Bracarda Sergio, Sisani Michele, Marrocolo Francesca, Hamzaj Alketa, Del Buono Sabrina, Altavilla Amelia
Department of Oncology, U.O.C. of Medical Oncology, USL-8, Istituto Toscano Tumori (ITT), Ospedale San Donato, Arezzo, Italy.
Expert Rev Anticancer Ther. 2014 Nov;14(11):1283-94. doi: 10.1586/14737140.2014.965686. Epub 2014 Oct 29.
Although docetaxel is still considered a mainstay of treatment in metastatic castrate-resistant prostate cancer (mCRPC), in the last few years, new agents have been developed to improve survival in this setting and reach a possible optimal personalized treatment strategy. In this paper, we provide a personal view and an algorithm for mCRPC patients, according to available evidence, personal opinion and experience. Abiratone acetate, cabazitaxel, radium-223, sipuleucel-T and enzalutamide, together with docetaxel, have demonstrated a survival benefit in these patients. The use of rechallenge with docetaxel in mCRPC patients with disease progression after a first response has been considered. These new agents complicated the scenario and posed the challenge to move from the old sequential to a new algorithm-based approach. At this stage, the algorithm is necessarily based on experts' opinion, since the efficacy of a single agent in a specific setting has not been validated by sequential trials.
尽管多西他赛仍被视为转移性去势抵抗性前列腺癌（mCRPC）治疗的主要手段，但在过去几年中，已开发出新型药物以提高该情况下的生存率，并实现可能的最佳个性化治疗策略。在本文中，我们根据现有证据、个人观点和经验，为mCRPC患者提供了个人观点和一种算法。醋酸阿比特龙、卡巴他赛、镭-223、 sipuleucel-T和恩杂鲁胺，与多西他赛一起，已在这些患者中显示出生存获益。已考虑对首次缓解后疾病进展的mCRPC患者再次使用多西他赛。这些新型药物使情况变得复杂，并带来了从旧的序贯治疗转向基于新算法方法的挑战。在现阶段，该算法必然基于专家意见，因为单一药物在特定情况下的疗效尚未通过序贯试验得到验证。
