前列腺癌的新辅助疗法-当前模式和未来方向
Kieran Sandhu1,2, Abdullah Al-Khanaty1,3, David Hennes1,4
1Division of Cancer Surgery, Peter MacCallum Cancer Centre, Parkville, VIC 3000, Australia.
Cancers
|January 10, 2026
概括
高风险前列腺癌的新辅助疗法正在发展. 更新的治疗方法,如雄激素受体通路抑制剂和放射性体疗法,有望改善生存和个性化治疗策略.
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
- 医学物理 医学物理
背景情况:
- 高风险和局部晚期前列腺癌的复发率和死亡率很高.
- 新辅助期在急性前列腺切除或放射治疗之前为系统治疗提供了一个关键的窗口.
- 之前的新辅助疗法,包括第一代雄激素剥夺疗法 (ADT) 和基于多塞的疗法,显示出有限的生存益处.
研究的目的:
- 审查目前关于高风险前列腺癌新辅助疗法的证据.
- 探索新兴的系统性治疗和未来的研究方向在新辅助设置.
主要方法:
- 这是一个叙述性综述,综合了现有的临床试验数据和研究结果.
- 专注于评估各种新辅助全身疗法的疗效和结果.
- 讨论正在进行的III期试验和新的治疗方法.
主要成果:
- 第二代雄激素受体通路抑制剂 (ARPI) 与ADT结合,在转移性环境中显示出显著的生存益处,并且正在新辅助试验中进行研究.
- [177Lu]Lu-PSMA-617放射性干疗法在新辅助环境中显示出前景.
- 放射治疗 (RT) 单独面临着消除微转移性疾病的挑战,类似于手术,引发了对强化新辅助系统治疗的兴趣.
结论:
- 新辅助性ARPI和放射性连接体疗法代表了对高风险前列腺癌的有希望的进展.
- 未来的研究将专注于个性化的新辅助剂策略,包括基因组和分子分析.
- 识别免疫反应的亚型可以指导在术前环境中使用免疫导向疗法.
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