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Asian Journal of Urology, 2017, 4(2): 75-85    doi: 10.1016/j.ajur.2017.01.002
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A phase 3, double-blind, randomized placebo-controlled efficacy and safety study of abiraterone acetate in chemotherapynaïve patients with mCRPC in China, Malaysia, Thailand and Russia
Dingwei Yea, Yiran Huangb, Fangjian Zhouc, Keji Xied, Vsevolod Matveeve, Changling Lif, Boris Alexeevg, Ye Tianh, Mingxing Qiui, Hanzhong Lij, Tie Zhouk, Peter De Porrel, Margaret Yum, Vahid Nainim, Hongchuan Liangn, Zhuli Wun, Yinghao Sunk
a Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China;
b Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;
c Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China;
d Guangzhou First Municipal People's Hospital, Guangzhou, Guangdong, China;
e Department of Urology, Russian Academy of Medical Sciences, Moscow, Russia;
f Department of Urology, Cancer Institute (Hospital), Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China;
g Department of Oncology, Moscow Oncology Research Institute, Moscow, Russia;
h Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China;
i Department of Urology, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China;
j Department of Oncology, Peking Union Medical College Hospital, Beijing, China;
k Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China;
l Department of Oncology, Janssen Research & Development, Beerse, Belgium;
m Department of Medical Oncology, Janssen Research & Development, San Diego, CA, USA;
n Department of Urology, Janssen Research & Development, Beijing, China
A phase 3, double-blind, randomized placebo-controlled efficacy and safety study of abiraterone acetate in chemotherapynaïve patients with mCRPC in China, Malaysia, Thailand and Russia
Dingwei Yea, Yiran Huangb, Fangjian Zhouc, Keji Xied, Vsevolod Matveeve, Changling Lif, Boris Alexeevg, Ye Tianh, Mingxing Qiui, Hanzhong Lij, Tie Zhouk, Peter De Porrel, Margaret Yum, Vahid Nainim, Hongchuan Liangn, Zhuli Wun, Yinghao Sunk
a Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China;
b Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;
c Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China;
d Guangzhou First Municipal People's Hospital, Guangzhou, Guangdong, China;
e Department of Urology, Russian Academy of Medical Sciences, Moscow, Russia;
f Department of Urology, Cancer Institute (Hospital), Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China;
g Department of Oncology, Moscow Oncology Research Institute, Moscow, Russia;
h Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China;
i Department of Urology, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China;
j Department of Oncology, Peking Union Medical College Hospital, Beijing, China;
k Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China;
l Department of Oncology, Janssen Research & Development, Beerse, Belgium;
m Department of Medical Oncology, Janssen Research & Development, San Diego, CA, USA;
n Department of Urology, Janssen Research & Development, Beijing, China
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摘要 Objective: This double-blind, placebo-controlled phase 3 study was designed to compare efficacy and safety of abiraterone acetate+prednisone (abiraterone) to prednisone alone in chemotherapy-naïve, asymptomatic or mildly symptomatic metastatic castrationresistant prostate cancer (mCRPC) patients from China, Malaysia, Thailand and Russia.
Methods: Adult chemotherapy-naïve patients with confirmed prostate adenocarcinoma, Eastern Cooperative Oncology Group (ECOG) performance status (PS) grade 0-1, ongoing androgen deprivation (serum testosterone <50 ng/dL) with prostate specific antigen (PSA) or radiographic progression were randomized to receive abiraterone acetate (1000 mg, QD)+prednisone (5 mg, BID) or placebo+prednisone (5 mg, BID), until disease progression, unacceptable toxicity or consent withdrawal. Primary endpoint was improvements in time to PSA progression (TTPP).
Results: Totally, 313 patients were randomized (abiraterone:n=157; prednisone:n=156); and baseline characteristics were balanced. At clinical cut-off (median follow-up time:3.9 months), 80% patients received treatment (abiraterone:n=138, prednisone:n=112). Median time to PSA progression was not reached with abiraterone versus 3.8 months for prednisone, attaining 58% reduction in PSA progression risk (HR=0.418; p<0.0001). Abirateronetreated patients had higher confirmed PSA response rate (50% vs. 21%; relative odds=2.4; p<0.0001) and were 5 times more likely to achieve radiographic response than prednisonetreated patients (22.9% vs. 4.8%, p=0.0369). Median survival was not reached. Most common (10% abiraterone vs. prednisone-treated) adverse events:bone pain (7% vs. 14%), pain in extremity (6% vs. 12%), arthralgia (10% vs. 8%), back pain (7% vs. 11%), and hypertension (15% vs. 14%).
