Carboplatin and Etoposide for the Treatment of Metastatic Prostate Cancer with or without Neuroendocrine Features: A French Single-Center Experience.

Autor: Baude J; Department of Radiation Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France., Niogret J; Department of Medical Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France., Jacob P; Department of Medical Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France., Bardet F; Department of Urology, University Hospital François Mitterrand, 21000 Dijon, France., Desmoulins I; Department of Medical Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France., Zanetta S; Department of Medical Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France., Kaderbhai C; Department of Medical Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France., Galland L; Department of Medical Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France., Mayeur D; Department of Medical Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France., Delattre B; Department of Urology, University Hospital François Mitterrand, 21000 Dijon, France., Cormier L; Department of Urology, University Hospital François Mitterrand, 21000 Dijon, France.; UFR des Sciences de Santé, Université of Bourgogne Franche-Comté, 21000 Dijon, France., Ladoire S; Department of Medical Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France.; UFR des Sciences de Santé, Université of Bourgogne Franche-Comté, 21000 Dijon, France.; Platform of Transfer in Biological Oncology, Georges-François Leclerc Cancer Center, 21000 Dijon, France.; INSERM U1231 «Lipid, Nutrition, Cancer», 21000 Dijon, France.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2024 Jan 09; Vol. 16 (2). Date of Electronic Publication: 2024 Jan 09.
DOI: 10.3390/cancers16020280
Abstrakt: Background: Chemotherapy using carboplatin and etoposide (CE) is frequently pragmatically proposed to treat metastatic prostate cancer (mPC), both primary small-cell neuroendocrine (PSC-NE) carcinoma and adenocarcinoma with or without neuroendocrine (NE) marker elevation. However, the real benefit of CE is poorly reported in the recent therapeutic context.
Methods: We retrospectively analyzed the efficacy and tolerance of CE chemotherapy in these three different groups of mPC patients. Efficacy endpoints included radiological response, progression-free survival (PFS), and overall survival (OS), as well as PSA response and PFS2/PFS1 ratio in patients with adenocarcinoma.
Results: Sixty-nine patients were included in this single-center study ( N = 18 with PSC-NE carcinoma and 51 with adenocarcinoma with ( N = 18) or without ( N = 33) NE marker elevation). Patients with adenocarcinoma were highly pretreated with next-generation hormonal agents (NHAs) and taxanes. In patients with adenocarcinoma, a PSA response ≥50% was observed in six patients (15.8%), four of whom had NE marker elevation. The radiological response was higher in PSC-NE and tended to be higher in adenocarcinoma when NE marker elevation was present. Comparing patients with adenocarcinoma with vs. without NE marker elevation, the median PFS was 3.7 and 2.1 months and the median OS was 7.7 and 4.7 months, respectively. Overall, 62.3% of patients experienced grade 3-4 adverse events (mainly hematological), and three treatment-related deaths were recorded.
Conclusion: Reports of the clinical results of CE suggest that we should not mix PSC-NE and castration-resistant adenocarcinoma of the prostate. In patients with heavily pretreated adenocarcinoma, the benefit/risk ratio of CE chemotherapy seems unfavorable due to poor response and high toxicity.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje