Switch from abiraterone plus prednisone to abiraterone plus dexamethasone in patients with metastatic castration-resistant prostate cancer: a case report.
10.3760/cma.j.cn112330-20210408-00009
- VernacularTitle:泼尼松转换为地塞米松联合阿比特龙治疗转移性去势抵抗性前列腺癌一例报告
- Author:
Kangxin NI
1
;
Zhenghui WANG
;
Gonghui LI
Author Information
1. 浙江大学医学院附属邵逸夫医院泌尿外科，杭州 310020
- Keywords:
Prostatic neoplasms;
Castration resistant;
Abiraterone;
Prednisone;
Dexamethasone
- From:
Chinese Journal of Urology
2021;42(Z1):35-38
- CountryChina
- Language:Chinese
-
Abstract:
To explore the therapeutic effect of abiterone combined with dexamethasone by reporting a case of metastatic castration-resistant prostate cancer (mCRPC) who was treated with abiterone combined with prednisone and then changed to abiterone combined with dexamethasone. A 61-year-old man was admitted to Sir Run Run Shaw Hospital in November 2017 due to elevated prostate-specific antigen (PSA) at 11 ng/ml. Prostate MRI showed that abnormal signal intensities in the periphery of the prostate which was considered as prostate cancer. Consideration of metastases in the right iliac crest; partial signal changes in the medial seminal vesicles of both sides which were considered involved. The prostate needle biopsy demonstrated that left prostate adenocarcinoma while Gleason score: 5+ 4=9, diagnosed as metastatic hormone-sensitive prostate cancer (mHSPC). In December 2017, the patient underwent robot assisted laparoscopic radical prostatectomy. Prostatic adenocarcinoma was confirmed by postoperative pathology, Gleason score: 5+ 4=9. The bilateral seminal vesicles and nerves were invaded. The level of PSA was monitored during the continuous postoperative treatment using bicalutamide and goserelin.The PSA was 0.32, 0.15, and 1.72 ng/ml in February, June and October of 2018. In October 2018, the testosterone was 40 ng/dl, considering the biochemical progress. In November 2018, the PSA was 2.51ng/ml, considering entering mCRPC. The treatment plan was switched to abiraterone, prednisone and goserelin, and PSA was monitored. In January, March, and June of 2019, the PSA was 0.1, 0.03, and 1.1 ng/ml. By March 2020, it had reached 8.9 ng/ml. The treatment plan was changed to abiraterone and dexamethasone. In April, July and September of 2020, PSA was 7.9, 3.98, and 2.58 ng/ml respectively. The treatment is still ongoing.Abiraterone combined with prednisone is still effective after asymptomatic PSA progression in mCRPC.
