目的是制定一个预测模型，以找到在醋酸阿比特龙（AA）治疗转移性去势抵抗期间首次前列腺特异性抗原（PSA）进展（增加≥25%）时皮质类固醇转换（从泼尼松龙到地塞米松）的反应者前列腺癌 (mCRPC) 患者。如果转换后 PSA 下降 (≥25%)，则患者被视为有反应者。使用来自常规实验室和患者病史的 19 个二分参数的逻辑回归在 67 名患者的队列中找到最佳模型。该模型在另一组 42 名患者中进行了验证。该模型在测试组和验证组中的准确率分别为 92.5% 和 90.5%。总体准确率为 91.7%。 ROC曲线的AUC为0.92（95% CI 0.85-0.96）。中位随访 27.9 (26.3-84) 个月后，无应答者和应答者的中位 AA 地塞米松治疗持续时间 (TD) 分别为 4.7 (3.1-6.5) 和 11.1 (8.5-12.9) 个月，中位总生存期(OS) 分别为 23.2 (15.6-25.8) 和 33.5 (26.1-38) 个月。多变量 Cox 回归显示，反应性是 TD 和 OS 的独立标志。为 mCRPC 患者开发了高精度模型，用于预测可能从转换中受益的病例。对于无反应者，需要诱导下一次全身治疗。

The aim was to elaborate a predictive model to find responders for the corticosteroid switch (from prednisolone to dexamethasone) at the first prostate-specific antigen (PSA) progression (≥25% increase) during abiraterone acetate (AA) treatment of metastatic castration-resistant prostate cancer (mCRPC) patients.If PSA has decreased (≥25%) after switch, patients were considered responders. Logistic regression of 19 dichotomized parameters from routine laboratory and patients' history was used to find the best model in a cohort of 67 patients. The model was validated in another cohort of 42 patients.The model provided 92.5% and 90.5% accuracy in the testing and the validation cohorts, respectively. Overall the accuracy was 91.7%. The AUC of ROC curve was 0.92 (95% CI 0.85-0.96). After a median follow-up of 27.9 (26.3-84) months, the median AA+dexamethasone treatment duration (TD) in non-responders and responders was 4.7 (3.1-6.5) and 11.1 (8.5-12.9) months and the median overall survival (OS) was 23.2 (15.6-25.8) and 33.5 (26.1-38) months, respectively. Multivariate Cox regression revealed that responsiveness was an independent marker of TD and OS.A high accuracy model was developed for mCRPC patients in predicting cases which might benefit from the switch. For non-responders, induction of the next systemic treatment is indicated.