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Опыт клинического применения абиратерона ацетата в лечении больных кастрационно-резистентным раком предстательной железы
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Аннотация
Недавние рандомизированные исследования III фазы по оценке эффективности абиратерона ацетата у больных метастатическим кастрационно-резистентным раком предстательной железы (КРРПЖ), как сразу после регистрации кастрационной резистентности, так и после прогрессии на доцетакселе, показали значительное увеличение времени до радиографической прогрессии и общей выживаемости, в том числе у пациентов с наличием выраженного болевого синдрома, высоким уровнем простатоспецифического антигена и висцеральными метастазами. В данной статье мы представляем собственный опыт применения абиратерона ацетата у больных метастатическим КРРПЖ c наличием неблагоприятных факторов прогноза выживаемости. В исследование вошли 25 пациентов с метастатическим КРРПЖ, получавших терапию абиратероном.
Ключевые слова: абиратерона ацетат, кастрационно-резистентный рак предстательной железы.
Ключевые слова: абиратерона ацетат, кастрационно-резистентный рак предстательной железы.
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In a recent randomized, double-blind, phase III clinical trials among patients with metastatic castration-resistant prostate cancer (CRPC) progressing on androgen-deprivation therapy or after docetaxel chemotherapy, abiraterone acetate was shown to significantly prolong radiographic progression free survival and overall survival compared with prednisone alone, even in symptomatic patients and patients having visceral metastases and high level of prostate specific antigen at baseline. Here we present our own experience with abiraterone acetate in patients who represent negative prognostic factors of castration-resistant prostate cancer outside of clinical trials. 25 metastatic CRPC patients were treated with abiraterone acetate from 2012 to 2014.
Key words: abiraterone acetate, castration-resistant prostate cancer.
Полный текст
Список литературы
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2. Snoek R, Cheng H, Margiotti K et al. In vivo knockdown of the Androgen Receptor Results in Growth Inhibition and Regression of Well-Established, Castration-Resistant Prostate Tumors. Clin Cancer Res 2009; 15: 39–47.
3. Scher HI, Halabi S, Tannock I et al. Design and end points of clinical trials for patients with progressive prostate cancer and castrate levels of testosterone: recommendations of the Prostate Cancer Clinical Trials Working Group. J Clin Oncol 2008; 26: 1148–59.
4. Tannock IF, De Wit R, Berry WR et al. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med 2004; 351: 1502–12.
5. Petrylak DP, Tangen CM, Hussain MH et al. Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer. N Engl J Med 2004; 351: 1513–20.
6. Saad F, Gleason DM, Murray R et al. A randomized, placebo-controlled trial of zoledronic acid in patients with hormone-refractory metastatic prostate carcinoma. J Natl Cancer Inst 2002; 94: 1458–68.
7. Sternberg CN, Petrylak DP, Sartor O et al. Multinational, double-blind, phase III study of prednisone and either satraplatin or placebo in patients with castrate-refractory prostate cancer progressing after prior chemotherapy: the SPARC trial. J Clin Oncol 2009; 27: 5431–8.
8. Engel-Nitz NM, Alemayehu B, Parry D, Nathan F. Differences in treatment patterns among patients with castration-resistant prostate cancer treated by oncologists versus urologists in a US managed care population. Cancer Manag Res 2011; 3: 233–45.
9. Harris V, Lloyd K, Forsey S, Rogers P, Roche M, Parker C. A population-based study of prostate cancer chemotherapy. Clin Oncol (R Coll Radiol) 2011; 23: 706–8.
10. Kantoff PW, Higano CS, Shore ND et al. Sipuleucel-T immunotherapy for castration-resistant prostate cancer. N Engl J Med 2010; 363: 411–22.
11. Mottet N et al. Guidelines on prostate cancer. Eur Urol 2014; 65 (1): 124–37; Eur Urol 2014; 65 (2): 467–79.
12. Berthold DR et al. Docetaxel Plus Prednisone or Mitoxantrone Plus Prednisone for Advanced Prostate Cancer: Updated Survival Analysis in the TAX 327 study. J Clin Oncol 2008; 26: 242–5.
13. Attard G, Reid AH, A’Hern R et al. Selective inhibition of CYP17 with abiraterone acetate is highly active in the treatment of castration-resistant prostate cancer. J Clin Oncol 2009; 27: 3742–8.
14. Attard G, Reid AH, De Bono JS. Abiraterone acetate is well tolerated without concomitant use of corticosteroids. J Clin Oncol 2010; 28 (29): e560–e561.
15. Attard G, Reid AH, Yap TA et al. Phase I clinical trial of a selective inhibitor of CYP17, abiraterone acetate, confirms that castration-resistant prostate cancer commonly remains hormone driven. J Clin Oncol 2008; 26: 4563–71.
16. Danila DC, Morris MJ, De Bono JS et al. Phase II multicenter study of abiraterone acetate plus prednisone therapy in patients with docetaxel-treated castration-resistant prostate cancer. J Clin Oncol 2010; 28:1496–501.
17. Reid AH, Attard G, Danila DC et al. Significant and sustained antitumor activity in post docetaxel, castration-resistant prostate cancer with the CYP17 inhibitor abiraterone acetate. J Clin Oncol 2010; 28:1489–95.
18. Ryan CJ, Smith MR, Fong L et al. Phase I clinical trial of the CYP17 inhibitor abiraterone acetate demonstrating clinical activity in patients with castration-resistant prostate cancer who received prior ketoconazole therapy. J Clin Oncol 2010; 28:1481–8.
19. De Bono JS, Logothetis CJ, Molina A et al. Abiraterone and increased survival in metastatic prostate cancer. N Engl J Med 2011; 364: 1995–2005.
20. Fizazi K, Scher HI, Molina A. Abiraterone acetate for treatment of metastatic castration-resistant prostate cancer: final overall survival analysis of the COU-AA-301 randomised, double-blind, placebo-controlled phase 3 study. Lancet Oncol 2012; 13 (Issue 10): 983–99.
21. Ryan CJ, Smith MR, De Bono JS. Abiraterone in Metastatic Prostate Cancer without Previous Chemotherapy. N Engl J Med 2013; 368 (2): 138–48.
22. Jr Goodman OB et al. Exploratory analysis of the visceral disease subgroup in a phase III study of abiraterone acetate in metastatic castration-resistant cancer. Prostate Cаncer Prostatic Dis 2014; 17: 34–9.
23. Rathkopf DE. Genitourinary Cancers Symposium. J Clin Oncol 2013; 31 (Suppl. 6): 5.
Авторы
Я.В.Гриднева1, В.Б.Матвеев1, Д.З.Купчан1, С.А.Калинин2, М.В.Петерс3
1 ФГБУ Российский онкологический научный центр им. Н.Н.Блохина РАМН, Москва;
2 ГБОУ ВПО РНИМУ им. Н.И.Пирогова Минздрава России, Москва;
3 ГБОУ ДПО РМАПО Минздрава России, Москва
1 ФГБУ Российский онкологический научный центр им. Н.Н.Блохина РАМН, Москва;
2 ГБОУ ВПО РНИМУ им. Н.И.Пирогова Минздрава России, Москва;
3 ГБОУ ДПО РМАПО Минздрава России, Москва
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Ya.V.Gridneva, V.B.Matveev, D.Z.Kupchan, S.A.Kalinin, M.V.Peters
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