Shaffer David R, Scher Howard I
Genitourinary Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Lancet Oncol. 2003 Jul;4(7):407-14. doi: 10.1016/s1470-2045(03)01138-0.
Despite high response rates and palliative clinical benefits, androgen ablation does not cure advanced prostate cancer because of the inevitable emergence of resistant cells. Many new therapies under development for prostate cancer target pathways and molecules that contribute to the growth and survival of these cells. The rational and effective use of targeted therapies to eradicate resistant populations of tumour cells should be grounded on the premise that prostate cancer is a dynamic disease that evolves as it progresses, and that specific molecular determinants mediating sensitivity and resistance may be relevant only during specific states of the disease. Directed approaches must account for this changing dynamic so that clinical outcomes may be improved.
尽管雄激素剥夺疗法具有较高的缓解率和姑息性临床益处，但由于耐药细胞不可避免地出现，它并不能治愈晚期前列腺癌。目前正在研发的许多前列腺癌新疗法都针对有助于这些细胞生长和存活的信号通路和分子。合理有效地使用靶向疗法根除肿瘤细胞的耐药群体，应以这样的前提为基础：前列腺癌是一种动态疾病，会随着病情进展而演变，而且介导敏感性和耐药性的特定分子决定因素可能仅在疾病的特定阶段才相关。有针对性的方法必须考虑到这种不断变化的动态情况，以便改善临床结果。
