A changing landscape in castration-resistant prostate cancer treatment.
A changing landscape in castration-resistant prostate cancer treatment.
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DOI：
10.3389/fendo.2012.00085
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发表时间：
2012-01-01
影响因子：
5.2
通讯作者：
Carlini, Paolo
中科院分区：
文献类型：
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作者：
Felici, A;Pino, M S;Carlini, Paolo
前列腺癌（PC）是西方世界男性癌症的主要原因，也是癌症死亡的第二大原因。约10-20%的男性PC患者在诊断时存在转移性疾病，而20-30%诊断为局限性疾病的患者最终会发生转移。虽然大多数人对初始雄激素剥夺治疗（ADT）有反应，但进展为去势抵抗性PC （CRPC）是普遍的。2004年，多西他赛/泼尼松方案被批准用于转移性CRPC患者的治疗，成为标准的一线治疗方案。在过去的几年中，最近的进展导致了前所未有的新药批准，为转移性CRPC患者提供了许多新的治疗选择。四种新药分别在2010年和2011年获得了美国食品和药物管理局（FDA）的批准：免疫治疗剂sipuleucel-T；新型微管抑制剂卡巴他赛；新型雄激素生物合成抑制剂醋酸阿比特龙还有denosumab，一种骨靶向药物。本综述描述了支持这些药物批准的数据，以及目前治疗转移性CRPC的方法和正在进行的新治疗和策略的临床试验。
Prostate cancer (PC) is the leading cause of cancer and the second leading cause of cancer-death among men in the Western world. About 10-20% of men with PC present with metastatic disease at diagnosis, while 20-30% of patients diagnosed with localized disease will eventually develop metastases. Although most respond to initial androgen-deprivation therapy (ADT), progression to castration-resistant PC (CRPC) is universal. In 2004 the docetaxel/prednisone regimen was approved for the management of patients with metastatic CRPC, becoming the standard first-line therapy. Recent advances have now led to an unprecedented number of new drug approvals within the past years, providing many new treatment options for patients with metastatic CRPC. Four new drugs have received U.S. Food and Drug Administration (FDA)-approval in 2010 and 2011: sipuleucel-T, an immunotherapeutic agent; cabazitaxel, a novel microtubule inhibitor; abiraterone acetate, a new androgen biosynthesis inhibitor; and denosumab, a bone-targeting agent. The data supporting the approval of each of these agents are described in this review, as are current approaches in the treatment of metastatic CRPC and ongoing clinical trials of novel treatments and strategies.