Dawson Nancy A
Marlene and Stewart Greenebaum Cancer Center, University of Maryland, 22 South Greene Street, Baltimore, MD 21201-1595, USA.
Expert Rev Anticancer Ther. 2006 Jul;6(7):993-1002. doi: 10.1586/14737140.6.7.993.
Classically, advanced prostate cancer has been treated with hormonal therapy and, most recently, chemotherapy. This treatment clearly demonstrated a survival benefit, but never a cure. With the ever-expanding understanding of the pathophysiology of prostate cancer, there has been a recent explosion in the potential molecular targets and novel therapeutic approaches to both advanced and potentially localized prostate cancer. This review will focus on what the author perceives to be the most promising of these new strategies. The endothelin pathway has been identified as pivotal in the viscous cycle of tumorigenesis in bone, leading to the development of endothelial receptor antagonists. Vaccine therapy using autologous granulocyte-macrophage colony-stimulating factor-producing prostate cancer cells has been effective in producing both immune and clinical responses. Randomized clinical trials of the immunotherapy cell product APC8015 (Provenge) have demonstrated improved survival in the hormone-refractory setting. The development of antisense oligonucleotides to segments of mRNA critical to the progression to androgen-independent disease has emerged as one further tool in the expanding armamentarium of potential therapies being tested. Clearly, headway is being made in improving outcomes in this most prevalent health problem.
传统上，晚期前列腺癌一直采用激素疗法进行治疗，最近也开始采用化疗。这种治疗方法明显显示出了生存获益，但从未实现治愈。随着对前列腺癌病理生理学的认识不断扩展，针对晚期和潜在局限性前列腺癌的潜在分子靶点和新型治疗方法最近出现了激增。本综述将聚焦于作者认为这些新策略中最具前景的部分。内皮素途径已被确定在骨肿瘤发生的恶性循环中起关键作用，从而催生出了内皮素受体拮抗剂。使用自体产生粒细胞-巨噬细胞集落刺激因子的前列腺癌细胞进行疫苗治疗，已在产生免疫反应和临床反应方面取得成效。免疫治疗细胞产品APC8015（Provenge）的随机临床试验表明，在激素难治性情况下患者生存率有所提高。针对对进展为雄激素非依赖性疾病至关重要的mRNA片段的反义寡核苷酸的开发，已成为正在测试的潜在治疗手段不断扩充的武器库中的又一工具。显然，在改善这一最普遍的健康问题的治疗效果方面正在取得进展。
