Department of Genitourinary Medical Oncology and David H Koch Center for Applied Research of Genitourinary Cancers, University of Athens, Athens, Greece.
Clin Cancer Res. 2010 Feb 15;16(4):1100-7. doi: 10.1158/1078-0432.CCR-09-1215. Epub 2010 Feb 9.
Efficacy equivalent to that reported in other common adult solid tumors considered to be chemotherapy-sensitive has been reported with Docetaxel in patients with castrate-resistant prostate cancer. However, in contrast to other cancers, the expected increase in efficacy with the use of chemotherapy in earlier disease states has not been reported to date in prostate cancer. On the basis of these observations, we speculated that the therapy development paradigm used successfully in other cancers may not apply to the majority of prostate cancers. Several lines of supporting clinical and experimental observations implicate the tumor microenvironment in prostate carcinogenesis and resistance to therapy. We conclude that a foundation to guide the development of therapy for prostate cancer is required. The therapy paradigm we propose accounts for the central role of the tumor microenvironment in bone and, if correct, will lead to microenvironment-targeted therapy.
在去势抵抗性前列腺癌患者中，多西他赛在其他被认为对化疗敏感的常见成人实体肿瘤中的疗效与报告的疗效相当。然而，与其他癌症不同的是，迄今为止，在前列腺癌中，尚未报告在疾病早期使用化疗会提高疗效。基于这些观察结果，我们推测在其他癌症中成功应用的治疗开发范例可能不适用于大多数前列腺癌。几条支持的临床和实验观察结果暗示肿瘤微环境在前列腺癌发生和对治疗的抵抗中起作用。我们得出结论，需要一个指导前列腺癌治疗开发的基础。我们提出的治疗范例考虑了肿瘤微环境在骨骼中的核心作用，如果正确，将导致针对微环境的治疗。
