基于疾病体积的转移性激素敏感前列腺癌的最佳治疗方法:系统性审查和网络元分析
Fabrizio Di Costanzo1,2, Chiara Mercinelli3,4, Alessio Signori5,6
1Department of Medical Oncology, Università degli Studi di Napoli Federico II, Naples, Italy.
The oncologist
|November 17, 2025
概括
三重组合为高体积转移性激素敏感前列腺癌 (mHSPC) 提供了最好的生存益处. 受体通路抑制剂 (ARPI) 双剂在低体积的mHSPC中最有效,指导一线治疗选择.
科学领域:
- 在瘤学瘤学.
- 临床试验 临床试验
- 前列腺癌研究 研究前列腺癌
背景情况:
- 转移性激素敏感前列腺癌 (mHSPC) 呈现治疗异质性.
- 由于试验结果多样化,医生在选择一线治疗时面临挑战.
研究的目的:
- 系统地审查和网络分析批准的mHSPC治疗方法.
- 根据疾病负担 (高与低体积) 和转移性发病 (同步与元时代) 来分层治疗疗效.
主要方法:
- 在2024年10月30日之前发表的11项随机对照试验 (RCT).
- 治疗方案包括三组治疗 (docetaxel,ARPI,ADT),双组治疗 (docetaxel/ADT,ARPI/ADT) 和单一治疗 (ADT).
- 在各小组中分析了整体存活率 (OS) 和无放射性进展生存率 (rPFS).
主要成果:
- 三重组合显著改善了高容量和高容量/同步mHSPC中的OS和rPFS.
- ARPI/ADT双体在低体积和低体积/元时代的mHSPC中表现出优异的结果.
- 在高体积/超慢性疾病中,三胞胎和双胞胎的疗效相似.
结论:
- 证据支持基于疾病体积和转移时间的mHSPC治疗选择.
- 三胞胎为高容量/同步mHSPC提供了最强的生存益处.
- 对于低容量的mHSPC来说,ARPI双是首选的选择.
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