Preliminary evaluation on efficacy and safety of abiraterone in the treatment of metastatic castration resistant prostate cancer

Abstract:

Objective：To collect and organize the clinical data of the patients who were diagnosed ascastration resistant prostate cancer（CRPC）and were treated by abiraterone in our hospital’s urology center，and to analyze the clinical data including the response rate，drug adverse event，early survival time，and the follow-up treatment. Methods：The clinical data of 55 CRPC patients who were treated with abiraterone from October 2015 to October 2017 were analyzed，including the treatment of the serum PSA，the serum testosterone level，the follow-up to the body bone imaging and other imaging studies. Results：Following data analysis，in accordance with PSA workgroup（PSAWG） standard，55 patients had a PSA overall relief rate of 56.4%，lower than that of 68% based on the international multicenter randomized double blind controlled trials，cp-aa-302.For 31 patients with a marked PSA relief，the serum PSA had been decreased by more than 50%，some patients even had decreased to more than 90%，and clinical symptoms were significantly im－proved. According to the baseline，PSA baseline value can be divided into different levels：PSA<20 ng/mL，20 to 80 ng/mL，>80 ng/mL，and the PSA response rates were 63.6%，59.1%，55.6%. The Gleason scores were divided into <8，8 and >8，with the PSA remission rate of 30.7%，58.1% and 81.8%. The difference of effective endocrine therapy time can be divided into <18 months，18 to 36 months，>36 months，and its PSA remission rateswere63.2%，52% and 54.5%. In addition，at the early stage of the early use of abiraterone，the occurrence of PSA Flare in 15 patients（15/51，27.2%）in the urosurgical treatment center in our hospital was observed and recorded. The patients were divide into ease and not alleviate group. The method of statistical Kaplan Meier-survival analysis was used and it is concluded that the use of combined therapy with prednisone and abiraterone acetatehad obvious benefit（17.06 monthsvs. 11.68 months）. Conclusion：Most of the CRPC patients who have been treated with abiraterone have benefited from it；the clinical symptoms and quality of life are improved. In addition to the Gleason rating，patients with different baseline values are expected to have an uncorrelated therapeutic effect and obvious benefit can be achieved for CRPC patient treated with the combination of the abiraterone. It has been found that the PSA Flare will pro－duce a more positive response to the response of the tumor to the drug，affecting the level of PSA relief. The occurrence of adverse events should also be closely monitored to assist in the treatment.