晚期前列腺癌的治疗。
Treatment of Advanced Prostate Cancer.
机构信息
Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA; email:
出版信息
Annu Rev Med. 2019 Jan 27;70:479-499. doi: 10.1146/annurev-med-051517-011947.
Abstract
The therapeutic landscape of prostate cancer has been transformed over the last decade by new therapeutics, advanced functional imaging, next-generation sequencing, and better use of existing therapies in early-stage disease. Until 2004, progression on androgen deprivation therapy for metastatic disease was treated with the addition of secondary hormonal manipulation; in the last decade, six systemic agents have been approved for the treatment of castration-resistant prostate cancer. We review clinical trials and survival benefit for these therapies and assess how the understanding of the disease shifted as these therapies were developed. We also discuss advances in noncastrate disease states, identification of biomarkers for prognosis and treatment selection, and opportunities in locoregional therapy to delay androgen deprivation therapy.
摘要
过去十年中，新的治疗方法、先进的功能成像、下一代测序以及在早期疾病中更好地利用现有治疗方法，改变了前列腺癌的治疗格局。直到 2004 年，转移性疾病的雄激素剥夺治疗进展才通过添加二线激素治疗来处理；在过去十年中，已有六种全身药物被批准用于治疗去势抵抗性前列腺癌。我们回顾了这些疗法的临床试验和生存获益，并评估了随着这些疗法的发展，对疾病的认识是如何改变的。我们还讨论了非去势疾病状态的进展、预后和治疗选择的生物标志物的鉴定，以及延迟雄激素剥夺治疗的局部区域治疗的机会。
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