资源描述：
《Progress in the treatment of advanced prostate cancer》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。
1、PROGRESSINADVANCEDPROSTATECANCERProgressintheTreatmentofAdvancedProstateCancerCoraN.Sternberg,MD,DanielP.Petrylak,MD,RaviA.Madan,MD,andChrisParker,MDOVERVIEWTheandrogenreceptor(AR)isthemostsignificanttargetforpatientswithmetastaticcastration-resistantprostatecancer(mCRPC).Thereisnowirrefutablee
2、videncethattheARaxisisfunctionalinmostpatientsthroughoutthehistoryofprostatecancer,iscrucialfromdiagnosistodeath,eveninpatientswhohavereceivedhormonalmanipulation,andrepresentsarelevanttherapeutictargetinallphasesofthedisease.Thepotentialmechanismsoftumorescapeaftercastrationaremultifold,withe
3、achmechanismtodayrepresentingatherapeuticopportunity.PhaseIIItrialshavebeenabletodemonstrateimprovedoverallsurvival(OS),improvedqualityoflife,decreasedskeletal-relatedevents,andotherimportantclinicalbenefitsinyoungandelderlypatients.Aftertheinitialpositiveresultswithdocetaxelchemotherapyinimpro
4、vingOS,furtherresearchhasresultedinfivenewtreatmentsinthepastfewyears.Immunotherapywithsipuleucel-T,cabazitaxelchemotherapy,theandrogenbiosynthesisinhibitorabirateroneacetate,theantiandrogenenzalutamide,andtheradioisotoperadium-223haveallbeenshowntoimproveOSinlarge-scale,well-conductedclinicalt
5、rials.Properunderstandingofmechanismsofresistanceandofcross-resistanceamongtheseagents,sequencing,andcombinationsisnowapriority.rostatecanceristhesecondmostcommoncauseofcan-9monthsto12months.SignifıcantmorbidityfromdiseasePcerworldwide.1Itisestimatedthatmorethan29,000progressioninCRPCmaybecaus
6、edbyanemia,urinarytractmenwilldiefrommetastaticprostatecancerin2014.2Forobstruction,spinalcordcompression,pathologicfractures,patientswhorelapseaftertreatmentoforgan-confıneddis-pain,andcachexia.easeorthosewhopresentwithmetastaticdisease,testoster-Today,theARstillrepresentsthemostrelevanttarge
7、tforonesuppressionwithhormonetherapyisthefoundationofpatientswithmCRPC.Althoughinthepastprostatecancertherapy.Loweringtestosteroneanditsprecursorsandalter-hasbeenreferredtoas“hormonerefractory”or“androgeningtheARaxiswasthefırstmethoddis
