Queen University, Belfast, United Kingdom.
Private Practice, Elliot Abramowitz, Ph.D, Long Beach, NY.
Future Oncol. 2023 May;19(15):1021-1028. doi: 10.2217/fon-2022-1296. Epub 2023 Mar 21.
WHAT IS THIS SUMMARY ABOUT?: Few life-prolonging treatment options are available for patients with metastatic castration-resistant prostate cancer (mCRPC). This article provides an overview of the current systemic treatments available for mCRPC and reviews studies that investigate the optimal timing for the use of radium-223. The aim is to illustrate possible systemic treatment sequences to maximize benefit from radium-223 therapy.
WHAT IS METASTATIC CASTRATION-RESISTANT PROSTATE CANCER & HOW IS IT TREATED?: Prostate cancer is called mCRPC when it spreads to organs outside of the prostate (such as the lymph nodes, bones, liver, or lungs) and no longer responds to hormonal therapy. There are several treatment options available for mCRPC, such as abiraterone, enzalutamide, radium-223, docetaxel, cabazitaxel, olaparib, rucaparib, sipuleucel-T, and 177Lu-PSMA. It is important to understand the risks and benefits associated with each treatment and whether current use may have an impact on future treatment options, including eligibility in certain clinical trials. Maintaining bone health is also an important part of prostate cancer care.
WHAT IS RADIUM-223?: Radium-223 is a radioactive molecule that releases strong radiation within a very small range around itself. It mainly travels to the bone where the prostate cancer has spread and kills the cancer cells in that area. Results from a clinical study named ALSYMPCA showed that men who received radium-223 lived longer in addition to having less bone pain. The most common side effects of radium-223 are nausea, vomiting, and diarrhea. Radium-223 minimally suppresses the bone marrow, which means that it slightly reduces the levels of red and white blood cells.
这篇综述主要讲了什么内容？
转移性去势抵抗性前列腺癌（mCRPC）患者的延长生命的治疗选择有限。本文概述了 mCRPC 目前可用的系统治疗方法，并回顾了研究镭-223最佳使用时机的研究。目的是说明可能的系统治疗顺序，以最大限度地从镭-223 治疗中获益。
什么是转移性去势抵抗性前列腺癌，如何治疗？
当前列腺癌扩散到前列腺以外的器官（如淋巴结、骨骼、肝脏或肺部）并且对激素治疗不再有反应时，就称为 mCRPC。mCRPC 有几种治疗选择，如阿比特龙、恩杂鲁胺、镭-223、多西他赛、卡巴他赛、奥拉帕利、鲁卡帕利、sipuleucel-T 和 177Lu-PSMA。了解每种治疗方法的风险和益处，以及当前的使用是否会对未来的治疗选择产生影响，包括在某些临床试验中的资格，这一点很重要。维持骨骼健康也是前列腺癌护理的重要组成部分。
什么是镭-223？
镭-223 是一种放射性分子，在其自身周围非常小的范围内释放出强烈的辐射。它主要到达前列腺癌已经扩散到的骨骼，并杀死该区域的癌细胞。名为 ALSYMPCA 的临床研究结果表明，接受镭-223 治疗的男性不仅寿命更长，而且骨痛也更少。镭-223 的最常见副作用是恶心、呕吐和腹泻。镭-223 对骨髓的抑制作用极小，这意味着它会轻微降低红细胞和白细胞的水平。
