Hahn Andrew W, Hale Peter, Rathi Nityam, Agarwal Neeraj
Division of Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA.
Curr Opin Urol. 2017 Nov;27(6):559-565. doi: 10.1097/MOU.0000000000000443.
Upfront docetaxel and androgen deprivation therapy (ADT) has improved outcomes over ADT alone in men with metastatic hormone-sensitive prostate cancer (mHSPC). Here in, we review the emerging role of novel androgen axis inhibitors in the treatment of men with mHSPC.
Recently two studies, LATITUDE and STAMPEDE arm G, showed improved survival with addition of abiraterone acetate with prednisone or prednisolone to ADT in men with hormone-naïve advanced prostate cancer.
Upfront docetaxel in addition to ADT has been shown to improve survival outcomes in men with high-volume mHSPC. Recently, abiraterone acetate and prednisone or prednisolone and ADT have been shown to improve survival outcomes compared with ADT alone in men with mHSPC. Multiple other novel androgen axis inhibitors are being investigated in this setting, and expected to garner regulatory approval in the near future. Biomarkers predicting response to these agents are urgently needed to optimize treatment selection, not only to improve outcomes but to also minimize cost and toxicities.
对于转移性激素敏感性前列腺癌（mHSPC）男性患者，一线多西他赛联合雄激素剥夺治疗（ADT）较单纯ADT改善了预后。在此，我们综述新型雄激素轴抑制剂在mHSPC男性患者治疗中的新作用。
最近两项研究，即LATITUDE研究和STAMPEDE研究的G组，显示在初治晚期前列腺癌男性患者中，ADT联合醋酸阿比特龙与泼尼松或泼尼松龙可提高生存率。
在高负荷mHSPC男性患者中，一线多西他赛联合ADT已被证明可改善生存预后。最近，在mHSPC男性患者中，醋酸阿比特龙与泼尼松或泼尼松龙联合ADT较单纯ADT已被证明可改善生存预后。在此背景下，正在研究多种其他新型雄激素轴抑制剂，预计在不久的将来获得监管批准。迫切需要预测这些药物反应的生物标志物，以优化治疗选择，不仅要改善预后，还要尽量降低成本和毒性。
