Department of Hematology/Oncology, American University of Beirut Medical Center, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon.
Crit Rev Oncol Hematol. 2013 Aug;87(2):122-31. doi: 10.1016/j.critrevonc.2013.01.002. Epub 2013 Jan 29.
Inhibition of angiogenic pathways has proven an effective strategy for the treatment of several common solid tumors however its role in the management of prostate cancer is yet to be defined. Advances in clinical research have resulted in five new treatments for metastatic prostate cancer in the last two years. The immunotherapy sipuleucel-T, the cytotoxic cabazitaxel, the androgen biosynthesis inhibitor abiraterone acetate, the radioisotope radium-223 and the antiandrogen enzalutamide have all been shown to improve overall survival in randomized phase III studies treatment paradigms are changing rapidly. Angiogenesis is known to play a central role in the progression of advanced prostate cancer however established antiangiogenic therapies including bevacizumab and sunitinib have failed to improve survival in randomized trials to date. Novel treatment combinations and novel agents such as cabozantinib are showing promising early results and it is hoped that further well-designed studies will validate the strong biological hypothesis for the benefit of antiangiogenic therapy to improve outcomes for patients with prostate cancer.
抑制血管生成途径已被证明是治疗几种常见实体瘤的有效策略，但其在前列腺癌治疗中的作用尚待确定。近年来，临床研究取得了进展，为转移性前列腺癌带来了五种新的治疗方法。免疫疗法 sipuleucel-T、细胞毒性药物 cabazitaxel、雄激素生物合成抑制剂 abiraterone acetate、放射性同位素镭-223 和抗雄激素恩杂鲁胺，在随机 III 期研究中均显示出可改善总生存期，治疗模式正在迅速改变。血管生成被认为在晚期前列腺癌的进展中起着核心作用，然而，迄今为止，包括贝伐单抗和舒尼替尼在内的既定抗血管生成疗法未能改善生存。新的治疗组合和新型药物，如 cabozantinib，正在早期研究中显示出有希望的结果，人们希望进一步精心设计的研究将验证强有力的生物学假设，即抗血管生成治疗有益于改善前列腺癌患者的预后。
