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前列腺癌患者的间歇性雄激素剥夺疗法:梳理相关要点

Intermittent androgen deprivation therapy in patients with prostate cancer: Connecting the dots.

作者信息

Abrahamsson Per-Anders

机构信息

Department of Urology, Skåne University Hospital, Lund University, Malmö, Sweden.

出版信息

Asian J Urol. 2017 Oct;4(4):208-222. doi: 10.1016/j.ajur.2017.04.001. Epub 2017 Apr 22.


DOI:10.1016/j.ajur.2017.04.001
PMID:29387553
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5772839/
Abstract

Intermittent androgen deprivation therapy (IADT) is now being increasingly opted by the treating physicians and patients with prostate cancer. The most common reason driving this is the availability of an off-treatment period to the patients that provides some relief from treatment-related side-effects, and reduced treatment costs. IADT may also delay the progression to castration-resistant prostate cancer. However, the use of IADT in the setting of prostate cancer has not been strongly substantiated by data from clinical trials. Multiple factors seem to contribute towards this inadequacy of supportive data for the use of IADT in patients with prostate cancer, e.g., population characteristics (both demographic and clinical), study design, treatment regimen, on- and off-treatment criteria, duration of active treatment, endpoints, and analysis. The present review article focuses on seven clinical trials that evaluated the efficacy of IADT . continuous androgen deprivation therapy for the treatment of prostate cancer. The results from these clinical trials have been discussed in light of the factors that may impact the treatment outcomes, especially the disease (tumor) burden. Based on evidence, potential candidate population for IADT has been suggested along with recommendations for the use of IADT in patients with prostate cancer.

摘要

目前,治疗前列腺癌的医生和患者越来越多地选择间歇性雄激素剥夺疗法(IADT)。促使这种情况出现的最常见原因是患者有一段停止治疗的时期,这能在一定程度上缓解治疗相关的副作用,并降低治疗成本。IADT还可能延缓前列腺癌向去势抵抗性前列腺癌的进展。然而,在前列腺癌治疗中使用IADT尚未得到临床试验数据的有力证实。多种因素似乎导致了在前列腺癌患者中使用IADT缺乏支持性数据,例如人群特征(包括人口统计学和临床特征)、研究设计、治疗方案、治疗期和非治疗期标准、积极治疗的持续时间、终点指标以及分析方法。本综述文章聚焦于七项评估IADT(连续雄激素剥夺疗法)治疗前列腺癌疗效的临床试验。已根据可能影响治疗结果,尤其是疾病(肿瘤)负担的因素,对这些临床试验的结果进行了讨论。基于证据,提出了IADT的潜在候选人群以及在前列腺癌患者中使用IADT的建议。

相似文献

[1]
Intermittent androgen deprivation therapy in patients with prostate cancer: Connecting the dots.

Asian J Urol. 2017-10

[2]
Intermittent androgen deprivation therapy for prostate cancer: translating randomized controlled trials into clinical practice.

Can J Urol. 2014-4

[3]
Improving intermittent androgen deprivation therapy: lessons learned from basic and translational research.

Asian J Androl. 2014

[4]
The effect of continuous androgen deprivation treatment on prostate cancer patients as compared with intermittent androgen deprivation treatment.

Korean J Urol. 2015-10

[5]
Is intermittent androgen-deprivation therapy beneficial for patients with advanced prostate cancer?

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[6]
Real-World Practice Patterns and Predictors of Continuous versus Intermittent Androgen Deprivation Therapy Use for Prostate Cancer in Older Men.

J Urol. 2021-10

[7]
Efficacy of intermittent androgen deprivation therapy vs conventional continuous androgen deprivation therapy for advanced prostate cancer: a meta-analysis.

Urology. 2013-8

[8]
[Risks of diabetes mellitus and impaired glucose tolerance induced by intermittent versus continuous androgen-deprivation therapy for advanced prostate cancer].

Zhonghua Nan Ke Xue. 2017-7

[9]
Population-based Assessment of Intermittent Androgen Deprivation Therapy Utilization for Relapsed, Nonmetastatic, Hormone-sensitive Adenocarcinoma of the Prostate.

Am J Clin Oncol. 2020-12-1

[10]
Intermittent androgen deprivation therapy: recommendations to improve the management of patients with prostate cancer following the GRADE approach.

Cancer Manag Res. 2018-8-2

引用本文的文献

[1]
Safety and early efficacy of involved-field SBRT for nodal oligo-recurrent prostate cancer.

Front Oncol. 2024-10-17

[2]
Mechanisms of Prostate Cancer Cells Survival and Their Therapeutic Targeting.

Int J Mol Sci. 2023-2-2

[3]
Rationale for Involved Field Stereotactic Body Radiation Therapy-Enhanced Intermittent Androgen Deprivation Therapy in Hormone-Sensitive Nodal Oligo-Recurrent Prostate Cancer Following Prostate Stereotactic Body Radiation Therapy.

Front Oncol. 2021-1-18

[4]
Resistance to Antiandrogens in Prostate Cancer: Is It Inevitable, Intrinsic or Induced?

Cancers (Basel). 2021-1-17

[5]
Intermittent versus continuous androgen deprivation therapy for advanced prostate cancer.

Nat Rev Urol. 2020-8

[6]
hASH1 nuclear localization persists in neuroendocrine transdifferentiated prostate cancer cells, even upon reintroduction of androgen.

Sci Rep. 2019-12-13

本文引用的文献

[1]
Risks of Serious Toxicities from Intermittent versus Continuous Androgen Deprivation Therapy for Advanced Prostate Cancer: A Population Based Study.

J Urol. 2016-12-16

[2]
Intermittent versus continuous androgen deprivation therapy to biochemical recurrence after external beam radiotherapy: a phase 3 GICOR study.

Clin Transl Oncol. 2017-3

[3]
Adverse Health Events Following Intermittent and Continuous Androgen Deprivation in Patients With Metastatic Prostate Cancer.

JAMA Oncol. 2016-4

[4]
Evaluating Intermittent Androgen-Deprivation Therapy Phase III Clinical Trials: The Devil Is in the Details.

J Clin Oncol. 2016-1-20

[5]
Intermittent Versus Continuous Androgen Deprivation Therapy in Patients with Relapsing or Locally Advanced Prostate Cancer: A Phase 3b Randomised Study (ICELAND).

Eur Urol. 2016-4

[6]
Non-inferiority trials: why oncologists must remain wary.

Lancet Oncol. 2015-4

[7]
Intermittent versus continuous androgen deprivation for locally advanced, recurrent or metastatic prostate cancer: a systematic review and meta-analysis.

BMC Urol. 2014-1-25

[8]
Intermittent versus continuous cyproterone acetate in bone metastatic prostate cancer: results of a randomized trial.

World J Urol. 2014-10

[9]
Intermittent androgen deprivation therapy: clarity from confusion.

Eur Urol. 2013-11

[10]
Intermittent androgen-deprivation therapy in prostate cancer: a critical review focused on phase 3 trials.

Eur Urol. 2013-4-19

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