosteroid switch from prednisone to dexamethasone is effective for mCRPC which progressed on A + P treatment. Patients with lower PSA at corticosteroid switch and/or longer mCRPC-free survival may gain more benefits by the corticosteroid switch.

【 授权许可】

CC BY