Keizman Daniel, Maimon Natalie, Gottfried Maya
Genitourinary Oncology Service, Division of Oncology, Meir Medical Center, Sackler Faculty of Medicine, Tel Aviv University.
Harefuah. 2012 Sep;151(9):545-9, 555, 554.
Prostate cancer is the second leading cause of cancer death in men in the western world. Most deaths will occur due to the progression of cancer into a hormone refractory state. Until recently, docetaxel-based chemotherapy was the only established treatment (shown to increase survival) for patients with metastatic hormone refractory prostate cancer. The improved understanding of prostate cancer biology in recent years led to the development of drugs directed against precise tumorigenesis-associated molecular pathways, and significant expansion of treatment horizons for these patients. In 2010-2011, three more agents, with different mechanisms of action, were shown to be associated with a survival benefit in mHRPC, including the dendritic cell vaccine sipuleucel-T (immunotherapy), the 17,20 lyase inhibitor abiraterone (hormonal therapy), and the taxane cabazitaxel (chemotherapy). A fourth agent, denosumab (bone targeted therapy) was also recently approved by the FDA for patients with bone metastasis after showing a reduction in the occurrence of skeletal-related events. This review will focus on recent advances in the standard treatments paradigm in mHRPC.
前列腺癌是西方世界男性癌症死亡的第二大主要原因。大多数死亡是由于癌症进展为激素难治性状态所致。直到最近，基于多西他赛的化疗仍是转移性激素难治性前列腺癌患者唯一已确立的治疗方法（已证明可提高生存率）。近年来对前列腺癌生物学的深入了解促使了针对精确肿瘤发生相关分子途径的药物研发，显著拓宽了这些患者的治疗视野。在2010 - 2011年，又有三种作用机制不同的药物被证明可使转移性激素难治性前列腺癌患者受益，包括树突状细胞疫苗西妥昔单抗-T（免疫疗法）、17,20裂解酶抑制剂阿比特龙（激素疗法）和紫杉烷卡巴他赛（化疗）。第四种药物地诺单抗（骨靶向治疗）最近也被美国食品药品监督管理局批准用于骨转移患者，因为它能减少骨相关事件的发生。本综述将聚焦于转移性激素难治性前列腺癌标准治疗模式的最新进展。
