Duarte Cassandra, Jimeno A, Kessler E R
Department of Medicine, Division of Medical Oncology, and Developmental Therapeutics Program, University of Colorado Cancer Center, Aurora, USA.
Department of Medicine, Division of Medical Oncology, and Developmental Therapeutics Program, University of Colorado Cancer Center, Aurora, USA. Antonio.Jimeno@ucdenver.
Drugs Today (Barc). 2019 Jan;55(1):5-15. doi: 10.1358/dot.2019.55.1.2914339.
Prostate cancer is one of the most common cancers in the United States, with an estimated incidence of 164,690 cases, accounting for 9.5% of all new cancer diagnoses. The mainstay of therapy for metastatic prostate cancer involves suppressing testosterone production through androgen deprivation therapy. However, nearly all patients on androgen deprivation therapy will develop resistance to hormone therapy. An improved understanding of the biology of castration resistance has allowed for the development of novel inhibitors of the androgen axis. Agents such as abiraterone acetate, which provides additional androgen suppression by inhibiting cytochrome P450 17A (CYP17A), have improved survival outcomes of patients with advanced prostate cancer. The longest experience with abiraterone acetate is in the metastatic castration-resistant setting. However, more recent trials have demonstrated that abiraterone acetate is an option for treatment earlier in the prostate cancer paradigm. This review will cover the current use of abiraterone acetate in combination with prednisone for the treatment of castration-resistant prostate cancer.
前列腺癌是美国最常见的癌症之一，估计发病率为164,690例，占所有新癌症诊断病例的9.5%。转移性前列腺癌的主要治疗方法是通过雄激素剥夺疗法抑制睾酮生成。然而，几乎所有接受雄激素剥夺疗法的患者都会对激素治疗产生耐药性。对去势抵抗生物学的进一步了解促进了新型雄激素轴抑制剂的研发。诸如醋酸阿比特龙之类的药物，通过抑制细胞色素P450 17A（CYP17A）提供额外的雄激素抑制作用，改善了晚期前列腺癌患者的生存结局。醋酸阿比特龙使用经验最长的是在转移性去势抵抗的情况下。然而，最近的试验表明，醋酸阿比特龙在前列腺癌治疗早期也是一种选择。本综述将涵盖醋酸阿比特龙联合泼尼松目前在去势抵抗性前列腺癌治疗中的应用。
