雄激素受体抑制剂联合多西他赛治疗转移性去势敏感性前列腺癌：一线治疗的下一步？
Combination Androgen Receptor Inhibition and Docetaxel in Metastatic Castration-sensitive Prostate Cancer: The Next Step in First-line Treatment?
机构信息
Department of Internal Medicine, University of South Florida, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.
Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA.
出版信息
Clin Genitourin Cancer. 2020 Dec;18(6):425-428. doi: 10.1016/j.clgc.2020.05.003. Epub 2020 May 11.
The addition of docetaxel and abiraterone to androgen deprivation therapy (ADT) heralded a new era in the first-line treatment of metastatic castration-sensitive prostate cancer (mCSPC). Following the success of these combination regimens, 3 new trials presented data on using enzalutamide or apalutamide in men with mCSPC, which showed similar success. These seminal trials collectively established the addition of docetaxel, enzalutamide, apalutamide, or abiraterone to ADT as standards in the upfront treatment of mCSPC. Notably, a subset of patients in these more recent trials were treated with a combination of docetaxel, ADT, and androgen receptor signaling inhibitors or maintenance androgen receptor signaling inhibitors after docetaxel and ADT that provided an initial glimpse into the efficacy of these triplet or maintenance strategies. We discuss the implications of these recent findings and place them in context of the current mCSPC treatment landscape.
多西他赛和阿比特龙联合雄激素剥夺治疗（ADT）开创了转移性去势敏感前列腺癌（mCSPC）一线治疗的新纪元。这些联合治疗方案取得成功后，3 项新试验报告了在 mCSPC 男性中使用恩扎卢胺或阿帕鲁胺的数据，结果相似。这些开创性的试验共同确立了在 mCSPC 的一线治疗中，在 ADT 的基础上加用多西他赛、恩扎卢胺、阿帕鲁胺或阿比特龙作为标准治疗。值得注意的是，这些最近的试验中有一部分患者在接受多西他赛和 ADT 治疗后，联合使用了雄激素受体信号抑制剂或维持性雄激素受体信号抑制剂，这初步揭示了这些三联或维持策略的疗效。我们讨论了这些最新发现的意义，并将其置于当前 mCSPC 治疗格局的背景下。
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