Vogelzang Nicholas J
a Division of Hematology/Oncology , Comprehensive Cancer Centers of Nevada , Las Vegas , NV , USA.
Expert Rev Clin Pharmacol. 2017 Aug;10(8):809-819. doi: 10.1080/17512433.2017.1345624. Epub 2017 Jul 3.
Castration-resistant prostate cancer (CRPC) is associated with the development of bone metastases, increased mortality, and a reduction in the patient's quality of life (QOL). The management of metastatic CRPC (mCRPC) has rapidly evolved over the past decade, with a number of available therapeutic agents improving overall survival. Radium-223 dichloride (radium-223), the first targeted alpha therapy, improves survival accompanied by QOL benefits with a favorable safety profile. It is approved in over 40 countries for the treatment of patients with CRPC with symptomatic bone metastases and no known visceral metastatic disease. Areas covered: The current management of CRPC in men with bone metastases, and in particular the role of radium-223 in this setting, is reviewed and discussed. A search of bibliographic databases for peer-reviewed literature and major meetings was conducted. Expert commentary: In treating patients with mCRPC, the best sequencing and/or combination of radium-223 with other agents has yet to be fully elucidated. The role of radium-223 in treating patients with hormone-sensitive metastatic prostate cancer who are candidates for chemotherapy should also be investigated in well-designed trials. The ability to tailor radium-223 therapy to both the clinical and genetic profiles of CRPC patients would be a promising development.
去势抵抗性前列腺癌（CRPC）与骨转移的发生、死亡率增加以及患者生活质量（QOL）下降相关。在过去十年中，转移性CRPC（mCRPC）的治疗方法迅速发展，多种可用治疗药物提高了总生存率。二氯化镭-223（镭-223）是第一种靶向α治疗药物，可提高生存率，并伴有生活质量改善，且安全性良好。它在40多个国家被批准用于治疗有症状性骨转移且无已知内脏转移疾病的CRPC患者。涵盖领域：本文回顾并讨论了骨转移男性CRPC的当前治疗方法，特别是镭-223在这种情况下的作用。我们检索了书目数据库以查找同行评审文献和主要会议资料。专家评论：在治疗mCRPC患者时，镭-223与其他药物的最佳序贯和/或联合使用方式尚未完全阐明。还应在精心设计的试验中研究镭-223在治疗适合化疗的激素敏感性转移性前列腺癌患者中的作用。根据CRPC患者的临床和基因特征调整镭-223治疗方案将是一个有前景的发展方向。
