Abiraterone, Orteronel, Enzalutamide and Docetaxel: Sequential or Combined Therapy?
Abiraterone, Orteronel, Enzalutamide and Docetaxel: Sequential or Combined Therapy?
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DOI：
10.3389/fphar.2022.843110
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发表时间：
2022
影响因子：
5.6
通讯作者：
Zhao SC
中科院分区：
文献类型：
--
作者：
Chen MK;Liang ZJ;Luo DS;Xue KY;Liao DY;Li Z;Yu Y;Chen ZS;Zhao SC
目的：总结化疗药物多西他赛和内分泌治疗药物（ARAT、阿比特龙、奥特罗奈或恩杂鲁胺）治疗转移性去势抵抗性前列腺癌（mCRPC）的现状，包括序贯治疗和联合治疗，以促进最佳方案的共识，以达到更好的治疗效果。 方法：通过PubMed文献检索，收集并分析以下相关关键词的文章：CRPC、阿比特龙、奥特罗奈和恩杂鲁胺、中位生存期、总生存期、前列腺特异性抗原（PSA）、PSA反应率和中位放射学无进展生存期。 结果：本次综述共获得并分析了 58 篇文章。这些文章包括多西他赛之后的雄激素轴靶向药物、雄激素轴靶向药物之后的多西紫杉醇、三联序贯疗法和联合疗法，涵盖了目前治疗mCRPC的四种药物：多西他赛、阿比特龙、奥特罗奈和恩杂鲁胺。研究发现，雄激素轴靶向药物之间可能存在一定的交叉耐药性，这会降低后续药物治疗的疗效。虽然联合治疗的研究均未显示出严重的药物毒性，但序贯治疗的疗效并不如预期。据报道，治疗后大多数不良反应为1-2级。 结论：根据目前的研究结果，阿比特龙随后恩杂鲁胺治疗是大多数未接受过多西紫杉醇患者的最佳序贯治疗。这种治疗不仅实现了良好的 OS，而且还实现了 PFS 和 PSA 缓解率。此外，对于既往多西紫杉醇治疗失败的患者，恩杂鲁胺是后续治疗的最佳选择。
Objective: To summarize the current therapeutic status using chemotherapeutic agent docetaxel and endocrine therapeutic agents (ARAT, abiraterone, orteronel or enzalutamide) for the treatment of metastatic castration-resistant prostate cancer (mCRPC), including sequential therapy and combined therapy, to promote the consensus on the optimal regimen for achieving superior treatment efficacy. Methods: Through literature search in PubMed, articles with the following relevant keywords were collected and anlyzed: CRPC, abiraterone, orteronel and enzalutamide, median survival, overall survival, prostate specific antigen (PSA), PSA response rate and median radiologic progression-free survival. Results: Fifty-eight articles were obtained and analyzed in this review. These articles included androgen axis-targeting agents after docetaxel, docetaxel after androgen axis-targeting agents, Triple sequential and combination therapy, covering four current drugs for mCRPC treatment: docetaxel, abiraterone, orteronel, and enzalutamide. It was found that there may be some cross-resistance between androgen axis-targeting agents, which will reduce the efficacy of subsequent drug treatment. Although neither of the studies of using combination therapy showed serious drug toxicity, the efficacy of sequential therapy was not as good as expected. Most adverse reactions after treatment were reported to be level 1–2. Conclusion: Based on the results of the current studies, abiraterone followed by enzalutamide treatment is the best sequential treatment for most docetaxel-naïve patients. This treatment achieves not only good OS, but also PFS and PSA response rates. In addition, for patients who have previously failed docetaxel treatment, enzalutamide is the best choice as the subsequent treatment.
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影响因子：
45.3
作者：
Attard, Gerhardt;Borre, Michael;Taplin, Mary-Ellen
通讯作者：
Taplin, Mary-Ellen
影响因子：
45.3
作者：
Efstathiou, Eleni;Titus, Mark;Logothetis, Christopher J.
通讯作者：
Logothetis, Christopher J.
影响因子：
51.1
作者：
Khalaf, Daniel J.;Annala, Matti;Chi, Kim N.
通讯作者：
Chi, Kim N.
影响因子：
11.5
作者：
Hoffman-Censits, Jean;Kelly, Wm Kevin
通讯作者：
Kelly, Wm Kevin
影响因子：
23.4
作者：
Efstathiou, Eleni;Titus, Mark;Wen, Sijin;Hoang, Anh;Karlou, Maria;Ashe, Robynne;Tu, Shi Ming;Aparicio, Ana;Troncoso, Patricia;Mohler, James;Logothetis, Christopher J.
通讯作者：
Logothetis, Christopher J.