Turco Fabio, Di Prima Lavinia, Pisano Chiara, Poletto Stefano, De Filippis Marco, Crespi Veronica, Farinea Giovanni, Cani Massimiliano, Calabrese Mariangela, Saporita Isabella, Di Stefano Rosario Francesco, Tucci Marcello, Buttigliero Consuelo
Department of Oncology, University of Turin, at Division of Medical Oncology, San Luigi Gonzaga Hospital, Turin, Italy.
Department of Medical Oncology, Cardinal Massaia Hospital, Asti, Italy.
Res Rep Urol. 2023 Jan 19;15:9-26. doi: 10.2147/RRU.S350793. eCollection 2023.
Prostate cancer (PC) is a hormone-sensitive tumor. Androgen deprivation therapy (ADT) is the cornerstone of systemic therapy for patients with intermediate or high-risk localized, recurrent, and metastatic prostate cancer. Although generally well tolerated, ADT can lead to short- and long-term adverse events that can worsen the quality of life of patients with PC. In the last decade, the introduction of novel generation androgen receptor pathway inhibitors (ARPI) has resulted in an improvement in the prognosis of patients with metastatic PC when used in combination with ADT. The use of ARPI in increasingly early stages of the disease determines a longer exposure of patients to these treatments. Although ARPIs are normally well-tolerated drugs, they generally cause an increase in toxicity compared to ADT alone, being able to worsen some adverse events already induced by ADT or leading to the development of specific side effects. Although there are no specific treatments for all the adverse events induced by hormonal therapies, it is essential to know the possible toxicities induced by the different treatments and to start procedures to prevent and/or recognize and consequently treat them early in order to not compromise the quality of life of the patients with PC. The aim of this review is to describe the adverse events induced by hormonal therapies. We will first describe the side effects induced by both ADT and ARPI and then the specific adverse events of the different ARPIs. Furthermore, we will try to highlight the possible therapeutic options to prevent or mitigate the toxicity induced by hormone therapies in order to improve the quality of life of the patients with PC.
前列腺癌（PC）是一种激素敏感性肿瘤。雄激素剥夺疗法（ADT）是局部中高危、复发及转移性前列腺癌患者全身治疗的基石。尽管ADT通常耐受性良好，但它会导致短期和长期不良事件，从而使前列腺癌患者的生活质量恶化。在过去十年中，新一代雄激素受体通路抑制剂（ARPI）的引入使转移性前列腺癌患者在与ADT联合使用时预后得到改善。在疾病越来越早的阶段使用ARPI，会使患者接受这些治疗的时间更长。尽管ARPI通常是耐受性良好的药物，但与单独使用ADT相比，它们通常会导致毒性增加，能够使ADT已经引发的一些不良事件恶化，或导致特定副作用的出现。尽管对于激素疗法引发的所有不良事件没有特异性治疗方法，但了解不同治疗方法可能导致的毒性，并启动预防和/或识别程序，进而尽早治疗这些毒性，对于不影响前列腺癌患者的生活质量至关重要。本综述的目的是描述激素疗法引发的不良事件。我们将首先描述ADT和ARPI引发的副作用，然后描述不同ARPI的特定不良事件。此外，我们将试图强调预防或减轻激素疗法引发的毒性的可能治疗选择，以改善前列腺癌患者的生活质量。
