Valdespino Victor, Tsagozis Panagiotis, Pisa Pavel
Department of Surgery, UMAE de Oncologia del CMN SXXI, Instituto Mexicano del Seguro Social, Universidad Autonoma Metropolitana, Mexico, Mexico.
Med Oncol. 2007;24(3):273-86. doi: 10.1007/s12032-007-0017-9.
Prostate cancer (PC) continues to be an important world health problem for men. Patients with locally confined PC are treated with either radiotherapy or surgery. However, treatment of more advanced stages of the disease is problematic. Initially, androgen deprivation offers a period of clinical stability, which is however invariably followed by progression to non-responsiveness to hormonal manipulation. Current management of patients with androgen-independent prostate cancer (AIPC) displays modest response rates and achieves only short-term benefit. Recently, knowledge in the complex pathophysiology of advanced PC has led to the identification of mechanisms and target molecules permitting the introduction of new therapies. Consequently, many investigational treatments are ongoing for AIPC in Phase-II and Phase-III trials aiming at the combination of chemotherapeutic regimens along with immunotherapy targeting PC-associated antigens. Other attractive options are gene therapy, as well as the targeting of survival signaling, differentiation, and apoptosis of the malignant PC cells. Further treatment modalities are directed against the tumor microenvironment, bone metastasis, or both. Collectively, the aforementioned efforts introduce a new era in the management of advanced PC. Novel pharmaceutical compounds and innovative approaches, integrated into the concept of individualized therapy will hopefully, during the next decade, improve the outcome and survival for hundreds of thousands of men worldwide.
前列腺癌（PC）仍然是困扰全球男性健康的重要问题。局限性前列腺癌患者通常接受放射治疗或手术治疗。然而，对于疾病更晚期的治疗却存在问题。起初，雄激素剥夺疗法能带来一段临床稳定期，但最终不可避免地会发展为对激素治疗无反应。目前，雄激素非依赖性前列腺癌（AIPC）患者的治疗反应率较低，且仅能获得短期益处。近年来，对晚期前列腺癌复杂病理生理学的深入了解，促使人们发现了相关机制和靶点分子，从而推动了新疗法的研发。因此，许多针对AIPC的研究性治疗正在进行II期和III期试验，旨在联合化疗方案以及针对前列腺癌相关抗原的免疫疗法。其他有吸引力的选择包括基因治疗，以及针对恶性前列腺癌细胞生存信号、分化和凋亡的靶向治疗。此外，还有针对肿瘤微环境、骨转移或两者的治疗方法。总的来说，上述努力开启了晚期前列腺癌治疗的新时代。新型药物化合物和创新方法融入个体化治疗理念，有望在未来十年改善全球数十万男性患者的治疗效果和生存率。
