Genitourinary, Sarcoma, and Central Nervous System Tumor Program, Medical Oncology Department, Universitat Autònoma Barcelona, Barcelona, Spain.
BJU Int. 2014 Mar;113(3):367-75. doi: 10.1111/bju.12110. Epub 2013 Apr 12.
Initial therapy for metastatic prostate cancer consists of androgenic suppression. However, this is only a palliative treatment with an effective duration that usually lasts 12-24 months. Historically, castration-resistant prostate cancer (CRPC) had been considered a chemoresistant tumour. In 2004, docetaxel received USA Food and Drug Administration approval as a first-line treatment for metastatic prostate cancer, after two independent phase III trials showed an increased survival benefit. Recently, five new drugs have shown increased survival in CRPC: sipuleucel-T (assymptomatic or minimally symptomatic), abiraterone acetate (before and after docetaxel), cabazitaxel (after docetaxel), MDV3100 (after docetaxel) and radium-223 (not suitable for docetaxel or after docetaxel). The identification of antigens in normal prostate tissue or prostate cancer that are recognised by immune effectors cells has resulted in several new studies based on immunotherapy. Prostate cancer disease provides a test system to determine the efficacy of vaccines for different reasons. This cancer is a tumour that grows relatively slowly. Recurrence is often diagnosed early (with many patients presenting only with biochemical progression), there is a biological marker that can predict prognosis and outcome (PSA doubling time), various specific antigens have been identified and characterised, and vaccines can be used with a good safety profile combined with anti-androgen therapy, chemotherapy, or radiotherapy. Here we provide a review of the main important immune treatments in CRPC.
转移性前列腺癌的初始治疗包括雄激素抑制。然而，这只是一种姑息性治疗，有效持续时间通常为 12-24 个月。历史上，去势抵抗性前列腺癌（CRPC）被认为是一种化疗耐药肿瘤。2004 年，多西他赛获得美国食品和药物管理局批准，作为转移性前列腺癌的一线治疗药物，此前两项独立的 III 期试验显示生存获益增加。最近，五种新药物在 CRPC 中显示出生存获益增加：sipuleucel-T（无症状或轻度症状）、醋酸阿比特龙（多西他赛前和后）、卡巴他赛（多西他赛后）、MDV3100（多西他赛后）和镭-223（不适合多西他赛或多西他赛后）。在正常前列腺组织或前列腺癌细胞中识别出被免疫效应细胞识别的抗原，导致了几项基于免疫疗法的新研究。前列腺癌疾病为评估不同疫苗的疗效提供了一个测试系统。由于多种原因，这种癌症是一种生长相对缓慢的肿瘤。复发通常早期诊断（许多患者仅表现为生化进展），有一个可以预测预后和结果的生物标志物（PSA 倍增时间），已经确定和表征了各种特定的抗原，并且疫苗可以与良好的安全性结合使用与抗雄激素治疗、化疗或放疗联合使用。在这里，我们回顾了 CRPC 中主要的重要免疫治疗方法。
