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对于激素敏感前列腺癌的三重系统疗法:以多学科方法进行批判性审查

Almudena Zapatero¹, Teresa Alonso-Gordoa², Alfredo Rodríguez Antolín³

¹Radiation Oncology Department, Health Research Institute, Hospital Universitario de La Princesa, Madrid, Spain.

Oncology reviews

|August 11, 2025

概括

结合雄激素剥夺疗法 (ADT),多塞和雄激素受体通路抑制剂 (ARPI) 的三重疗法显示,转移性激素敏感前列腺癌 (mHSPC) 的存活率有所改善. 耐受性类似于ADT加多塞塔塞尔,三重疗法是特定患者群体首选的第一线选择.

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
药理学药理学是指药理学的学科.

背景情况:

转移性激素敏感前列腺癌 (mHSPC) 治疗已经发展出新的治疗组合.
雄激素剥夺疗法 (ADT) 仍然是基石,但通过与化疗和向药物结合,其疗效得到增强.

研究的目的:

在mHSPC中批判性地评估三重疗法 (ADT,多塞和第二代雄激素受体通路抑制剂[ARPI]) 的证据.
评估这些治疗方案的临床效用和比较有效性.

主要方法:

在2024年4月的PubMed,Medline,Embase,Cochrane,Scopus和Web of Science的综合文献搜索.
包括前性/后性观察性试验,随机对照试验 (RCT) 和元分析.
分析了52篇相关文章,包括3个RCT和14个元分析.

主要成果:

与ADT + docetaxel相比,与abiraterone或darolutamide的三重治疗显著改善了整体存活率,特别是在高体积/同步疾病中.
三重疗法和ADT + docetaxel之间的耐受性概况相似, docetaxel导致了大多数不良事件.
三重疗法和ADT + ARPI双重疗法之间没有直接的比较数据.

结论:

三重疗法是mHSPC,良好表现状态和高体积/同步转移的男性最有效的第一线治疗方案.
基于达洛胺的三重疗法可能会使更广泛的患者受益,包括那些患有低风险疾病的患者.
个性化风险-益处评估对于选择可能避免使用多塞塔克塞尔的患者至关重要.

关键词:

雄激素剥夺疗法是一种治疗方法.针对雄激素受体的向疗法多塞塔克塞尔 (Docetaxel) 是一种药物.对激素敏感的前列腺癌转移性前列腺癌转移性前列腺癌

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