抑那通治疗前列腺癌的新进展.ppt

抑那通3.75mg预充式注射器 AUA(2010)内分泌治疗新进展 RESULTS The mean time off therapy prior to a rise in PSA 0.1ng/ml above base line for all patients and those with 2 consecutive rises was 15.4 and 9.5 months respectively. The mean base line PSA, mean PSA at one, and at two years off therapy was 0.3ng/ml, 1.1ng/ml, and 5ng/ml respectively. Mean testosterone at base line, one, and two years off therapy was 13.9ng/ml, 76ng/ml, and 150.6ng/ml respectively. AUA(2010)内分泌治疗新进展 RESULTS Twelve (63%) patients had recovery of testosterone above 50ng/dl. Four (21%) patients remained castrate off therapy a mean of 20 months. The mean time to testosterone recovery was 12.8 months. Two (10.5%) patients in the study have died. One death was attributed to prostate cancer. AUA(2010)内分泌治疗新进展 CONCLUSION The recovery of testosterone and significant elevations of PSA after long term LHRH agonist therapy is significantly delayed in most patients. This helps to support the concept of intermittent androgen ablation which has benefits in quality of life and reduced cost of therapy. Data on file 手术去势的副作用 增加心血管疾病和糖尿病发病率 Data on file 手术去势的副作用 增加骨折发病率 抑那通通过抑制雄性激素的作用而抑制大白鼠前列腺肿瘤的增殖 醋酸亮丙瑞林水溶液 0.333mg/kg/日（1日1次投药) 醋酸亮丙瑞林水溶液 0.333mg/kg/日（1日2次投药) 抑那通 相当于0.333mg/kg/日（1月1次投药) 阉割 肿瘤移植后的天数 肿 瘤 体 积(cm) 对照 醋酸亮丙瑞林水溶液 1mg/kg/日（1日1次投药) 抑那通与睾丸切除术抗肿瘤作用比较 抑那通治疗前列腺癌的综合效果 抑那通治疗前列腺癌各病灶的疗效 抑那通改善前列腺癌各种症状的效果明显 抑那通治疗前列腺癌从起效到部分缓解的时间 间歇疗法与持续疗法患者生存率相当 Data on file 抑那通间歇疗法显著降低前列腺体积 第1周期 第2周期 前列腺体积变化比例(%) Bruchovsky N, et al. Cancer.2006 Jul 15;107(2):389-95 抑那通间歇疗法迅速降低PSA值 到达PSA最低值所需时间(月) Higano CS, et al. Urology.1996 Nov;48(5):800-4 间歇疗法减少骨质丢失，降低副反应发生率 Uif Tunn 2007 Bju International 99,supplement 1,19-22 Data on file 间歇期雄激素明显恢复，可改善患者生活质量 间歇疗法有利于患者性功能恢复 N.A.Spry,et al European Journal of Cancer 42(2006):1083-1092 间歇期暂停用药，大幅度降低治疗成本 总 结 有效治疗前列腺癌 患者生存率与持续疗法相当 与去势疗法相比，副作用显著降低 改善性功能，提高生活质量 降低治疗成本 抑那通间歇疗法优势突出 现有剂型 上市新剂型 抑那通治