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The heterogeneity of intraductal carcinoma of the prostate is associated with different efficacy of standard first‐line therapy for patients with metastatic castration‐resistant prostate cancer

BACKGROUND: To explore whether metastatic castration‐resistant prostate cancer (mCRPC) patients with distinct intraductal carcinoma of the prostate (IDC‐P) subtypes respond differently to abiraterone and docetaxel treatment. METHODS: We retrospectively analyzed data of 170 mCRPC patients receiving a...

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Detalles Bibliográficos
Autores principales: Wang, Zhipeng, Zhu, Sha, Zhao, Jinge, Nie, Ling, Chen, Xueqin, Zhang, Mengni, Chen, Ni, Sun, Guangxi, Chen, Junru, Ni, Yuchao, Dai, Jindong, Liu, Zhenhua, Tao, Ronggui, Zhang, Xingming, Zhu, Xudong, Zhang, Haoran, Liang, Jiayu, Wang, Zilin, He, Ben, Shen, Pengfei, Zeng, Hao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9290811/
https://www.ncbi.nlm.nih.gov/pubmed/34435696
http://dx.doi.org/10.1002/pros.24215
Descripción
Sumario:BACKGROUND: To explore whether metastatic castration‐resistant prostate cancer (mCRPC) patients with distinct intraductal carcinoma of the prostate (IDC‐P) subtypes respond differently to abiraterone and docetaxel treatment. METHODS: We retrospectively analyzed data of 170 mCRPC patients receiving abiraterone or docetaxel as first‐line therapy. PSA response, PSA progression‐free survival (PSA‐PFS), radiographic progression‐free survival (rPFS), and overall survival (OS) were analyzed based on the presence of IDC‐P and its subpatterns. RESULTS: IDC‐P was confirmed in 91/170 (53.5%) patients. Among them 36/91 (39.6%) and 55/91 (60.4%) harbored IDC‐P patterns 1 and 2, respectively. Patients with IDC‐P pattern 1 shared similar clinical outcomes to those without IDC‐P in both abiraterone and docetaxel treatment. However, against cases without IDC‐P or with IDC‐P pattern 1, patients with IDC‐P pattern 2 had markedly poorer prognosis in either abiraterone (mPSA‐PFS: 11.9 vs. 11.1 vs. 6.1 months, p < 0.001; mrPFS: 18.9 vs. 19.4 vs. 9.6 months, p < 0.001) or docetaxel (mPSA‐PFS: 6.2 vs. 6.6 vs. 3.0 months, p < 0.001; mrPFS: 15.1 vs. 12.6 vs. 5.5 months, p < 0.001) treatment. For patients without IDC‐P, docetaxel had comparable therapeutic efficacy with abiraterone. However, the efficacy of docetaxel was significantly inferior to abiraterone in patients with either IDC‐P pattern 1 (mPSA‐PFS: 6.6 vs. 11.1 months, p = 0.021; mrPFS: 12.6 vs. 19.4 months, p = 0.027) or pattern 2 (mPSA‐PFS: 3.0 vs. 6.1 months, p = 0.003; mrPFS: 5.5 vs. 9.6 months, p = 0.007). CONCLUSION: Compared to docetaxel, abiraterone exhibited better efficacy in patients with IDC‐P of either pattern. However, IDC‐P pattern 2 responded unsatisfactorily to either abiraterone or docetaxel therapy. Novel therapeutic strategies for IDC‐P pattern 2 need further investigations.