Recent Advances in the Treatment for Metastatic Castration-Refractory Prostate Cancer
PWK Kwong
Hong Kong J Radiol 2013;16(Suppl):S44-9
In Hong Kong, prostate cancer is the third most common cancer in men, with increasing incidence over the past two decades. Advanced prostate cancer is typically sensitive to androgen-deprivation therapy, but invariably develops into castration-resistant disease. Until recently, patients with castration-resistant prostate cancer who progressed after docetaxel therapy had limited treatment options. Recent advances in this field have resulted in better understanding of the mechanisms of cancer progression and led to the development of new therapeutic strategies for this disease. Agents that have recently become available and demonstrated survival benefits include inhibitors of the androgen receptor pathway, microtubule inhibitors, and bone-targeted therapy. Further promising investigational agents are under clinical evaluation and expected to provide more options to improve patient prognosis. For optimal treatment, the timing, sequencing, and potential combinations of strategies should be considered and individualised for patients. This article summarises recent improvements in the treatment landscape for metastatic castration-resistant prostate cancer and discusses the role of new therapeutics for improving the outlook of patients with this lethal and aggressive disease.
中文摘要
醫治睪丸摘除治療失效前列腺癌的最新發展
鄺維基
前列腺癌在香港男性最常見癌症中排第三位，而且發病率在過去二十年不斷上升。晚期前列腺癌一般對雄激素阻斷治療有反應，但總會發展成為睪丸摘除治療失效的疾病。直至最近為止，患有睪丸摘除治療失效前列腺癌（CRPC）在多西他賽（docetaxel）治療後惡化的患者，可選擇的治療十分有限。近期的發展讓我們對癌症惡化的機制加深了解，因而發展出治療這種疾病的新治療方法。在最近可供使用而且有證據證明具存活益處的藥物包括雄激素受體途徑抑制劑、微管抑製劑及骨靶向治療。其他前景樂觀的研究性藥物正在臨床評估中，預計會帶來更多治療選擇以改善病人的預後。為達到最理想的治療，應考慮並為病人個人化治療的時機、次序和療法的可能組合。本文總結了轉移性CRPC治療的近期進展，並討論新療法對改善患此可致命及具侵略性疾病的病人，其治療成效的作用。