Texas Oncology, Baylor College of Medicine, TX, USA.
Expert Rev Anticancer Ther. 2010 Mar;10(3):439-50. doi: 10.1586/era.10.17.
Neoadjuvant therapy improves outcomes for a number of malignancies and provides intermediate pathologic outcomes, which correlate with long-term outcomes. Neoadjuvant androgen-deprivation therapy, alone or with docetaxel chemotherapy, preceding prostatectomy for localized prostate cancer is feasible and demonstrates pathologic activity, but evidence for improved long-term outcomes is lacking. Data in support of the further exploration of neoadjuvant therapy for localized prostate cancer preceding prostatectomy are reviewed. Ongoing randomized trials are elucidating the impact of neoadjuvant androgen deprivation combined with docetaxel chemotherapy on pathologic and long-term outcomes. The correlation of pathologic and biologic outcomes with long-term outcomes in this setting is unknown. The neoadjuvant therapy approach followed by prostatectomy is feasible with a wide array of agents and provides a paradigm for evaluating the activity, and mechanism of action and resistance to new treatments. This promising modality may aid the rapid development of novel therapeutic agents. A multidisciplinary approach involving oncologists, urologists and pathologists is critical to the success of this model.
新辅助治疗改善了许多恶性肿瘤的预后，并提供了与长期预后相关的中间病理结果。在前列腺癌局部切除术前行新辅助去势治疗（单独或联合多西他赛化疗）是可行的，并显示出一定的病理活性，但缺乏改善长期预后的证据。本文回顾了支持在前列腺癌局部切除术前行新辅助治疗的进一步探索的数据。正在进行的随机试验正在阐明新辅助去势联合多西他赛化疗对病理和长期预后的影响。在这种情况下，病理和生物学结果与长期结果的相关性尚不清楚。新辅助治疗后行前列腺切除术是可行的，可使用多种药物，并为评估新治疗方法的活性、作用机制和耐药性提供了范例。这种很有前途的方法可能有助于新治疗药物的快速开发。涉及肿瘤学家、泌尿科医生和病理学家的多学科方法对于该模型的成功至关重要。
