The clinical characters and prognostic value of flare phenomenon in metastatic castration resistant prostate cancer patients treated with Abiterone
10.3760/cma.j.cn112330-20210624-00343
- VernacularTitle:转移性去势抵抗性前列腺癌阿比特龙治疗后闪烁现象的临床特征和预后
- Author:
Tao YANG
1
;
Ying LIU
;
Shuzhen CHEN
;
Yingyi QIN
;
Denglong WU
;
Cuidong BIAN
;
Tin JIANG
;
Feng LIU
;
Chengdang XU
;
Xin’an WANG
;
Yongnan CHI
;
Shengsong HUANG
Author Information
1. 同济大学附属同济医院泌尿外科，上海 200065
- Keywords:
Prostatic neoplasms;
Carcinoma;
Castration resistance;
Abiraterone;
Flare
- From:
Chinese Journal of Urology
2023;44(12):911-916
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characters and prognostic value of PSA flare and bone flare in metastatic castration resistant prostate cancer(mCRPC) patients received Abiterone acetate(AA) therapy.Methods:A retrospective study was conducted for 93 mCRPC patients treated with AA from Jul.2016 to Dec.2020. Mean age was (75.4±8.9)years, median PSA was 58.2 (16.4, 148.6)ng/ml. Patients received at least 6 months of AA treatment. PSA flare was defined as an increase of PSA after AA therapy followed by a decrease. Bone flare was defined as disease progression after 3 months of therapy, typically based on increased lesion intensity or number, and reevaluation 6-9 months later showed improvement in the scan. The clinical characters and prognostic value of the flare phenomenon was evaluated and analyzed respectively.Results:The median follow up time was 16 months(6, 54 months), fourteen patients showed PSA flare at first month after AA treatment, and median time of duration was 2 months(1, 7 months). The serum alkaline phosphatase (ALP) had a similar rising trend along with PSA flare[115.5(98.0, 198.5)U/L vs. 119.0(97.0, 288.8)U/L, P=0.016]. Seven patients showed bone flare and 3 cases co-existed with PSA flare. Multivariate Cox regression analysis indicated bone flare was an independent protective factor for progression free survival(PFS)( HR=0.117, 95% CI 0.015-0.895, P=0.039), PSA flare had no significant influence on PFS ( HR=1.314, 95% CI 0.554-3.121, P=0.536)and overall survival(OS)( HR=1.348, 95% CI 0.393-4.263, P=0.635). Log-rank test showed patients with bone flare had a longer PFS( P=0.016) and OS( P=0.047) compared with patients without bone flare. Conclusions:PSA flare always faded away after 2 months AA therapy and had no influence on PFS and OS. Bone flare maybe an indication for better prognosis.
