肿瘤瞭望:当地时间6月2日下午,美国杜克大学Daniel George 博士带来了Abi Race研究结果。该研究为比较美国黑人与白人mCRPC阿比特龙治疗差异的前瞻性、多中心研究(LBA5009)。Abi Race研究给予我们提示,前列腺癌在东西方人群中,除了发病率存在差异,对阿比特龙等新型内分泌治疗药物的反应率也可能有所区别,我们也期待中国人群的研究数据提供更加个性化的内分泌治疗策略。
《肿瘤瞭望》在现场采访了Daniel George 博士,一起分享前列腺癌前沿研究结果!
《肿瘤瞭望》:请简要介绍一下您在此次会议上带来的研究成果
Dr. Daniel George:我们带来了一项多中心、前瞻性、平行分组研究,共纳入50例非裔美国人和50例转移性去势抵抗性前列腺癌经醋酸阿比特龙治疗的患者,随访患者临床转归及副反应事件。该研究结果显示,非裔美国人在每个截点上表现出更明显的PSA反应率;与白人患者相比,PSA进展时间延长了40%。我们还发现两组之间的放射学无进展生存率是相似的。需要更大规模的研究来比较这些人群和其他种族群体,以了解前列腺癌相关的种族差异。
该研究得出的三个重要结论是:一是(此类患者对阿比特龙治疗反应的)种族研究是可行的。二是(该项)前瞻性研究,可观察到有显著差异的治疗转归和副反应。第三是需要对这些患者的遗传图谱进一步探索,因为二者(差异)不仅仅是种族外观,更重要的是需要了解与种族相关的、导致此结果差异的遗传决定因素。
《肿瘤瞭望》:研究中所发现的差异是否可能改变临床实践?
Dr. Daniel George:我认为这些研究结果应该可以支持尽早在非裔美国人前列腺癌患者中临床使用,并提供相关信息以助患者评估是否可从此类治疗中获益。
《肿瘤瞭望》:该研究是否仍在进行中(您下一步的研究方向是什么)?
Dr. Daniel George:没错,我们仍在寻找血样来了解与此疾病相关的遗传学特征。我们希望将来的研究中,也是目前正在进行的研究,可进一步界定这些差异。
Ioncology:Please briefly introduce your key finding and highlight the 3 take-home messages.
Dr. Daniel George:We did a multicenter prospective study, parallel group study, 50 African Americans and 50 Caucasians treated with metastatic castrate-resistant prostate cancer with abiraterone acetate and followed patients for clinical outcomes and adverse events.
In our study we were able to show that African American patients had greater PSA response rates at every cut-off that we looked at, and a 40% longer time to PSA progression compared to the white patients. And we also found that radiographic progression free survival between the two groups was similar. Larger studies comparing these population and other racial populations are needed to understand it, the racial differences associated with outcome in prostate cancer.
Our three important conclusions are one: that racial studies are possible, that it is possible to do these studies. Two, that meaningful differences in outcomes and side-effects can be seen when these studies are done prospectively. And three, that genetic profiles of these patients should be pursued because it is more than just the outward appearance of race that matters, we need to understand the genetic determinants associated with race that drive these differences in outcomes.
Ioncology:Is it possible to change the clinical practice?
Dr. Daniel George:I think these results should be supportive of the clinical use of the drug like abiraterone in African American patients early, on label, and to make sure that patients are offered this to realize that they are at least as likely, if not more likely, to benefit from this therapy.
Ioncology:If I didn’t remember wrong,your study is still on going right? What’s your future plan?)
Dr. Daniel George:That is correct. We are still looking at out blood samples to understand the genetics associated with this disease, and we hope that with future studies, we have a confirmation study ongoing now that will be able to further define these differences.
Thank you!