转移性激素敏感前列腺癌和组合治疗结果:一篇评论
Maha Hussain1, Karim Fizazi2, Neal D Shore3
1Division of Hematology-Oncology, Department of Medicine, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
JAMA oncology
|May 9, 2024
概括
转移性激素敏感前列腺癌的治疗正在取得进展. 结合雄激素剥夺疗法,雄激素受体通路抑制剂和多塞的三重疗法显著改善了患者的生存结果.
科学领域:
- 在瘤学瘤学.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 医学瘤学 医学瘤学
背景情况:
- 转移性荷尔蒙敏感前列腺癌 (mHSPC) 仍然是无法治愈的,往往进展为抵抗割的疾病.
- 安卓素剥夺疗法 (ADT) 是标准的,但不足以长期控制.
- 用组合疗法加强治疗是一种新兴的策略.
研究的目的:
- 审查目前和新兴的mHSPC的管理策略.
- 总结了结合疗法治疗加剧的证据.
- 为临床实践提供建议,以改善生存结果.
主要方法:
- 对最近证据的系统审查.
- 国际第三期随机临床试验的分析.
- 评估三重疗法方案,包括ADT,雄激素受体通路抑制剂和多塞.
主要成果:
- 与ADT + docetaxel相比,三合一疗法 (ADT + 安卓素受体通路抑制剂 + 多塞塔塞尔) 显著改善了整体存活率.
- 第三期试验 (ARASENS,PEACE-1,ENZAMET) 在各种患者亚组中显示出生存益处.
- 组合疗法通常耐受良好,具有可管理的不良影响.
结论:
- 有令人信服的证据支持mHSPC患者的三重组合治疗.
- 三重疗法提供了最好的整体生存益处.
- 符合化疗条件的患者应考虑使用ADT+雄激素受体通路抑制剂+多塞塔塞尔,特别是那些患有大量,高风险或新发转移性疾病的患者.
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