转移性去势抵抗性前列腺癌化疗与激素治疗策略

Strategies to chemotherapy and hormone therapy in the treatment of metastatic castrate-resistantprostate cancer

关键词:  去势抵抗性前列腺癌  阿比特龙  镭-223  sipuleucel-T  恩杂鲁胺  多西他赛复治

Key words:  [Key words]　metastatic castrate-resistant prostate cancer  abiratone acetate  radium-223  sipuleucel-T  enzalutamide  docetaxel rechallege

摘要:

[摘要]　以多西他赛为核心的化疗方案已经成为转移性去势抵抗性前列腺癌(metastatic castrate-resistant prostate cancer,mCRPC)治疗的一线方案。但在过去的几年中, 一些新药的出现改善了患者的总体生存，同时也使优化个体化治疗方案成为可能。已有证据表明阿比特龙、卡巴他赛、镭-223、sipuleucel-T、恩杂鲁胺等与多西他赛一同使去势抵抗性前列腺癌患者生存获益。另外，mCRPC患者对多西他赛一线治疗初始反应良好，出现疾病进展后复治应作为一线治疗的延伸。这些新的治疗手段使mCRPC治疗方案更加复杂化，并且使以往的序贯治疗方案向基于一定规则的新的治疗方式转变。

Abstract:

[Abstract]　Chemotherapy with docetaxel has become the first line treatment for metastatic castrate-resistantprostate cancer (mCRPC), in the last few years, new agents have been developed to improve survival obviously in this setting and reach a possible optimal personalized treatment strategy. There is evidence to suggest that abiratone acetate, cabazitaxel,radium-223, sipuleucel-T and enzalutamide, together with docetaxel, have demonstrated a survival benefit in these patients. The use of rechallenge with docetaxel in mCRPC patients with disease progression after a first response in the first line treatment should been considered as the extension. These new agents make the scenario more complicated and the challenge to move from the old sequential to a new algorithm-based approach.