Efficacy of abiraterone acetate combined with prednisone in the treatment of castration-resistant prostate cancer

doi:10.3969/j.issn.1006-7795.2021.06.013

Abstract

Abstract: Objective To analyze the efficacy and safety of abiraterone acetate (AA) combined with prednisone (P) in patients with castration-resistant prostate cancer (CRPC). Methods Retrospective analysis was performed on 46 CRPC patients who were treated with AA+P from July 2018 to April 2021 in the Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, and finally 37 patients were included in the study. To analyze the basic data of 37 patients, the prostate specific antigen (PSA) response rate was calculated according to the PSA Working Group 2 (PSAWG2) standard, and the patient’s imaging outcome during treatment was evaluated according to response evaluation criteria in solid tumors(RECIST) standard. The difference in PSA response rate was compared with each other group for AA+P treatment with/without docetaxel chemotherapy. Results The median follow-up time was 9.7 months after 37 CRPC patients received AA+P treatment. At the beginning of receiving AA+P, 5 patients had PSA flare, and the median time for their PSA rising to peak followed by a drop below the baseline level was 3.0(2.0,4.5) months. The overall PSA response rate of 37 patients was 59.5%, of which 13 patients had PSA recurrence after reaching remission, with a median recurrence time of 7.0 months. According to RECIST criteria, of 37 CRPC patients, 7 patients had imaging progression, and 5 patients had definite imaging remission. Six patients who relapsed after reaching PSA remission were treated with dexamethasone as an alternative of prednisone. Among them, 2 patients had PSA response, with the PSA response rate 33.3%. For the patients with or without docetaxel chemotherapy, the PSA response rate was 20.0% (1/5), and 65.6% (21/32),respectively. There was no statistically significant difference in response rate (P=0.076). In addition, the response rate of PSA of patients with PSA flare was significantly lower than that without this phenomenon (20.0% vs 65.6%, P=0.070). Abiraterone acetate was generally well tolerated and had fewer adverse drug reactions. Conclusion In CRPC patients, oral abiraterone acetate combined with prednisone had a definite effect and high safety. For patients who were unwilling to choose or could not tolerate chemotherapy, there is a higher PSA response rate. PSA flare was not uncommon during AA treatment, and the proportion of these patients who achieved PSA response was relatively low. The median time to recurrence after PSA response was 7.0 months, and some patients with PSA progression could regain PSA response by replacing prednisone with dexamethasone.

Key words: castration-resistant prostate cancer, abiraterone acetate, PSA progression, PSA flare, docetaxel

CLC Number:

R737.25

Ye Xiaobo, Xiong Tianyu, Cui Yun, Wang Mingshuai, Yang Hui, An Zhuoling, Niu Yinong. Efficacy of abiraterone acetate combined with prednisone in the treatment of castration-resistant prostate cancer[J]. Journal of Capital Medical University, 2021, 42(6): 978-985.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2021.06.013

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2021/V42/I6/978

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