Ferretti Simone, Mercinelli Chiara, Marandino Laura, Litterio Giulio, Marchioni Michele, Schips Luigi
Department of Medical, Oral and Biotechnological Sciences, G. d'Annunzio University of Chieti, Urology Unit, Chieti, Italy.
Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Res Rep Urol. 2023 Jun 26;15:243-259. doi: 10.2147/RRU.S385257. eCollection 2023.
The therapeutic landscape of metastatic hormone sensitive and metastatic castration-resistant prostate cancer (mCRPC) is rapidly changing. We reviewed the current treatment options for mCRPC, with insights on new available therapeutic strategies. Chemotherapy with docetaxel or cabazitaxel (for patients progressing on docetaxel), as well as treatment with androgen receptor axis targeted therapies, and Radium-223 are well-established treatment options for patients with mCRPC. The advent of theragnostic in prostate cancer established Lutetium-177 (177Lu)-PSMA-617 as a new standard of care for PSMA-positive mCRPC previously treated with ARAT and taxane-based chemotherapy. Olaparib, a poly-ADP-ribose polymerase (PARP) inhibitor, is approved for selected patients with mCRPC progressed on ARATs and in combination with abiraterone acetate as first-line treatment for mCRPC. Immunotherapy showed limited efficacy in unselected patients with mCRPC and novel immunotherapy strategies need to be explored. The search for biomarkers is a growing field of interest in mCRPC, and predictive biomarkers are needed to support the choice of treatment and the development of tailored strategies.
转移性激素敏感性和转移性去势抵抗性前列腺癌（mCRPC）的治疗格局正在迅速变化。我们回顾了mCRPC的当前治疗选择，并对新的可用治疗策略进行了深入分析。多西他赛或卡巴他赛化疗（用于多西他赛治疗后进展的患者），以及雄激素受体轴靶向治疗和镭-223治疗，是mCRPC患者公认的治疗选择。前列腺癌中治疗诊断学的出现确立了镥-177（177Lu）-PSMA-617作为PSMA阳性mCRPC患者的新护理标准，这些患者先前接受过雄激素受体轴靶向治疗（ARAT）和紫杉烷类化疗。奥拉帕尼，一种聚二磷酸腺苷核糖聚合酶（PARP）抑制剂，被批准用于在ARAT治疗后进展的特定mCRPC患者，并与醋酸阿比特龙联合作为mCRPC的一线治疗。免疫疗法在未选择的mCRPC患者中疗效有限，需要探索新的免疫疗法策略。寻找生物标志物是mCRPC中一个日益受关注的领域，需要预测性生物标志物来支持治疗选择和制定个性化策略。
