转移性去势抵抗性前列腺癌的治疗顺序与策略

Optimal sequence and combination strategies of metastatic castration-resistant prostate cancer

我国前列腺癌发病率呈逐年上升趋势,且大多数在发现时已处于中晚期,去势治疗（ADT）是目前治疗进展期前列腺癌的标准治疗方法,但在经历18-24个月的中位有效期之后,几乎所有患者都会激素抵抗大多数患者发展为去势抵抗性前列腺癌（CRPC）,并且多数患者伴有骨转移以及远处脏器转移。虽然多西他赛一直作为一线治疗方案,但对于转移性去势抵抗性前列腺癌（mCRPC）的治疗仍然是一大难点。近几年一些新药物的出现,一些大型临床研究的支持,使得对mCRPC的治疗有了很大的突破,但合适的治疗策略、治疗顺序仍有很大的争论。在此篇综述中将对mCRPC的治疗进展做一个探讨,并提出合理的治疗策略。

The incidence of prostate cancer shows a rising trend and most patients are diagnosed at an advanced stage in China.Androgen deprivation therapy is regarded as the standard treatment for advanced disease,but nearly all of the patients will finally reach a state of castration-resistant prostate cancer（CRPC）with bone and visceral metastasis.Although docetaxel has been used as first-line therapy,the treatment of metastatic castrationresistant prostate cancer（mCRPC）remains a challenge.In recent years,several new therapeutic drugs show a survival benefit in large trials.However,optimal sequence and combination strategies remain controversial.In this review,we summarize the recent progress of the therapy and clinical trials of mCRPC as well as discuss the rational strategies for mCRPC.