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Archive > Volume 32 Issue 11 > 2025,32(11):1175-1180. DOI:10.3872/j.issn.1007-385X.2025.11.010 Prev Next
Clinical Research
Efficacy and prognosis of abiraterone combined with dexamethasone in the treatment of patients with castration-resistant prostate cancer
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Abstract:
[Abstract] Objective: To investigate the effects of dexamethasone combined with abiraterone on the urodynamic parameters, levels of androgen receptor splice variant 7 (AR-V7) and human homeobox B13 (HoxB13) in peripheral blood circulating tumor cells, and survival prognosis of patients with castration-resistant prostate cancer (CRPC). Methods: Medical records of 114 CRPC patients admitted to our hospital were retrospectively selected. According to the treatment regimen, they were divided into the control group (treated with 0.5 mg dexamethasone, n = 51) and the observation group (treated with 0.5 mg dexamethasone combined with 1 000 mg abiraterone, n = 63). The efficacy, urodynamic parameters, levels of AR-V7 and HoxB13 in peripheral blood circulating tumor cells, and survival prognosis of the two groups were compared. Results: There were 63 patients in the observation group and 51 in the control group. After 8 weeks of treatment, both the disease control rate (42.86% vs 23.53%) and the objective response rate (96.83% vs 86.27%) were significantly higher in the observation group than in the control group (P < 0.05). The maximum urinary flow rate ([14.58 ± 1.02] mL/s vs [11.18 ± 1.16] mL/s) and the average urinary flow rate ([12.92 ± 1.21] mL/s vs ([9.83 ± 0.59] mL/s) were significantly higher in the observation group, while the residual urine volume ([24.12 ± 1.96] mL vs [28.03 ± 1.68] mL) was significantly lower than in the control group (all P < 0.05). The expression levels of AR-V7 mRNA were similar between the observation group (1.78 ± 0.32) and the control group (1.68 ± 0.46), with no statistically significant difference (P > 0.05). However, the expression level of HoxB13 mRNA in the observation group (1.21 ± 0.27) was significantly lower than that in the control group (1.57 ± 0.37) (P < 0.05). The median progression-free survival was significantly longer in the observation group (6.22 months [95% CI: 5.63~ 6.63]) than in the control group (3.66 months [95% CI: 3.01~3.74]) (P < 0.05). The 3-year overall survival rate was 12.70% in the observation group, significantly higher than 0.00% in the control group (P < 0.05). Conclusion: The combination of dexamethasone and abiraterone demonstrates significant efficacy in treating CRPC patients. It can markedly improve urodynamic parameters, downregulate HoxB13 expression in peripheral blood circulating tumor cells without significantly affecting AR-V7 expression, prolong progression-free survival, and increase the 3-year overall survival rate.
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