Laccetti Andrew L, Morris Michael J, Kantoff Philip W
Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Onco Targets Ther. 2020 Dec 29;13:13247-13263. doi: 10.2147/OTT.S242921. eCollection 2020.
Enzalutamide was the first novel androgen receptor signaling inhibitor to demonstrate an overall survival benefit in non-metastatic and metastatic castration-sensitive prostate cancer (CSPC). It has emerged as one of the most commonly prescribed oral prostate cancer therapies (ARSI) by medical oncologists and urologists. Amongst a panoply of treatment options for metastatic CSPC, safe and effective utilization of enzalutamide dictates a detailed understanding of alternative therapy options and competing toxicity profiles. Ongoing research supports the potential for expanded enzalutamide use in earlier disease states, in combination with other systemic agents and as monotherapy (without androgen deprivation therapy). Optimal application of enzalutamide will ultimately require greater insight and attention to mitigating strategies for treatment-associated fatigue, cognitive impairment, and functional decline. This publication will comprehensively analyze the clinical evidence and guiding principles of enzalutamide use in CSPC. We will also provide a critical review of ongoing and future ARSI research focusing on pharmacologic approaches to overcome treatment resistance and strategies to improve treatment-associated functional impairment.
恩杂鲁胺是首个在非转移性和转移性去势敏感性前列腺癌（CSPC）中显示出总生存获益的新型雄激素受体信号抑制剂。它已成为肿瘤内科医生和泌尿外科医生最常处方的口服前列腺癌治疗药物（ARSI）之一。在转移性CSPC的众多治疗选择中，安全有效地使用恩杂鲁胺需要详细了解替代治疗方案和竞争性毒性特征。正在进行的研究支持恩杂鲁胺在更早疾病状态下扩大使用的潜力，可与其他全身治疗药物联合使用或作为单一疗法（无需雄激素剥夺治疗）。恩杂鲁胺的最佳应用最终将需要更深入地了解并关注减轻治疗相关疲劳、认知障碍和功能衰退的策略。本出版物将全面分析恩杂鲁胺在CSPC中应用的临床证据和指导原则。我们还将对正在进行和未来的ARSI研究进行批判性综述，重点关注克服治疗耐药性的药理学方法以及改善治疗相关功能损害的策略。
