Background

Cabazitaxel has played an important role in the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC); however, several types of sequential therapy against mCRPC have been performed in routine clinical practice. The objective of this study was to investigate the impact of third-line treatment on prognostic outcomes of mCRPC patients.

Methods

This study retrospectively analyzed the clinical outcomes of 166 patients who received 3 agents following the diagnosis of mCRPC, consisting of 81 sequentially treated with either abiraterone or enzalutamide and then docetaxel, followed by third-line cabazitaxel (group A) and 85 treated with 3 agents, including abiraterone, enzalutamide, and docetaxel (group B).

Results

There were no significant differences in major characteristics at the introduction of the third-line agent between these 2 groups. The proportion of patients with prostate-specific antigen (PSA) reduction > 50% by cabazitaxel in group A was significantly greater than that by either third-line agent in group B. Both PSA progression-free survival (PFS) and overall survival (OS) following third-line therapy in group A were significantly longer than those in group B. Furthermore, OS after the diagnosis of mCRPC in group A was significantly longer than that in group B. Multivariate analysis identified independent predictors of favorable prognostic outcomes after third-line therapy as follows: high-performance status (PS), low PSA level and third-line cabazitaxel for PSA PFS, and high PS, low lactate dehydrogenase level and third-line cabazitaxel for OS.

Conclusions

The introduction of cabazitaxel as a third-line agent could markedly improve the prognostic outcomes of mCRPC patients.

中文翻译：

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三线治疗对转移性去势抵抗性前列腺癌患者的预后意义：卡巴他赛与其他药物的比较评估

背景

Cabazitaxel 在转移性去势抵抗性前列腺癌 (mCRPC) 患者的治疗中发挥了重要作用；然而，在常规临床实践中已经进行了几种针对 mCRPC 的序贯治疗。本研究的目的是调查三线治疗对 mCRPC 患者预后的影响。

方法

本研究回顾性分析了 166 名在 mCRPC 诊断后接受 3 种药物治疗的患者的临床结局，其中 81 名患者依次接受阿比特龙或恩杂鲁胺治疗，然后多西他赛，随后接受三线卡巴他赛（A 组）和 85 名接受 3 种药物治疗的患者，包括阿比特龙、恩杂鲁胺和多西他赛（B 组）。

结果

这两组在引入三线药物时的主要特征没有显着差异。A 组卡巴他赛治疗后前列腺特异性抗原 (PSA) 降低 > 50% 的患者比例显着高于 B 组任何一种三线药物治疗的患者比例。 PSA 无进展生存期 (PFS) 和总生存期 (OS) ) A 组三线治疗后显着长于 B 组。此外，A 组 mCRPC 诊断后的 OS 显着长于 B 组。多变量分析确定了三线治疗后良好预后结果的独立预测因子。线治疗如下：高性能状态 (PS)、低 PSA 水平和用于 PSA PFS 的三线卡巴他赛，以及高 PS，

结论

卡巴他赛作为三线药物的引入可以显着改善 mCRPC 患者的预后结果。