Conteduca Vincenza, Poti Giulia, Caroli Paola, Russi Sabino, Brighi Nicole, Lolli Cristian, Schepisi Giuseppe, Romeo Antonino, Matteucci Federica, Paganelli Giovanni, Marchetti Paolo, De Giorgi Ugo
Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori "Dino Amadori" (IRST), IRCCS, Via Piero Maroncelli 40, Meldola (FC), Emilia-Romagna 47014, Italy.
Department of Clinical and Molecular Medicine, University "La Sapienza", Rome, Lazio, Italy.
Ther Adv Med Oncol. 2021 Feb 24;13:1758835920987654. doi: 10.1177/1758835920987654. eCollection 2021.
Over the years, an increasing proportion of metastatic prostate cancer patients has been found to experience an initial bone flare phenomenon under both standard therapies (androgen deprivation therapy, chemotherapy, radiotherapy, abiraterone, enzalutamide) and novel agents (immunotherapy, bone-targeting radioisotopes). The underlying biological mechanisms of the flare phenomenon are still elusive and need further clarification, particularly in relation to different types of treatment and their treatment response assessment. Flare phenomenon is often underestimated and, in some cases, can negatively affect clinical outcome. In cases with suspected bone flare, the treatment should be continued for a minimum of 12 more weeks before further decisions about efficacy can be taken. Physicians and patients should be aware of this effect to avoid unwarranted anxiety and inadequate early discontinuation of treatment. This review aims at highlighting new evidence on flare phenomenon arising after the introduction of new drugs extending across the biochemical, radiographic and clinical spectrum of the disease.
多年来，人们发现在标准疗法（雄激素剥夺疗法、化疗、放疗、阿比特龙、恩杂鲁胺）和新型药物（免疫疗法、骨靶向放射性同位素）治疗下，越来越多的转移性前列腺癌患者会出现初始骨痛现象。骨痛现象的潜在生物学机制仍不清楚，需要进一步阐明，特别是在不同类型的治疗及其治疗反应评估方面。骨痛现象常常被低估，在某些情况下，会对临床结果产生负面影响。对于疑似骨痛的病例，在对疗效做出进一步决定之前，治疗应至少再持续12周。医生和患者应了解这种效应，以避免不必要的焦虑和过早不适当停药。本综述旨在强调在引入新药后出现的关于骨痛现象的新证据，这些证据涵盖了该疾病的生化、影像学和临床范围。
