王丽丽, 霍彬, 柳青, 王磊, 霍小东, 王金焕, 臧立, 王海涛. 甲磺酸阿帕替尼靶向治疗转移性去势抵抗性前列腺癌的临床疗效观察[J]. 中国肿瘤临床, 2019, 46(16): 845-850. DOI: 10.3969/j.issn.1000-8179.2019.16.693
引用本文: 王丽丽, 霍彬, 柳青, 王磊, 霍小东, 王金焕, 臧立, 王海涛. 甲磺酸阿帕替尼靶向治疗转移性去势抵抗性前列腺癌的临床疗效观察[J]. 中国肿瘤临床, 2019, 46(16): 845-850. DOI: 10.3969/j.issn.1000-8179.2019.16.693
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Wang Lili, Huo Bin, Liu Qing, Wang Lei, Huo Xiaodong, Wang Jinhuan, Zang Li, Wang Haitao. Clinical efficacy of apatinib for metastatic castration-resistant prostate cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 46(16): 845-850. DOI: 10.3969/j.issn.1000-8179.2019.16.693
Citation: Wang Lili, Huo Bin, Liu Qing, Wang Lei, Huo Xiaodong, Wang Jinhuan, Zang Li, Wang Haitao. Clinical efficacy of apatinib for metastatic castration-resistant prostate cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 46(16): 845-850. DOI: 10.3969/j.issn.1000-8179.2019.16.693
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甲磺酸阿帕替尼靶向治疗转移性去势抵抗性前列腺癌的临床疗效观察

Clinical efficacy of apatinib for metastatic castration-resistant prostate cancer

    摘要
  • 摘要:
      目的  评价甲磺酸阿帕替尼单药靶向治疗常规治疗失败的转移性去势抵抗性前列腺癌（metastatic castration-resistant prostatecancer，mCRPC）的近期疗效和不良反应。
      方法  收集天津医科大学第二医院2016年6月至2017年12月收治的25例常规治疗失败的mCRPC患者临床资料，观察口服甲磺酸阿帕替尼后的影像学检查，根据最新修订的实体瘤疗效评价标准（m-RECIST）、癌痛评分和前列腺特异性抗原（prostate specific antigen，PSA）的变化，回顾性分析阿帕替尼靶向治疗4个疗程（平均约112 d）后患者的近期疗效，并对靶向治疗后出现的不良反应进行初步分析。
      结果  25例患者平均发病年龄72（53~81）岁，病理类型均为腺癌，除3例失访，无完全缓解（complete response，CR），部分缓解（povtial response，PR）11例（44%），疾病稳定（stable disease，SD）8例（32%），疾病进展（progresive disease，PD）3例（12%）。客观缓解率（objective remission rate，ORR）为44%，疾病控制率（disease control rate，DCR）为76%。25例患者治疗中出现一系列不良反应，其中乏力22例（88%）、胃肠道反应15例（60%），血压升高7例（28%），手足综合征6例（24%），头晕不适、蛋白尿等其他不良反应，经对症处理后好转。
      结论  甲磺酸阿帕替尼治疗常规治疗失败的mCRPC近期疗效满意，治疗过程中不良反应的发生率较高，但多为轻中度反应，需要积极对症处理。今后仍需进一步探索该药治疗mCRPC的机制，为更多患者寻求更为有效的治疗策略。

     

    Abstract:
      Objective  To evaluate the therapeutic effects and adverse events related to apatinib use among conventional, treatmentfailed, advanced, metastatic castration-resistant prostate cancer (mCRPC).
      Methods  A total of 25 patients were treated with apatinib at The Second Hospital of Tianjin Medical University from June 2016 to December 2017. Clinical data were classified according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Pain relief evaluation, changes in serum prostate specific antigen (PSA), and adverse effects, were recorded. The evaluation period included 4 cycles (approximately 112 days).
      Results  The 25 patients were aged between 53 and 81 years (median:72 years). All tumors were classified as adenocarcinomas in terms of histopathology. Classification of the therapeutic effect was as follows:0 patients (0) had complete remission; 11 patients (44%) had partial remission; 8 patients (32%) had stable disease; and 3 patients (12%) had progressive disease. The objective remission rate (ORR) was 44%, and the disease control rate (DCR) was 76%. Treatment-related adverse events were recorded for all patients:fatigue (n=22, 88%), gastrointestinal symptoms (n=15, 60%), hypertension (n=7, 28%), hand-foot syndrome (n=6, 24%), dizziness, proteinuria, and others.
      Conclusions  Based on the demonstrated short-term therapeutic effects, apatinib could be a promising agent for conventional treatmentfailed advanced CRPC. Adverse events are mild to moderate, and patients should be kept under observation and active management. To improve the effectiveness of apatinib treatment in the future, the mechanism of action of apatinib against mCRPC showld be explored.

     

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