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《泌尿肿瘤学进展》“肿瘤论坛”:2016年精华

Developments in urologic oncology «OncoForum»: The best of 2016.

作者信息

Gómez-Veiga F, Alcaraz-Asensio A, Burgos-Revilla J, Cózar-Olmo J M

机构信息

Servicio de Urología, Hospital Universitario de Salamanca, Grupo de Investigación Traslacional de Urología GITUR-IBSAL, Salamanca, España.

Servicio de Urología, Hospital Clinic Universitari, Barcelona, España.

出版信息

Actas Urol Esp. 2017 Nov;41(9):543-551. doi: 10.1016/j.acuro.2017.07.001. Epub 2017 Jul 19.

Abstract

OBJECTIVE

To put forth new findings of urologic oncology with impact on clinical practice presented during 2016 in the main annual meetings.

ACQUISITION OF EVIDENCE

This document reviews abstracts on prostate, kidney and bladder cancer presented at the congresses of 2016 (EAU, AUA, ASCO, ESMO and ASTRO) and publications with the highest impact in this period valued with the highest scores by the OncoForum committee.

SYNTHESIS OF EVIDENCE

In High-Risk Renal-Cell carcinoma after nephrectomy, disease-free survival was significantly greater for sunitinib than placebo group, with adverse events more frequents. In locally advanced and metastatic urotherial carcinoma patients, aletozumab achieved overall response rate in all subgroups of patients, included poor prognostic. In localized prostate cancer, the difference of prostate-cancer-specific mortality among active monitoring, radical prostatectomy and external-beam radiotherapy was not significant (P=0,48). In TERRAIN study, with castration-resistant prostate cancer patients, adverse events was reported in 31% and 23% of patients treated with enzalutamide and bicalutamide, respectively. Moreover, enzalutamide significantly improved median progression-free survival (15.7 months) compared bicalutamide (5.8 months) (P<.0001). In SRTIVE study, Enzalutamide reduced the risk of progression or death by 76% compared with bicalutamide (P<.001).

CONCLUSIONS

In high-risk renal-cell carcinoma after nephrectomy, sunitinb has been considered as treatment choice. In localized prostate cancer, prostate-cancer-specific mortality was low irrespective of the treatment assigned (active monitoring, radical prostatectomy and external-beam radiotherapy). In metastatic castration-resistant prostate cancer new results of treatment with enzalutamide and abiraterone has been published, wich have been shown beneficial effects in metastatic and no metastatic patients.

摘要

目的

提出2016年主要年度会议期间展示的对临床实践有影响的泌尿肿瘤学新发现。

证据获取

本文回顾了2016年大会(欧洲泌尿外科学会、美国泌尿外科学会、美国临床肿瘤学会、欧洲肿瘤内科学会和美国放射肿瘤学会)上发表的关于前列腺癌、肾癌和膀胱癌的摘要,以及该时期内OncoForum委员会评分最高、影响最大的出版物。

证据综合

在肾切除术后的高危肾细胞癌中,舒尼替尼组的无病生存期显著长于安慰剂组,但不良事件更频繁。在局部晚期和转移性尿路上皮癌患者中,阿雷佐单抗在所有患者亚组中均实现了总体缓解率,包括预后较差的患者。在局限性前列腺癌中,主动监测、根治性前列腺切除术和外照射放疗之间的前列腺癌特异性死亡率差异不显著(P = 0.48)。在TERRAIN研究中,对于去势抵抗性前列腺癌患者,接受恩杂鲁胺和比卡鲁胺治疗的患者不良事件报告率分别为31%和23%。此外,与比卡鲁胺(5.8个月)相比,恩杂鲁胺显著改善了中位无进展生存期(15.7个月)(P < 0.0001)。在SRTIVE研究中,与比卡鲁胺相比,恩杂鲁胺使疾病进展或死亡风险降低了76%(P < 0.001)。

结论

在肾切除术后的高危肾细胞癌中,舒尼替尼被视为治疗选择。在局限性前列腺癌中,无论采用何种治疗方法(主动监测、根治性前列腺切除术和外照射放疗),前列腺癌特异性死亡率都较低。在转移性去势抵抗性前列腺癌中,已发表了恩杂鲁胺和阿比特龙治疗的新结果,这些结果在转移性和非转移性患者中均显示出有益效果。

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