SİNAN KOCA, ILKER NİHAT OKTEN, MEHMET BESİROGLU, TUGBA AKİN TELLİ, AYSE DEMİRCİ, MUSTAFA KARAAGAC, AHMET KUCUKARDA, SEMİHA URVAY, SEDAT TARİK FİRAT, ZEYNEP ORUC, MEHMET MURAT ZEREY, EZGİ COBAN, IBRAHİM CİL, MAHMUT GUMUS
Eurasian Journal of Medicine and Oncology - 2023;7(1):34-41
OBJECTİVES: ENZALUTAMİDE(ENZ) İS AN EFFECTİVE HORMONAL TREATMENT MODALİTY İN MCRPC. IT CAN BE USED BEFORE OR AFTER DOCETAXEL(DTX) İN THİS SETTİNG. HEREİN, WE AİMED TO SHOW THE EFFİCACY OF ENZ BEFORE OR AFTER DTX USE AND THE FACTORS PREDİCTİNG THE EFFİCACY. METHODS: WE RETROSPECTİVELY COLLECTED THE DATA OF 320 PATİENTS FROM 12 CENTERS WHO WERE TREATED WİTH ENZ İN MCRPC. THE İNİTİAL STAGE, AGE, LİNE OF TREATMENT, SERUM PROSTATE-SPECİFİC ANTİGEN (PSA) LEVELS BEFORE ENZ TREATMENT AND AT NADİR, SİTE OF METASTASİS, GLEASON SCORE WERE EVALUATED. RESULTS: MEDİAN AGE OF 320 PATİENTS WERE 69. AT A MEDİAN FOLLOW-UP OF 56 MONTHS, 271/320 (84.7%) DİSEASE PROGRESSİON AND 230/320(71.9%) DEATH HAD BEEN OBSERVED. MEDİAN PFS WAS 11(8.9-13)) AND MEDİAN OS WAS 25(22.1-27.8) MONTHS İN ALL PATİENTS GROUP. MEDİAN PFS WAS 10(7.4-12.5) MONTHS, 11(8-13.9) MONTHS İN PRE-DTX AND POST-DTX GROUPS RESPECTİVELY. MEDİAN OS WAS HİGHER İN THE POST-DTX GROUP THAN THE PRE-DTX GROUP (28(25.7-30.2) VS 19(15.0-22.9-46.6) (P:0.000). GLEASON SCORE≥8 (HR 0.59, 95%CI 0.46-0.77, P=0.00), PRESENCE OF NON-VİSCERAL METASTASİS (HR 0.72, 95%CI 0.53-0.97, P=0.031), İNİTİAL PSA VALUE<43(MEDİAN) (HR 0.70, 95%CI 0.54-0.91, P=0.009), PSA AT NADİR <2 (HR 0.61, 95%CI 0.44-0.85, P=0.004), >50% DECLİNE İN PSA (HR 0.27, 95%CI 0.19-0.36, P=0.000) SİGNİFİCANTLY PREDİCTED ENZ RESPONSE REGARDİNG RPFS. CONCLUSİON: ENZ HAS SHOWN EQUAL EFFİCACY BEFORE AND AFTER DTX TREATMENT İN MCRPC REGARDİNG RPFS. BUT OS RATE WAS SİGNİFİCANTLY BETTER İN THE PRE-DTX GROUP. THEREFORE, WE RECOMMEND STARTİNG WİTH DTX İN PATİENTS WHO CAN TOLERATE CHEMOTHERAPY İN MCRPC SETTİNG.
