Puente Javier, Grande Enrique, Medina Ana, Maroto Pablo, Lainez Nuria, Arranz Jose Angel
Medical Oncology Department, Hospital Clínico Universitario San Carlos, C/ Profesor Martín Lagos, S/N, 28040 Madrid, Spain.
Hospital Universitario Ramón y Cajal, Madrid, Spain.
Ther Adv Med Oncol. 2017 May;9(5):307-318. doi: 10.1177/1758834017692779. Epub 2017 Mar 1.
The increasing knowledge of prostate cancer is leading to many questions about its natural history and to reconsider conventional therapeutic strategies. Androgen ablation therapy has been the standard therapy in the advanced setting. Although docetaxel has demonstrated increased survival in patients with metastatic prostate cancer who had progressed to hormone treatments, due to its potential toxicity the role of chemotherapy has been relegated to patients who were symptomatic or who had high tumor burden. Several studies have assessed whether docetaxel could have a role in hormone-sensitive disease or even in earlier stages with no distant metastases. In the CHAARTED and STAMPEDE studies, docetaxel provides an unprecedented increase in overall survival (OS). This review summarizes the evidence behind the paradigm shift to strengthening docetaxel as a new standard of treatment that prolongs survival in earlier stages of prostate cancer.
对前列腺癌认识的不断增加引发了许多关于其自然病史的问题,并促使人们重新审视传统治疗策略。雄激素剥夺疗法一直是晚期前列腺癌的标准治疗方法。尽管多西他赛已证明可提高对激素治疗产生进展的转移性前列腺癌患者的生存率,但由于其潜在毒性,化疗的作用已局限于有症状或肿瘤负荷高的患者。多项研究评估了多西他赛在激素敏感性疾病甚至无远处转移的早期阶段是否能发挥作用。在CHAARTED和STAMPEDE研究中,多西他赛使总生存期(OS)得到了前所未有的提高。本综述总结了将多西他赛强化作为延长前列腺癌早期生存期的新治疗标准这一范式转变背后的证据。