期刊文献

Is there an anti-androgen withdrawal syndrome for enzalutamide? 收藏

是否有抗雄激素撤药综合征的enzalutamide？

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作者

Christoph A. J. von Klot [1] Mario W. Kramer [1] Alena Böker [1] Thomas R. W. Herrmann [1] Inga Peters [1] Markus A. Kuczyk [1] Uwe Ligges [7] Jürgen E. Gschwend [2] Margitta Retz [2] Sebastian C. Schmid [2] Arnulf Stenzl [3] Christian Schwentner [3] Tilmann Todenhöfer [3] Michael Stöckle [4] Carsten-Henning Ohlmann [4] Ines Azone [4] René Mager [5] Georg Bartsch [5] Axel Haferkamp [5] Axel Heidenreich [6] Charlotte Piper [6] Axel S. Merseburger [1]

作者单位

1. Department of Urology and Urologic Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany 7. Department of Statistics, TU Dortmund University, Dortmund, Germany 2. Urologische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany 3. Department of Urology, University of Tuebingen, Tübingen, Germany 4. Department of Urology, Saarland University, Homburg, Germany 5. Department of Urology, University of Frankfurt am Main, Frankfurt am Main, Germany 6. Department of Urology, RWTH University, Aachen, Germany

关键词

Anti-androgen withdrawal syndrome ;Enzalutamide ;mCRPC ;Prostate cancer

关键词译文

抗雄激素撤药综合征; Enzalutamide; mCRPC;前列腺癌

页码

1171-1176

来源信息

World Journal of Urology ISSN：0724-4983, 2014年, 32卷, 5期, 1171-1176页

摘要

Background The anti-androgen withdrawal syndrome (AAWS) can be seen in one-third of patients after discontinuation of first-generation non-steroidal anti-androgen therapy. With the introduction of new agents for anti-androgen therapy as well as alternate mechanisms of action, new therapeutic options before and after docetaxel chemotherapy have arisen (Ohlmann et al. in World J Urol 30(4):495–503, 2012). The question regarding the occurrence of an enzalutamide withdrawal syndrome (EWS) has not been evaluated yet. In this study, we assess prostate-specific antigen (PSA) response after discontinuation of enzalutamide. Methods In total 31 patients with metastatic castration-resistant prostate cancer (mCRPC) underwent an enzalutamide withdrawal and were evaluated. Data were gathered from 6 centres in Germany. Patients with continuous oral administration of enzalutamide with rising serum PSA levels were evaluated, starting from enzalutamide withdrawal until subsequent therapy was initiated, follow-up ended or death of the patient occurred. Statistical evaluation was performed applying one-sided binomial testing using R-statistical software, version 3.0.1. Results Mean withdrawal follow-up was 6.5 weeks (range 1–26.1 weeks). None of the 31 patients showed a PSA decline. Mean relative PSA rise over all patients was 73.9 % (range 0.5–440.7 %) with a median of 44.9 %. Conclusions If existent, an AAWS is at least very rare for enzalutamide in patients with mCRPC after taxane-based chemotherapy and does not play a clinical role in this setting. This may be attributed to the different pharmacodynamics of enzalutamide. Longer duration of therapy or a longer withdrawal interval may reveal a rare EWS in the future.

摘要译文

背景抗雄激素戒断综合症（AAWS）可以在第一代非甾体抗雄激素治疗停药后可以看出在三分之一的患者。通过引入新的试剂为抗雄激素疗法，以及动作的交替机制，新的治疗选择之前和多西紫杉醇化疗后已经出现（Ohlmann等。在世界Ĵ中华泌尿外科杂志30（4）：495-503，2012）。对于一个enzalutamide戒断综合征（EWS）发生的问题并没有得到评估呢。在这项研究中，我们评估enzalutamide停药后前列腺特异性抗原（PSA）的反应。方法：总共31例转移性去势抵抗前列腺癌（mCRPC）接受了enzalutamide撤离和评价。数据来自于德国6个中心聚集。患者enzalutamide与血清PSA升高水平的不断口服进行了评估，从enzalutamide退出起至随后的疗法开始，随访结束或患者的死亡发生。统计评价进行申请片面的二项式测试使用R-统计软件，3.0.1版本。结果平均戒断随访为6.5周（范围1-26.1周）。没有一个31患者表现为PSA下降。平均相对PSA上升对所有的患者为73.9％（范围0.5-440。7％）为44.9％，中值。结论：如果存在，一个AAWS至少是非常罕见的enzalutamide患者mCRPC后，紫杉类化疗，不会在此设置中发挥临床作用。这可以归因于enzalutamide的不同药效。治疗持续时间较长或更长的时间撤离可能会发现一种罕见的EWS的未来。