Borque-Fernando A, Calleja-Hernández M A, Cózar-Olmo J M, Gómez-Iturriaga A, Pérez-Fentes D A, Puente-Vázquez J, Rodrigo-Aliaga M, Unda M, Álvarez-Ossorio J L
Servicio de Urología, Hospital Universitario Miguel Servet, Zaragoza, Spain, IIS-Aragón, Spain.
Servicio de Farmacia, Hospital Universitario Virgen Macarena, Sevilla, Spain.
Actas Urol Esp (Engl Ed). 2023 Mar;47(2):111-126. doi: 10.1016/j.acuroe.2022.12.004. Epub 2023 Jan 28.
Androgen deprivation therapy (ADT) is the mainstay treatment for metastatic hormone-sensitive prostate cancer (mHSPC). The addition of docetaxel or new hormone therapies (abiraterone, apalutamide, or enzalutamide) improves overall survival and is currently the standard of care. However, the decision on the specific regimen to accompany ADT should be discussed with the patient, considering factors such as possible associated toxicities, duration of treatment, comorbidities, patient preferences, as there is no sufficient evidence to recommend one regimen over the other in most cases. This paper summarizes the evidence on the management of mHSPC and provides consensus recommendations on the optimal treatment in combination with ADT in mHSPC patients, with special attention to the patient's clinical profile.
雄激素剥夺疗法(ADT)是转移性激素敏感性前列腺癌(mHSPC)的主要治疗方法。多西他赛或新型激素疗法(阿比特龙、阿帕他胺或恩杂鲁胺)的加入可提高总生存率,目前是标准治疗方案。然而,应与患者讨论伴随ADT的具体治疗方案的决策,考虑可能的相关毒性、治疗持续时间、合并症、患者偏好等因素,因为在大多数情况下,没有足够的证据推荐一种方案优于另一种方案。本文总结了mHSPC管理的证据,并就mHSPC患者联合ADT的最佳治疗提供了共识性建议,特别关注患者的临床特征。