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CLIN CANCER RES:Alisertib治疗神经内分泌前列腺癌

2019-01-20 MedSci MedSci原创

神经内分泌前列腺癌(NEPC)是一种侵袭性前列腺癌,可能是治疗耐药的机制。N-myc能够促进NEPC进展。Alisertib能够抑制N-myc与Aurora-A之间的相互作用,抑制N-myc信号传导,抑制肿瘤生长。CLIN CANCER RES近期发表了一篇文章,报道了Alisertib治疗NEPC的研究结果。

神经内分泌前列腺癌(NEPC)是一种侵袭性前列腺癌,可能是治疗耐药的机制。N-myc能够促进NEPC进展。Alisertib能够抑制N-myc与Aurora-A之间的相互作用,抑制N-myc信号传导,抑制肿瘤生长。CLIN CANCER RES近期发表了一篇文章,报道了Alisertib治疗NEPC的研究结果。

60名男性接受每周两次Alisertib 50mg治疗,21天一个周期。入组标准包括转移性前列腺癌以及至少一种以下情况:小细胞神经内分泌形态; ≥50%神经内分泌标志物表达; 没有PSA进展的新发肝转移; 或血清神经内分泌标志物升高。主要终点是6个月影像学无进展生存期(rPFS)。通过全外显子组测序和RNA-seq研究治疗前肿瘤标本。研究结果表明:中位PSA为1.13 ng / mL,既往治疗次数为3次,内脏转移率为68%。基因组改变涉及RB1(55%),TP53(46%),PTEN(29%),BRCA2(29%)和AR(27%),并且存在一系列雄激素受体信号传导和NEPC标志物表达。6个月的rPFS为13.4%,中位总生存期为9.5个月。观察到治疗反应,包括肝转移的完全消退和疾病长期稳定,肿瘤显示出N-myc和Aurora-A过度活动。

文章最后认为,虽然该研究未达到其主要终点,但是一部分具有Aurora-A和N-myc活化分子特征的晚期前列腺癌患者可以从单药alisertib治疗明显获益。

原始出处:

Himisha Beltran, Clara Oromendia, et al. A Phase II Trial of the Aurora Kinase A Inhibitor Alisertib for Patients with Castration-resistant and Neuroendocrine Prostate Cancer: Efficacy and Biomarkers. CLIN CANCER RES. January 2019 doi: 10.1158/1078-0432.CCR-18-1912

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