Department of Urology, Mimihara General Hospital, 4-465, Kyowacho, Sakai Sakai-ku, Osaka, 590-8505, Japan.
Department of Urology, Faculty of Medicine, Kindai University Hospital, 377-2, Onohigashi, Osakasayama, Osaka, 589-8511, Japan.
World J Urol. 2023 Aug;41(8):2063-2068. doi: 10.1007/s00345-022-04134-9. Epub 2022 Aug 30.
The therapeutic landscape for metastatic hormone-sensitive prostate cancer (mHSPC) has changed dramatically. Here, we provide the current status and future prospective of the management of mHSPC.
We reviewed recent literature of landmark studies on the managements of mHSPC.
Upfront docetaxel or androgen receptor signaling inhibitor (ARSi) in addition to ADT has improved survival in mHSPC patients and has become the new standard of care. Triplet therapy with docetaxel, ARSi and ADT also improved survival. In the future, triplet therapy may become the standard of care. Oligometastatic mHSPC patients could benefit from local therapy. The inclusion of risk factors or the genetic biomarkers will provide the best treatment for individual mHSPC patients.
Strong systemic therapy in the first-line treatment of mHSPC has been shown to improve survival and quality of life. Currently, several clinical trials are evaluating novel compounds such as PARP inhibitor, AKT inhibitor, and immune checkpoint inhibitor. The therapeutic landscape of mHSPC management will change dramatically.
转移性激素敏感型前列腺癌（mHSPC）的治疗环境发生了巨大变化。在此，我们提供 mHSPC 管理的现状和未来展望。
我们回顾了关于 mHSPC 管理的重要研究的最新文献。
在 mHSPC 患者中，在 ADT 之前使用多西他赛或雄激素受体信号抑制剂（ARSi）治疗可提高生存率，已成为新的治疗标准。多西他赛、ARSi 和 ADT 的三联疗法也可提高生存率。未来，三联疗法可能成为标准治疗。寡转移性 mHSPC 患者可能从局部治疗中获益。纳入风险因素或遗传生物标志物将为每个 mHSPC 患者提供最佳治疗。
在一线治疗 mHSPC 中采用强烈的系统治疗已被证明可提高生存率和生活质量。目前，几项临床试验正在评估 PARP 抑制剂、AKT 抑制剂和免疫检查点抑制剂等新型化合物。mHSPC 管理的治疗环境将发生巨大变化。
