Oncology (Williston Park). 2014 Nov;28(11):974-80.
Men with metastatic castration-resistant prostate cancer have multiple treatment options, and the expanding palate of available therapies renders careful patient selection imperative. Men with visceral (especially hepatic) metastases have a particularly poor prognosis, regardless of the treatment selected. Retrospective analyses of datasets from large phase III randomized trials showed that men with visceral metastases appear to derive clinical benefit from second-generation antiandrogens as well as from docetaxel chemotherapy, but not from immunotherapy. The mechanistic underpinnings of these observations are currently not clear, but could involve factors that are intrinsic to the tumor cell, the tumor microenvironment, and/or systemic factors. Regardless of the underlying mechanism(s), a better understanding of the basic biology of visceral vs bone metastases will be critical in improving prostate cancer treatment in the setting of advanced disease.
患有转移性去势抵抗性前列腺癌的男性有多种治疗选择，而且可用疗法的范围不断扩大，这使得仔细选择患者变得至关重要。无论选择哪种治疗方法，患有内脏（尤其是肝脏）转移的男性预后都特别差。对来自大型 III 期随机试验数据集的回顾性分析表明，患有内脏转移的男性似乎从第二代抗雄激素和多西他赛化疗中获得临床获益，但不能从免疫疗法中获益。这些观察结果的机制基础目前尚不清楚，但可能涉及肿瘤细胞、肿瘤微环境和/或全身因素固有的因素。无论潜在的机制如何，更好地了解内脏转移与骨转移的基础生物学将是改善晚期前列腺癌治疗的关键。
