Publication: Evaluación de abiraterona posquimioterápica en cáncer de próstata metastásico resistente a la castración
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2015-06
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Abstract
El cáncer de próstata resistente a la castración metastático (mCPRC) es una complicación de la patología inicial para la que solo se dispone de tratamientos que aumentan la supervivencia unos meses, pero no erradican la enfermedad. Un nuevo fármaco hormonal que inhibe la síntesis de testosterona de la cual se nutre el tumor es la abiraterona, aprobada en octubre de 2012 por la AEMPS. El objeto de este trabajo es evaluar el progreso de 8 pacientes con mCPRC que han sido tratados con abiraterona como segunda o tercera línea de tratamiento. Para ello se ha observado la progresión de la enfermedad y los efectos adversos que hayan podido tener lugar. Se apreció que los efectos adversos habían sido prácticamente inexistentes y solo en uno de los casos se tuvo que retirar el fármaco por la aparición de hepatotoxicidad. Para evaluar la efectividad del tratamiento se tuvo en cuenta principalmente la evolución de los niveles sanguíneos del antígeno prostático específico (PSA), un marcador tumoral empleado en el diagnóstico del cáncer de próstata. Únicamente en 1 de los 8 pacientes se lograron alcanzar niveles dentro de los límites normales del PSA. En 2 pacientes no se consiguió disminuir el PSA respecto al inicio. En uno de los pacientes el PSA estaba dentro de los límites y se evaluó el antígeno carcinoembriónico (CEA), otro marcador tumoral empleado en el diagnóstico de diversos tipos de cáncer. Todo lo anterior llevó a concluir que pese a que la abiraterona es un fármaco muy seguro y bien tolerado, no se pudo llegar a resultados concluyentes sobre la efectividad si bien se observó que la evolución del PSA no fue la esperada.
Castration-resistant metastasis are one of the complications of prostate cancer, for which there only exist therapies that increase survival by some months but don’t erradicate the disease. A new hormonal drug that inhibits the synthesis of testosterone- main growth factor in this tumors- is abiraterone, aproved in october of 2012 by the AEMPS. The goal of this research is to evaluate the progress of 8 patients withs castration-resistant metastasic prostate cancer that have been treated using abiraterone as a second or third line of treatament. For this purpose we have evaluated the progression of the disease and the posible side effects that might have taken place. Side effects practically non-existent and only one patient did the drug have to be removed because of incipient hepatotoxicity. In RESUMEN 4 order to evaluate the efectiveness of the therapy we mainly evaluated the evolution of bloods levels of specific postate antigen (SPA), a tumoral marker used in the diagnosis of prostate cancer. Only 1 out of 8 patients was a normal range SPA blood level reached. In 2 patients there was no evident SPA decrease from its initial levels. In one of the patients SPA was in normal range and the carcinoembrionic antigen (CEA) was evaluated, another tumoral marker used in the diagnosis of various cancer types. All the above brought us to the conclusion that, although abiraterone is well tolerated and safe drug, no concluding results could be shown about its effectiveness on prostate cancer, and that the evolution of SPA levels was not the expected one.
Castration-resistant metastasis are one of the complications of prostate cancer, for which there only exist therapies that increase survival by some months but don’t erradicate the disease. A new hormonal drug that inhibits the synthesis of testosterone- main growth factor in this tumors- is abiraterone, aproved in october of 2012 by the AEMPS. The goal of this research is to evaluate the progress of 8 patients withs castration-resistant metastasic prostate cancer that have been treated using abiraterone as a second or third line of treatament. For this purpose we have evaluated the progression of the disease and the posible side effects that might have taken place. Side effects practically non-existent and only one patient did the drug have to be removed because of incipient hepatotoxicity. In RESUMEN 4 order to evaluate the efectiveness of the therapy we mainly evaluated the evolution of bloods levels of specific postate antigen (SPA), a tumoral marker used in the diagnosis of prostate cancer. Only 1 out of 8 patients was a normal range SPA blood level reached. In 2 patients there was no evident SPA decrease from its initial levels. In one of the patients SPA was in normal range and the carcinoembrionic antigen (CEA) was evaluated, another tumoral marker used in the diagnosis of various cancer types. All the above brought us to the conclusion that, although abiraterone is well tolerated and safe drug, no concluding results could be shown about its effectiveness on prostate cancer, and that the evolution of SPA levels was not the expected one.