Division of Genitourinary Malignancies, Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Los Angeles, CA, USA.
Asian J Androl. 2011 Sep;13(5):683-9. doi: 10.1038/aja.2011.35. Epub 2011 May 23.
Until recently, docetaxel-based therapy represented the only therapy shown to prolong survival in patients with metastatic castration-resistant prostate cancer (mCRPC). The past year and a half has been marked by unprecedented progress in treatments for this disease. Three positive phase III clinical trials have emerged, each evaluating agents (sipuleucel-T, cabazitaxel and abiraterone) with distinct mechanisms of action. Herein, the three pivotal trials are described alongside both past and current large phase III studies conducted in this mCRPC. The overall survival for patients with mCRPC treated in current clinical trials is considerably longer than noted in the past. We note that more recent trials with older agents have also shown improved survival and discuss potential non-therapeutic biases that influence this critical measure of outcome. The necessity for utilizing randomized trials when evaluating new therapeutics is emphasized given the changing prognosis in this mCRPC.
直到最近，基于多西紫杉醇的治疗方案仍是唯一被证实能够延长转移性去势抵抗性前列腺癌（mCRPC）患者生存时间的治疗方法。在过去的一年半时间里，这种疾病的治疗取得了前所未有的进展。三项积极的 III 期临床试验相继出现，每项试验都评估了具有不同作用机制的药物（sipuleucel-T、卡巴他赛和阿比特龙）。本文描述了这三项关键性试验，以及在 mCRPC 中开展的过去和当前的大型 III 期研究。与过去相比，目前临床试验中 mCRPC 患者的总体生存率显著延长。我们注意到，较新的试验中使用的旧药物也显示出了生存获益的改善，并讨论了可能影响这一关键预后评估的非治疗性偏倚。鉴于 mCRPC 患者的预后不断变化，在评估新疗法时强调了使用随机试验的必要性。
