Merseburger A S, Böker A, Kuczyk M A, von Klot C-A
Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Hannover.
Aktuelle Urol. 2015 Jan;46(1):59-65. doi: 10.1055/s-0034-1395655. Epub 2015 Feb 6.
Prostate cancer is still the most common urological cancer of the elderly man. In some patients, a metastatic prostate cancer arises which may remain a stable disease for years with palliative antiandrogen therapy. On average, after 3-4 years, affected men develop a PSA rise and disease progression with the formation of a so-called castration-resistant disease. 5 years ago cytotoxic chemotherapy with docetaxel was the only life-prolonging treatment option in this situation. In the last 5 years, the results of randomised phase III studies have led to the approval of 5 new agents for the treatment of metastatic castration resistant prostate cancer (mCRPC). The results and approval status of the substances, Abiraterone, Enzalutamide, Cabazitaxel, Sipuleucel-T and radium-223 are described below. In addition, some aspects of sequential therapy and possible future molecular approaches are discussed.
前列腺癌仍然是老年男性中最常见的泌尿系统癌症。在一些患者中，会出现转移性前列腺癌，通过姑息性抗雄激素治疗，这种癌症可能多年保持稳定。平均而言，3至4年后，患病男性的前列腺特异性抗原（PSA）会升高，疾病会进展并形成所谓的去势抵抗性疾病。5年前，在这种情况下，多西他赛细胞毒性化疗是唯一延长生命的治疗选择。在过去5年中，III期随机研究的结果使得5种新药物获批用于治疗转移性去势抵抗性前列腺癌（mCRPC）。以下将描述阿比特龙、恩杂鲁胺、卡巴他赛、西普拉塞-T和镭-223这些药物的结果及获批情况。此外，还将讨论序贯治疗的一些方面以及未来可能的分子治疗方法。
