State-of-the-art treatment of metastatic hormone-refractory prostate cancer
State-of-the-art treatment of metastatic hormone-refractory prostate cancer
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DOI：
10.1634/theoncologist.7-4-360
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发表时间：
2002-01-01
期刊：
影响因子：
5.8
通讯作者：
DiPaola, RS
中科院分区：
文献类型：
--
作者：
Goodin, S;Rao, KV;DiPaola, RS
晚期前列腺癌的初始治疗包括通过手术或药物去势进行雄激素消融。尽管如此，几乎所有转移的男性都会进展为难治性前列腺癌（HRPC）。目前美国食品和药物管理局批准的治疗HRPC的药物包括米托蒽醌和雌莫司汀，尽管长春花生物碱和紫杉烷在单药11期试验中显示出有希望的活性。这些药物的组合在超过50%的患者中诱导生化反应，但反应的中位持续时间约为6个月。接受这些联合治疗的患者的总生存期约为18-24个月。正在进行研究以开发针对化疗耐药的特定分子途径或机制的新疗法。正在开发的新药包括生长因子受体抑制剂、反义寡核苷酸、双膦酸盐和细胞分化剂。评估和纳入这些药物到现有的治疗方案将指导我们在HRPC治疗更积极的方案的发展。
Initial therapy for advanced prostate cancer includes androgen ablation by surgical or medical castration. Still, nearly all men with metastases will progress to hormone-refractory prostate cancer (HRPC). Current U.S. Food and Drug Administration-approved agents for the treatment of HRPC include mitoxantrone and estramustine, although the vinca alkaloids and the taxanes have shown promising activity in single-agent phase 11 trials. Combinations of these agents induce a biochemical response in greater than 50% of patients, but the median duration of response is approximately 6 months. Overall survival of patients treated with these combinations is approximately 18-24 months. Studies are ongoing to develop novel therapies that target specific molecular pathways or mechanisms of chemotherapy resistance. Novel agents under development include growth factor receptor inhibitors, antisense oligonucleotides, bisphosphonates, and cell differentiating agents. Evaluation and incorporation of these agents into existing treatment regimens will guide us in the development of more active regimens in the treatment of HRPC.