Therapy results of patients with metastatic castration‑resistant prostate cancer. Regional experience

Purpose of the study. To evaluate the results of first‑line treatment in patients with metastatic castration‑resistant prostate cancer (mCRPC).

Patients and methods. The evaluation of own clinical observations of 25 patients with mCRPC for the period from July 2014 to July 2021 by random sampling is given. Patients are divided into the ISUP group, the status of the initial treatment, and the type of previous treatment. Therapy was determined by the nature of progression. The following drugs were used as therapeutic agents: docetaxel, enzalutamide, abiraterone acetate + prednisolone, strontium (89 150 mBq). Results evaluation was carried out by RECIST 1.1. criteria. Statistical data processing was carried out using programs SPSS Statistica 2.0.

Results. When assessing the tumor response to the therapy in 2 (8 %) patients, a complete therapeutic response was obtained, partial was registered in 4 (16 %) cases, stabilization in 9 (36 %), progression in 10 (40 %). The main response was stabilization and partial response, which was noted in 13 (52 %) patients. On 11 (44 %) patients with bone metastases as the cause of mCRPC, enzalutamide showed the best effect. Patients with lymph node metastases 3 (12 %) had a partial and complete response with a combined treatment regimen – lymphadenectomy + enzalutamide. In the group of patients n = 9 (36 %) – metastases to lymph nodes and bones, the best effect in the form of stabilization and partial response in enzalutamide. In 1 (4 %) patient with visceral progressing metastatic pleural lesion. Two patients had passed away by the end of the research.

Conclusion. Enzalutamide and abiraterone showed the best responses in metastatic bone damage (as the cause of mCRPC). We observed more than 50 % of stabilizations during enzalutamide treatment. Combined treatment regimens should be used among patients with only metastatic lymph node lesion (oligo metastasis): this makes it possible to achieve a complete response and a greater number of stabilizations in some patients.

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