Enzalutamide is a second-generation androgen receptor inhibitor that increases overall survival (OS) rates in patients with metastatic castration-resistant prostate cancer (mCRPC). This study evaluates the efficacy of circulating tumor cell (CTC) status as a prognostic biomarker following enzalutamide administration. A retrospective subgroup analysis and prognostic survey were conducted on 43 patients with mCRPC and bone metastases treated in Juntendo University-affiliated hospitals from 2015 to 2022. Patients were treated with 160 mg enzalutamide daily. CTC analyses on blood samples were performed regularly before and every three months after treatment. The relationship between the patients’ clinical factors and the OS rate was analyzed using the log-rank test; the median OS was 37 months. Patients with no detected CTCs at baseline showed significantly longer OS than those with detectable CTCs at baseline. Furthermore, patients demonstrating negative reversion of CTCs during enzalutamide treatment had significantly longer OS than patients with CTC-positivity. Two biomarkers—higher hemoglobin at baseline and achieving negative reversion of CTCs—were significantly associated with prolonged OS. This study suggests that patients achieving CTC-negative reversion during treatment for mCRPC with bone metastases exhibit improved long-term OS. Chronological measurement of CTC status might be clinically useful in the treatment of mCRPC.
恩杂鲁胺是一种第二代雄激素受体抑制剂，可提高转移性去势抵抗性前列腺癌（mCRPC）患者的总生存率（OS）。本研究评估了恩杂鲁胺治疗后循环肿瘤细胞（CTC）状态作为预后生物标志物的有效性。对2015年至2022年在顺天堂大学附属医院接受治疗的43例伴有骨转移的mCRPC患者进行了回顾性亚组分析和预后调查。患者每日服用160 mg恩杂鲁胺。在治疗前及治疗后每三个月定期对血液样本进行CTC分析。采用对数秩检验分析患者临床因素与OS率的关系；中位OS为37个月。基线时未检测到CTC的患者OS显著长于基线时可检测到CTC的患者。此外，在恩杂鲁胺治疗期间CTC呈阴性逆转的患者OS显著长于CTC持续阳性的患者。两个生物标志物——基线时较高的血红蛋白水平和实现CTC阴性逆转——与OS延长显著相关。本研究表明，在伴有骨转移的mCRPC治疗期间实现CTC阴性逆转的患者表现出更优的长期OS。动态监测CTC状态可能在mCRPC的临床治疗中具有应用价值。
肿瘤(癌症)患者之家