Department of Urology, University "Aldo Moro", Bari, Italy.
Azienda Ospedaliero-Universitaria Policlinico, Bari, Italy.
Adv Exp Med Biol. 2018;1096:1-30. doi: 10.1007/978-3-319-99286-0_1.
In the contemporary scene, less than 5% of men with newly diagnosed prostate cancer (PC) have metastases at first presentation, compared to 20-25%, more than 20 years ago. Nonetheless, the use of androgen deprivation therapy (ADT) has increased over the years, suggesting that patients in Europe and United States may receive ADT in cases of lower disease burden, and not always according to evidence based indications. Nonetheless, PC remains the second most common cause of cancer death after lung cancer in American men. Thus, there is a need for more effective, specific and well tolerated agents which can provide a longer and good quality of life while avoiding the side effects related to disease and treatment morbidity.After mentioning the current knowledge on the endocrinology of androgens and androgen receptor, relevant to PC development, as well as the possible events occurring during PC initiation, we will compare different hormonal compounds available for the treatment of PC, both from a pharmacological standpoint, and in terms of contemporary clinical indications.
在当今的情况下，与 20-25%相比，初次诊断为前列腺癌 (PC) 的男性中，转移性疾病的比例不到 5%。尽管如此，雄激素剥夺疗法 (ADT) 的应用多年来一直在增加，这表明欧洲和美国的患者可能在疾病负担较低的情况下接受 ADT，而并不总是根据循证指征。尽管如此，PC 仍然是美国男性继肺癌之后第二大常见的癌症死因。因此，需要更有效、更特异、更耐受的药物，这些药物可以在避免与疾病和治疗相关的副作用的同时，提供更长的生存时间和良好的生活质量。在提到与 PC 发展相关的雄激素和雄激素受体的内分泌学的现有知识，以及 PC 发生过程中可能发生的事件之后，我们将从药理学和当代临床适应证的角度比较用于治疗 PC 的不同激素化合物。
