Heidenreich A
Klinik und Poliklinik für Urologie, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074 Aachen, Deutschland.
Urologe A. 2012 Jan;51(1):32-8. doi: 10.1007/s00120-011-2740-2.
Following the approval of Sipuleucel-T, the development of new immunomodulatory approaches such as ipilimumab and tasquinimod, and the development of new antihormonal drugs (abiraterone acetate, MDV3100, TAK-700), treatment of castration-resistant prostate cancer is finally reaching a new era of management. Docetaxel based chemotherapy remains the standard treatment of choice for patients with a high tumour burden, rapidly progressiong castration resistant prostate cancer, and poorly differentiated prostate cancer. Sipuleucel-T might be an option in the pre-docetaxel management of castration-resistant prostate cancer resulting in a 4-months improvement of overall survival. However, as with all other modalities of immunotherapy patients with good prognostic factors such as minimal tumour burden, slow PSA doubling time, Gleason score ≤ 7, and a long survival probability of > 1 year might be the best candidates taking into account that immunomodulatory approaches demonstrate positive responses after 4-6 months of therapy. Ipilimumab and tasqunimod as inhibitors of the immune checkpoints are additional, promising therapeutic agents with high clinical potential. It is the aim of the current article to critically review the current options of immune therapy in men with castration resistant prostate cancer.
随着西妥昔单抗获批，以及伊匹单抗和他喹莫德等新型免疫调节方法的研发，还有新型抗激素药物（醋酸阿比特龙、MDV3100、TAK - 700）的研发，去势抵抗性前列腺癌的治疗终于迈入了一个新的管理时代。基于多西他赛的化疗仍然是高肿瘤负荷、快速进展的去势抵抗性前列腺癌以及低分化前列腺癌患者的标准治疗选择。西妥昔单抗可能是去势抵抗性前列腺癌多西他赛治疗前管理的一种选择，可使总生存期延长4个月。然而，与所有其他免疫治疗方式一样，考虑到免疫调节方法在治疗4 - 6个月后显示出阳性反应，具有良好预后因素（如肿瘤负荷最小、前列腺特异抗原倍增时间缓慢、Gleason评分≤7以及生存概率大于1年）的患者可能是最佳候选者。伊匹单抗和他喹莫德作为免疫检查点抑制剂是另外两种具有很高临床潜力的、有前景的治疗药物。本文的目的是对去势抵抗性前列腺癌男性患者当前的免疫治疗选择进行批判性综述。
