4.5 Article

PD-1 inhibitor plus anlotinib for metastatic castration-resistant prostate cancer: a real-world study

Journal

ASIAN JOURNAL OF ANDROLOGY
Volume 25, Issue 2, Pages 179-+

Publisher

WOLTERS KLUWER MEDKNOW PUBLICATIONS
DOI: 10.4103/aja2022102

Keywords

anlotinib; ctDNA; immune checkpoint inhibitor; programmed cell death-1 inhibitor; prostate cancer

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We conducted a retrospective study to investigate the use of PD-1 inhibitor plus anlotinib as a potential solution for terminal mCRPC. The study showed that this combination treatment may be effective for patients with DDR or HRR pathway defects and warrants further investigation.
Management and treatment of terminal metastatic castration-resistant prostate cancer (mCRPC) remains heavily debated. We sought to investigate the efficacy of programmed cell death 1 (PD-1) inhibitor plus anlotinib as a potential solution for terminal mCRPC and further evaluate the association of genomic characteristics with efficacy outcomes. We conducted a retrospective real-world study of 25 mCRPC patients who received PD-1 inhibitor plus anlotinib after the progression to standard treatments. The clinical information was extracted from the electronic medical records and 22 patients had targeted circulating tumor DNA (ctDNA) next-generation sequencing. Statistical analysis showed that 6 (24.0%) patients experienced prostate-specific antigen (PSA) response and 11 (44.0%) patients experienced PSA reduction. The relationship between ctDNA findings and outcomes was also analyzed. DNA-damage repair (DDR) pathways and homologous recombination repair (HRR) pathway defects indicated a comparatively longer PSA-progression-free survival (PSA-PFS; 2.5 months vs 1.2 months, P = 0.027; 3.3 months vs 1.2 months, P = 0.017; respectively). This study introduces the PD-1 inhibitor plus anlotinib as a late-line therapeutic strategy for terminal mCRPC. PD-1 inhibitor plus anlotinib may be a new treatment choice for terminal mCRPC patients with DDR or HRR pathway defects and requires further investigation.

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