Markowski Mark C, Carducci Michael A
Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, MD, United States.
Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, MD, United States.
Cancer Treat Rev. 2017 Apr;55:218-224. doi: 10.1016/j.ctrv.2016.09.017. Epub 2016 Oct 3.
Since 2010, five new antineoplastic therapies have been FDA approved for the treatment of metastatic prostate cancer. With additional treatment options, questions arose about the optimal sequence of these agents. Until recently, chemotherapy has been deferred until later in the disease course in favor of next-generation androgen deprivation therapy. Prior to the development of abiraterone acetate and enzalutamide, clinical trials were opened investigating the combination of chemotherapy with androgen deprivation therapy in patients with metastatic hormone-sensitive disease. With the development of new oral therapies used to treat castration-resistant disease, these trials were largely forgotten or felt to be obsolete. Recently, two trials have been reported showing an overall survival benefit of the early use of chemotherapy in patients with hormone-naive prostate cancer, changing the treatment paradigm for metastatic disease. Here we review the history of chemotherapy in treating prostate cancer and the emerging evidence favoring its use as first-line therapy against metastatic hormone-sensitive disease.
自2010年以来，美国食品药品监督管理局（FDA）已批准五种新型抗肿瘤疗法用于治疗转移性前列腺癌。随着治疗选择的增加，关于这些药物的最佳使用顺序出现了问题。直到最近，化疗一直被推迟到疾病进程的后期，而优先采用新一代雄激素剥夺疗法。在醋酸阿比特龙和恩杂鲁胺研发之前，已经开展了临床试验，研究化疗与雄激素剥夺疗法联合用于转移性激素敏感性疾病患者的情况。随着用于治疗去势抵抗性疾病的新型口服疗法的出现，这些试验在很大程度上被遗忘或认为过时了。最近，有两项试验报告显示，在激素初治的前列腺癌患者中早期使用化疗可带来总生存获益，这改变了转移性疾病的治疗模式。在此，我们回顾前列腺癌化疗的历史以及支持将其用作转移性激素敏感性疾病一线治疗的新证据。
