镭-223 联合疗法治疗去势抵抗性前列腺癌骨转移患者：综述。
Combination radium-223 therapies in patients with bone metastases from castration-resistant prostate cancer: A review.
机构信息
Department of Medical Oncology, Campus Bio-Medico University of Rome, 00128, Rome, Italy.
Department of Medical Oncology, Campus Bio-Medico University of Rome, 00128, Rome, Italy.
出版信息
Crit Rev Oncol Hematol. 2020 Feb;146:102864. doi: 10.1016/j.critrevonc.2020.102864. Epub 2020 Jan 7.
Chemotherapeutic agents (docetaxel, cabazitaxel), hormonal therapies (abiraterone, enzalutamide) and radium-223 improve survival in patients with bone metastatic castration-resistant prostate cancer (mCRPC). Combinations of radium-223 with these agents or novel drugs have been investigated in order to improve survival and decrease bone-related morbidity. In mCRPC, clinical and preclinical data indicate that radium-223, abiraterone and enzalutamide have a direct effect on prostate cancer cells and bone microenvironment when administered as single agents. Initial results from studies of radium-223 and abiraterone, enzalutamide or docetaxel demonstrated efficacy without any safety concern in pre-treated mCRPC; however, this safety profile changed when radium-based combination therapies were administered in un-pretreated mCRPC. This review underline the biological rationale for combining radium strategies, investigating their effects on bone in terms of control of skeletal-related events and bone disease progression. The aim is to understand the possible reasons why different radium-based combination treatments can led to different clinical outcomes.
化疗药物（多西他赛、卡巴他赛）、激素疗法（阿比特龙、恩扎鲁胺）和镭-223 可改善转移性去势抵抗性前列腺癌（mCRPC）患者的生存。为了提高生存率并降低与骨骼相关的发病率，已经研究了镭-223 与这些药物或新型药物的联合治疗。在 mCRPC 中，临床和临床前数据表明，镭-223、阿比特龙和恩扎鲁胺单独给药时对前列腺癌细胞和骨微环境具有直接作用。在预处理 mCRPC 中，镭-223 与阿比特龙、恩扎鲁胺或多西他赛联合治疗的初步研究结果显示，疗效确切，且无安全性问题；然而，当在未经预处理的 mCRPC 中给予基于镭的联合治疗时，这种安全性特征发生了变化。本综述强调了联合镭治疗的生物学原理，研究了它们在控制骨骼相关事件和骨病进展方面对骨骼的影响。目的是了解为什么不同的基于镭的联合治疗会导致不同的临床结果的可能原因。
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