Vogiatzi P, Cassone M, Claudio L, Claudio P P
Department of Cancer Biology, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Drug News Perspect. 2009 Dec;22(10):593-601. doi: 10.1358/dnp.2009.10.1428872.
Prostate cancer is the most common noncutaneous malignancy in men and also the third leading cause of death due to cancer in males. The conventional initial therapy for localized advanced or metastatic disease is hormone or androgen deprivation therapy. Although hormone-based therapies generally result in rapid responses, the disease then progresses to a phase when they fail to control the malignancy despite castrate testosterone levels. Some patients with castration-resistant prostate cancer continue to respond to secondary hormonal manipulations, and docetaxel-based chemotherapy improves median survival to about 18 months. Prostate cancer is termed hormone-refractory when it no longer responds to hormonal therapy. Currently, other therapeutic options, such as radical prostatectomy, radiation therapy or cryotherapy offer improvement in survival mostly in early stages. New therapy approaches based on a deeper understanding of especially metastatic prostate cancer are of vital importance. Here we discuss up-to-date clinical trials of agents with novel targets and present paradigms in prostate cancer vaccine therapy, metastasis suppressor genes, and some provocative findings on combination therapies of cytotoxic agents, which might provide a platform for developing effective treatment for advanced prostate cancer.
前列腺癌是男性最常见的非皮肤恶性肿瘤，也是男性癌症死亡的第三大主要原因。对于局限性晚期或转移性疾病，传统的初始治疗方法是激素或雄激素剥夺疗法。尽管基于激素的疗法通常会迅速产生反应，但疾病随后会进展到一个阶段，即尽管睾酮水平已被抑制，但这些疗法仍无法控制恶性肿瘤。一些去势抵抗性前列腺癌患者继续对二次激素治疗有反应，基于多西他赛的化疗可将中位生存期提高到约18个月。当前列腺癌不再对激素治疗有反应时，就被称为激素难治性前列腺癌。目前，其他治疗选择，如根治性前列腺切除术、放射治疗或冷冻治疗，大多在早期阶段能提高生存率。基于对尤其是转移性前列腺癌更深入理解的新治疗方法至关重要。在此，我们讨论具有新靶点药物的最新临床试验，并介绍前列腺癌疫苗治疗、转移抑制基因方面的范例，以及关于细胞毒性药物联合治疗的一些引人深思的发现，这些可能为开发晚期前列腺癌的有效治疗方法提供一个平台。