Conclusion: Interim analysis confirmed favorable benefit-to-risk ratio of abiraterone in chemotherapy-naïve men with mCRPC, consistent with global study, thus supporting use of abiraterone in this patient population.
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Dingwei Ye
Yiran Huang
Fangjian Zhou
Keji Xie
Vsevolod Matveev
Changling Li
Boris Alexeev
Ye Tian
Mingxing Qiu
Hanzhong Li
Tie Zhou
Peter De Porre
Margaret Yu
Vahid Naini
Hongchuan Liang
Zhuli Wu
Yinghao Sun
关键词:  Abiraterone  Chemotherapy-naï  ve  Metastatic castrationresistant prostate cancer  Prostate specific antigen  Prednisone    
Abstract: Objective: This double-blind, placebo-controlled phase 3 study was designed to compare efficacy and safety of abiraterone acetate+prednisone (abiraterone) to prednisone alone in chemotherapy-naïve, asymptomatic or mildly symptomatic metastatic castrationresistant prostate cancer (mCRPC) patients from China, Malaysia, Thailand and Russia.
Methods: Adult chemotherapy-naïve patients with confirmed prostate adenocarcinoma, Eastern Cooperative Oncology Group (ECOG) performance status (PS) grade 0-1, ongoing androgen deprivation (serum testosterone <50 ng/dL) with prostate specific antigen (PSA) or radiographic progression were randomized to receive abiraterone acetate (1000 mg, QD)+prednisone (5 mg, BID) or placebo+prednisone (5 mg, BID), until disease progression, unacceptable toxicity or consent withdrawal. Primary endpoint was improvements in time to PSA progression (TTPP).
Results: Totally, 313 patients were randomized (abiraterone:n=157; prednisone:n=156); and baseline characteristics were balanced. At clinical cut-off (median follow-up time:3.9 months), 80% patients received treatment (abiraterone:n=138, prednisone:n=112). Median time to PSA progression was not reached with abiraterone versus 3.8 months for prednisone, attaining 58% reduction in PSA progression risk (HR=0.418; p<0.0001). Abirateronetreated patients had higher confirmed PSA response rate (50% vs. 21%; relative odds=2.4; p<0.0001) and were 5 times more likely to achieve radiographic response than prednisonetreated patients (22.9% vs. 4.8%, p=0.0369). Median survival was not reached. Most common (10% abiraterone vs. prednisone-treated) adverse events:bone pain (7% vs. 14%), pain in extremity (6% vs. 12%), arthralgia (10% vs. 8%), back pain (7% vs. 11%), and hypertension (15% vs. 14%).
Conclusion: Interim analysis confirmed favorable benefit-to-risk ratio of abiraterone in chemotherapy-naïve men with mCRPC, consistent with global study, thus supporting use of abiraterone in this patient population.
Key words:  Abiraterone    Chemotherapy-naïve    Metastatic castrationresistant prostate cancer    Prostate specific antigen    Prednisone
收稿日期:  2016-01-28      修回日期:  2016-08-31           出版日期:  2017-04-01      发布日期:  2017-05-08      整期出版日期:  2017-04-01
引用本文:    
Dingwei Ye, Yiran Huang, Fangjian Zhou, Keji Xie, Vsevolod Matveev, Changling Li, Boris Alexeev, Ye Tian, Mingxing Qiu, Hanzhong Li, Tie Zhou, Peter De Porre, Margaret Yu, Vahid Naini, Hongchuan Liang, Zhuli Wu, Yinghao Sun. A phase 3, double-blind, randomized placebo-controlled efficacy and safety study of abiraterone acetate in chemotherapynaïve patients with mCRPC in China, Malaysia, Thailand and Russia[J]. Asian Journal of Urology, 2017, 4(2): 75-85.
Dingwei Ye, Yiran Huang, Fangjian Zhou, Keji Xie, Vsevolod Matveev, Changling Li, Boris Alexeev, Ye Tian, Mingxing Qiu, Hanzhong Li, Tie Zhou, Peter De Porre, Margaret Yu, Vahid Naini, Hongchuan Liang, Zhuli Wu, Yinghao Sun. A phase 3, double-blind, randomized placebo-controlled efficacy and safety study of abiraterone acetate in chemotherapynaïve patients with mCRPC in China, Malaysia, Thailand and Russia. Asian Journal of Urology, 2017, 4(2): 75-85.
链接本文:  
http://www.ajurology.com/CN/10.1016/j.ajur.2017.01.002  或          http://www.ajurology.com/CN/Y2017/V4/I2/75
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