University of Athens, Sismanoglio General Hospital, School of Medicine, 2nd Department of Urology , Athens 15126 , Greece
Expert Opin Biol Ther. 2014 Jan;14(1):7-10. doi: 10.1517/14712598.2013.840582. Epub 2013 Sep 27.
Fortunately, more therapeutic progress has been achieved during the last 3 years for patients with castration resistant prostate cancer (CRPC) than during the previous 30 years. During this limited time frame, six compounds (sipuleucel-T, cabazitaxel, denosumab, abiraterone, radium-223 and enzalutamide, listed in chronologic order) yielded positive results in Phase III trials (Fizazi K. Nonhormone therapy for metastatic castration-resistant prostate cancer. Soc Clin Oncol Educ Book 2013;2013:161-5; Papatsoris AG, Karamouzis MV, Papavassiliou AG. Novel biological agents for the treatment of hormone-refractory prostate cancer (HRPC). Curr Med Chem 2005;12(3):277-96). Regarding skeletal related event (SREs) in patients with CRPC the last 20 years bisphosphonates (i.e., zolendronic acid) were the standard of care until the development of denosumab, which is a novel receptor-activated nuclear factor kappa-β ligand inhibitor. Recent studies demonstrated that denosumab (subcutaneous use) was better than zolendronic acid (intravenous use) for the prevention of SREs and the increase of the bone-metastasis-free survival, while the rate and grade of adverse effects was similar, except for osteonecrosis of the jaw and hypocalcemia. Cost-effectiveness of denosumab is under review in ongoing comparative studies.
幸运的是，在过去的 3 年中，针对去势抵抗性前列腺癌（CRPC）患者的治疗取得了比过去 30 年更多的进展。在这有限的时间内，六种化合物（sipuleucel-T、卡巴他赛、地舒单抗、阿比特龙、镭-223 和恩扎鲁胺，按时间顺序列出）在 III 期临床试验中取得了阳性结果（Fizazi K. 转移性去势抵抗性前列腺癌的非激素治疗。Soc Clin Oncol Educ Book 2013;2013:161-5; Papatsoris AG, Karamouzis MV, Papavassiliou AG. 用于治疗激素难治性前列腺癌（HRPC）的新型生物制剂。Curr Med Chem 2005;12(3):277-96）。关于 CRPC 患者的骨骼相关事件（SREs），过去 20 年来，双膦酸盐（即唑来膦酸）一直是标准治疗方法，直到地舒单抗的开发，地舒单抗是一种新型受体激活核因子 kappa-β 配体抑制剂。最近的研究表明，地舒单抗（皮下使用）在预防 SREs 和增加骨转移无进展生存期方面优于唑来膦酸（静脉使用），而不良反应的发生率和严重程度相似，除了下颌骨坏死和低钙血症。地舒单抗的成本效益正在正在进行的比较研究中进行审查。
