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Volume 25, Issue 2 (March 2023) 25, 179–183; 10.4103/aja2022102

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

Xin-Xing Du, Yan-Hao Dong, Han-Jing Zhu, Xiao-Chen Fei, Yi-Ming Gong, Bin-Bin Xia, Fan Wu, Jia-Yi Wang, Jia-Zhou Liu, Lian-Cheng Fan, Yan-Qing Wang, Liang Dong, Yin-Jie Zhu, Jia-Hua Pan, Bai-Jun Dong, Wei Xue

Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China

Correspondence: Dr. BJ Dong (dongbaijun@renji.com)

Received: 15 June 2022; Accepted: 31 October 2022; published online: 13 December 2022


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.

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

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Asian Journal of Andrology CN 31-1795/R ISSN 1008-682X  Copyright © 2023  Shanghai Materia Medica, Chinese Academy of Sciences.  All rights reserved.