Carolina Urologic Research Center/GenesisCare, Myrtle Beach, SC 29572, USA.
Analysis Group, Inc., New York, NY 10036, USA.
Future Oncol. 2023 Feb;19(5):385-395. doi: 10.2217/fon-2022-1123. Epub 2023 Feb 16.
Approval of apalutamide, enzalutamide and darolutamide has transformed the treatment landscape and guideline recommendations for patients with nonmetastatic castration-resistant prostate cancer but now raises the issue of decision-making regarding treatment selection. In this perspective, we discuss the efficacy and safety of these second-generation androgen receptor inhibitors and propose that for patients with nonmetastatic castration-resistant prostate cancer, safety considerations for these treatments are especially important. We examine these considerations in the context of patient and caregiver preferences as well as patient clinical characteristics. We further posit that consideration of treatments' safety profiles should include not only the initial direct impacts from potential treatment-emergent adverse events and drug-drug interaction events, but also the full cascade of potentially avoidable healthcare complications.
阿帕鲁胺、恩扎卢胺和达罗他胺的获批改变了转移性去势抵抗性前列腺癌患者的治疗格局和指南推荐，但现在又提出了治疗选择决策的问题。在这篇观点文章中，我们讨论了这些第二代雄激素受体抑制剂的疗效和安全性，并提出对于非转移性去势抵抗性前列腺癌患者，这些治疗的安全性考虑尤为重要。我们从患者和照护者的偏好以及患者的临床特征两方面来探讨这些考虑因素。我们进一步认为，治疗安全性的考虑不仅应包括潜在治疗相关不良事件和药物相互作用事件直接影响，还应包括潜在可避免的医疗并发症的全部级联反应。
