Forde Patrick M, Antonarakis Emmanuel S
Prostate Cancer Research Program, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD.
Int J Target Ther Cancer. 2012 Sep 1;1(3):40-42.
Until recently, treatment options for castration-resistant prostate cancer (CRPC) were limited to only the chemotherapeutic agent docetaxel which demonstrated a survival advantage over palliative chemotherapy. Abiraterone acetate (AA) is an orally available, potent irreversible inhibitor of the adrenal microsomal enzyme cytochrome P450-17 (CYP17). In a large phase III study of AA in docetaxel-pretreated patients, AA demonstrated excellent tolerance and a 4-month survival advantage over placebo, leading to the approval of AA for docetaxel-pretreated patients by the FDA in 2011. More recently, phase III data in docetaxel-naïve patients have become available, showing clear clinical benefits in this population as well, and it is likely that the label for AA will soon be expanded to include men with CRPC who have not yet received chemotherapy. This article summarizes clinical studies of AA in CRPC patients and discusses the emerging treatment paradigm in this rapidly evolving area.
直到最近，去势抵抗性前列腺癌（CRPC）的治疗选择还仅限于化疗药物多西他赛，该药物相较于姑息性化疗显示出了生存优势。醋酸阿比特龙（AA）是一种口服有效的、强力不可逆的肾上腺微粒体酶细胞色素P450-17（CYP17）抑制剂。在一项针对多西他赛预处理患者的大型III期AA研究中，AA显示出了良好的耐受性，且与安慰剂相比有4个月的生存优势，这使得AA于2011年被美国食品药品监督管理局（FDA）批准用于多西他赛预处理患者。最近，针对未接受过多西他赛治疗患者的III期数据也已公布，表明该药物在这一人群中也有明显的临床益处，而且AA的标签可能很快会扩大，将尚未接受化疗的CRPC男性患者纳入其中。本文总结了AA在CRPC患者中的临床研究，并讨论了这个快速发展领域中新兴的治疗模式。
