Department of Hematology and Medical Oncology, William Beaumont Hospital , Royal Oak, MI, USA.
Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute , Cleveland, OH, USA.
Expert Rev Anticancer Ther. 2020 Jun;20(6):513-522. doi: 10.1080/14737140.2020.1772759. Epub 2020 Jun 7.
The emergence of novel hormonal therapies and the increase availability of sensitive next-generation imaging techniques has significantly changed the management of recurrent prostate cancer.
In this review, we summarize the definition, diagnosis, treatment, and ongoing clinical trials in non-metastatic castration resistant prostate cancer (M0CRPC). We have also discussed the role of newer imaging modalities in the detection of advanced prostate cancer.
M0CRPC is a disease state in prostate cancer when serologic progression (PSA only disease) occurs despite castrated levels of testosterone and imaging shows no evidence of metastasis. With the availability of next-generation imaging, more patients are migrating from M0CRPC to mCRPC space. This stage migration impacts the treatment options currently available in clinical practice and requires the integration of novel imaging in prospective studies moving forward. Until that data become available men with M0CRPC should be considered for therapy with any of these three novel oral AR inhibitors, with a positive impact in metastasis-free and overall survival. Treatment selection should be based on Quality of Life, side effects, and drug-drug interactions.
新型激素疗法的出现和下一代敏感成像技术的可用性的提高，显著改变了复发性前列腺癌的治疗方法。
在这篇综述中，我们总结了非转移性去势抵抗性前列腺癌（M0CRPC）的定义、诊断、治疗和正在进行的临床试验。我们还讨论了新型成像方式在检测晚期前列腺癌中的作用。
M0CRPC 是前列腺癌的一种疾病状态，当血清学进展（仅 PSA 疾病）发生时，尽管睾酮水平被去势，但影像学检查没有显示转移的证据。随着下一代成像技术的出现，更多的患者从 M0CRPC 转移到 mCRPC 领域。这种阶段转移影响了目前临床实践中可用的治疗选择，需要在未来的前瞻性研究中整合新型影像学技术。在这些数据可用之前，应考虑对 M0CRPC 患者进行任何三种新型口服 AR 抑制剂治疗，这对无转移生存和总生存都有积极影响。治疗选择应基于生活质量、副作用和药物相互作用。
