醋酸阿比特龙片联合醋酸泼尼松片治疗雄激素剥夺治疗失败转移性去势抵抗性前列腺癌患者的临床研究  

Clinical trial of abiraterone acetate tablets combined with prednisone acetate tablets in the treatment of patients with metastatic castration-resistant prostate cancer after failure of androgen deprivation therapy

作　　者：李耀军 卢红荪 罗晓 陈善苗 刘守磊 姚一峰 王诗建 LI Yao-jun;LU Hong-sun;LUO Xiao;CHEN Shan-miao;LIU Shou-lei;YAO Yi-feng;WANG Shi-jian(Department of Urology,Tongxiang First People’s Hospital,Tongxiang 314500,Zhejiang Province,China)

机构地区：[1]桐乡市第一人民医院泌尿外科,浙江桐乡314500

出　　处：《中国临床药理学杂志》2023年第11期1538-1542,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的基于雄激素受体剪接变异体7(AR-V7)表达监测探究阿比特龙片联合泼尼松片治疗雄激素剥夺治疗(ADT)失败转移性去势抵抗性前列腺癌(mCRPC)患者的价值。方法选取ADT治疗失败的mCRPC患者,且每天使用醋酸阿比特龙片1000 mg联合泼尼松片5 mg进行治疗,治疗前采集外周静脉血进行循环肿瘤细胞AR-V7检测,根据AR-V7表达情况将患者分为AR-V7阳性组和AR-V7阴性组,统计并比较2组患者的一般资料、临床疗效、骨痛缓解率、前列腺癌患者生存质量测定量表(FACT-P)评分、前列腺特异性抗原(PSA)无进展生存期(PFS)、影像学PFS、总生存时间(OS)及药物不良反应发生情况。结果入选60例患者,其中AR-V7阳性组21例和AR-V7阴性组39例。治疗后,AR-V7阳性组和AR-V7阴性组的总有效率分别为57.14%和82.05%,差异有统计学意义(P<0.05)。治疗后,AR-V7阳性组和AR-V7阴性组的FACT-P评分分别为(92.32±10.24)和(101.26±11.14)分,PSA PFS分别为7.00和12.00个月,影像学PFS分别为12.00和15.00个月,差异均有统计学意义(均P<0.05)。AR-V7阳性组的药物不良反应主要有外周水肿、低钾血症和谷丙转氨酶升高,AR-V7阴性组的药物不良反应主要有外周水肿、高血压、低钾血症、谷丙转氨酶升高。AR-V7阳性组和AR-V7阴性组的总药物不良反应发生率分别为19.05%和15.38%,差异无统计学意义(P>0.05)。结论AR-V7可作为衡量mCRPC预后的敏感指标及是否选用阿比特龙片联合泼尼松片治疗的重要依据。Objective To explore the value of abiraterone combined with prednisone in the treatment of patients with metastatic castration-resistant prostate cancer(mCRPC)after failure of androgen deprivation therapy(ADT)based on the expression monitoring of androgen receptor splice variant 7(AR-V7).Methods mCRPC patients with ADT failure were selected and underwent Abiraterone acetate tablets 1000 mg and prednisone tablets 5 mg daily.Peripheral venous blood was collected before treatment for AR-V7 detection in circulating tumor cells.According to the expression of AR-V7,the patients were divided into positive AR-V7 group and negative AR-V7 group.The general data,clinical efficacy,bone pain remission rate,Functional Assessment of Cancer Therapy-Prostate(FACT-P)score,prostate-specific antigen(PSA)progression-free survival(PFS),imaging PFS,overall survival(OS)and occurrence of adverse reactions were recorded and compared between the two groups.Results Sixty patients were enrolled,21 in the AR-V7 positive group and 39 in the AR-V7 negative group.The total effective rate of AR-V7 positive group and AR-V7 negative group was 57.14%and 82.05%respectively,and the difference was statistically significant(P<0.05).The FACT-P scores of the AR-V7 positive group and the AR-V7 negative group were 92.32±10.24 and 101.26±11.14,respectively;the PSA PFS of the negative group were 7.00 months and 12.00 months,respectively;the imaging PFS were 12.00 months and 15.00 months,respectively.There were significant differences in the above indexes between AR-V7 negative group and AR-V7 positive group(all P<0.05).The adverse drug reactions in the AR-V7 positive group mainly included peripheral edema,hypokalemia and elevation of glutamic pyruvic transaminase,and the adverse drug reactions in the AR-V7 negative group mainly included peripheral edema,hypertension,hypokalemia and elevation of glutamic pyruvic transaminase.The total incidences of adverse drug reactions in the AR-V7 positive and AR-V7 negative groups were 19.05%and 15.38%,respectively,with

关 键 词：阿比特龙片 泼尼松片 转移性去势抵抗性前列腺癌 雄激素受体剪接变异体7 雄激素剥夺治疗失败 

分 类 号：R979.1[医药卫生—药品]