摘要
经雄激素剥夺疗法(ADT)治疗后,晚期前列腺癌(PCa)最终进展为去势抵抗性前列腺癌(CRPC)的原因是睾丸外器官(肾上腺)和前列腺癌细胞本身仍有合成雄激素的能力,继续刺激癌细胞的生长。醋酸阿比特龙是CYP17酶的选择性抑制剂,能全面阻断睾丸、肾上腺和前列腺癌细胞中的雄激素生物合成。大型三期随机对照临床试验均已证明,对未经化疗或者化疗失败的转移性CRPC(m CRPC)患者,醋酸阿比特龙联合小剂量泼尼松能够显著提高患者生存时间、延缓疾病进展、缓解疾病症状、提高患者生命质量。已发表的经济学分析表明,在化疗后的人群中,阿比特龙方案相对于其他新治疗方案具有成本效益优势。相关研究表明,由于醋酸阿比特龙适应症人群较小,同时其口服便利性和避免化疗相关的毒副作用,能够进一步降低卫生资源的使用,从而对医保的预算影响较小。目前国内在m CRPC领域能延长患者生存的治疗手段极为有限,醋酸阿比特龙在中国的上市为m CRPC患者和医生提供了一个新的选择。
Advanced prostate cancer（PCa） eventually progresses to castrate-resistant prostate cancer（CRPC） after androgen deprivation therapy（ADT） because the adrenal and prostate cancer cells still generate androgen that stimulates the growth of tumor cells. Abiraterone acetate is a specific inhibitor of CYP17 that blocks testicular, adrenal and tumor androgen biosynthesis. Large phase III randomized clinical trials have proved that abiraterone acetate improved overall survival, delayed disease progress, controlled disease-related symptoms, and improved quality of life in metastatic CRPC（m CRPC） patients without chemotherapy or with failed chemotherapy. The published economic analysis suggested that the combination of abiraterone and low dose prednisone was cost-effective compared with other new therapies in post-chemotherapy m CRPC patients. Additionally, abiraterone acetate was found to have minimal budget impact on health plans likely due to small size of patients and saved health resources utilization associated with administration and safety ofabiraterone acetate. The treatments for m CRPC in China are limited and the launch of using abiraterone acetate provided patients and health care providers a new treatment option.
出处
《中国医疗保险》
2016年第6期58-61,共4页
China Health Insurance
关键词
转移性去势抵抗性前列腺癌
醋酸阿比特龙
成本效益
预算影响
综述
metastatic castration-resistant prostate cancer
abiraterone acetate
cost-effectiveness
budget impact
review
