Miyamoto Hiroshi, Messing Edward M, Chang Chawnshang
George Whipple Laboratory for Cancer Research, Departments of Pathology, Urology, and Radiation Oncology, and the Cancer Center, University of Rochester Medical Center, Rochester, New York, USA.
Prostate. 2004 Dec 1;61(4):332-53. doi: 10.1002/pros.20115.
Androgens play a major role in promoting the development and progression of prostate cancer. As a result, androgen ablation or blockade of androgen action through the androgen receptor (AR) has been the cornerstone of treatment of advanced prostate cancer. Different strategies involving this hormonal therapy produce a significant clinical response in most of the patients, but most responders eventually lose dependency, resulting in mortality. Thus, whether hormonal therapy contributes to the improvement of overall survival rates, especially in patients with advanced prostate cancer, remains controversial. However, patients with advanced disease clearly have a benefit from androgen deprivation-based treatment for palliating their symptoms and for improving the quality of their lives. In order to improve overall survival, novel treatment strategies that prolong the androgen-dependent state and that are useful for androgen-independent disease based on specific molecular mechanisms need to be identified.
雄激素在促进前列腺癌的发生和发展中起主要作用。因此,通过雄激素受体(AR)进行雄激素去除或阻断雄激素作用一直是晚期前列腺癌治疗的基石。涉及这种激素疗法的不同策略在大多数患者中产生了显著的临床反应,但大多数反应者最终会失去依赖,导致死亡。因此,激素疗法是否有助于提高总体生存率,尤其是晚期前列腺癌患者的总体生存率,仍存在争议。然而,晚期疾病患者显然从基于雄激素剥夺的治疗中受益,可缓解症状并提高生活质量。为了提高总体生存率,需要确定基于特定分子机制延长雄激素依赖状态且对雄激素非依赖疾病有效的新型治疗策略。