Abstract:Objective: To analyze the early efficacy and safety of apalutamide treatment for the patients who were diagnosed as prostate cancer, and provide experience for future treatment. Methods: A total of 32 cases of prostate cancer in West China Hospital from January 2021 to October 2021 were treated with apalutamide. The clinical data were recorded and analyzed, including prostate specific antigen (PSA), testosterone level, bone scanning, CT, MRI and adverse events. Results: According to PSA workgroup standard, the PSA response rate of total 32 patients was 81.3%. For the patients at different disease stage, including metastatic hormone sensitive prostate cancer, non metastatic castration resistant prostate cancer and metastatic castration resistant prostate cancer, PSA response rate of these patients was 100%, 90.9% and 58.3%, respectively. Generally, apalutamide was well tolerant. Rash and fatigue were common and there was no adverse events at grade 3 or above. Conclusion: Apalutamide showed a great early clinical efficacy and high safety, which should be recommended for treatment of prostate cancer.
叶剑钧, 鲍一歌, 沈朋飞, 刘振华, 杨璐, 张朋, 李响, 曾浩, 魏强. 阿帕他胺治疗晚期前列腺癌32例报道[J]. 微创泌尿外科杂志, 2022, 11(2): 76-80.
Ye Jianjun, Bao Yige, Shen Pengfei, Liu Zhenhua, Yang Lu, Zhang Peng, Li Xiang, Zeng Hao, Wei Qiang. Clinical efficacy and safety of apalutamide in the treatment of prostate cancer: case series from West China Hospital. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2022, 11(2): 76-80.
[1] CLEGG N J, WONGVIPAT J, JOSEPH J D, et al.ARN-509: a novel antiandrogen for prostate cancer treatment[J]. Cancer Res,2012,72(6):1494-1503.
[2] LOGOTHETIS C J, GALLICK G, MAITY S N, et al.Molecular classification of prostate cancer progression: foundation for marker-driven treatment of prostate cancer[J]. Cancer Discov,2013,3(8):849-861.
[3] CHI K N, AGARWAL N, BJARTELL A, et al.Apalutamide for metastatic, castration-sensitive prostate cancer[J]. N Engl J Med,2019,381(1):13-24.
[4] SMITH M R, SAAD F, CHOWDHURY S, et al.Apalutamide treatment and metastasis-free survival in prostate cancer[J]. N Engl J Med,2018,378(15):1408-1418.
[5] HUSSAIN M, TANGEN CM, HIGANO C, et al.Absolute prostate-specific antigen value after androgen deprivation is a strong independent predictor of survival in new metastatic prostate cancer: data from Southwest Oncology Group Trial 9346 (INT-0162)[J]. J Clin Oncol. 2006;24(24):3984-3890.
[6] LI T T, SHORE N D, MEHRA M, et al.Impact of subsequent metastases on costs and medical resource use for prostate cancer patients initially diagnosed with localized disease[J]. Cancer,2017,123(18):3591-3601.
[7] LI J, XU C, LEE H J, et al.A genomic and epigenomic Atlas of prostate cancer in Asian populations[J]. Nature,2020,580(781):93-99.
[8] Rathkopf D, Antonarakis S, Shore DN, et al.Safety and antitumor activity of apalutamide (ARN-509) in metastatic castration-resistant prostate cancer with and without prior abiraterone acetate and prednisone. Clin[J]. Cancer Res,2017,23(14):3544-3551.
[9] DE VRIES R, JACOBS F, MANNENS G, et al.Apalutamide absorption, metabolism, and excretion in healthy men, and enzyme reaction in human hepatocytes[J]. Drug Metab Dispos,2019,47(5):453-464.
[10] MONBALIU J, GONZALEZ M, BERNARD A, et al.In vitro and in vivo drug-drug interaction studies to assess the effect of abiraterone acetate, abiraterone, and metabolites of abiraterone on CYP2C8 activity[J]. Drug Metab Dispos,2016,44(10):1682-1691.
[11] KHALAF D J, ANNALA M, TAAVITSAINEN S, et al.Optimal sequencing of enzalutamide and abiraterone acetate plus prednisone in metastatic castration-resistant prostate cancer: a multicentre, randomised, open-label, phase 2, crossover trial[J]. Lancet Oncol,2019,20(12):1730-1739.
[12] TANNOCK I F, DE WIT R, BERRY W R, et al.Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer[J]. N Engl J Med,2004,351(15):1502-1512.
[13] BEER T M, ARMSTRONG A J, RATHKOPF D, et al.Enzalutamide in men with chemotherapy-naïve metastatic castration-resistant prostate cancer: extended analysis of the phase 3 PREVAIL study[J]. Eur Urol,2017,71(2):151-154.