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Treatment sequencing in metastatic castrate-resistant prostate cancer

Asian Journal of Andrology 2014年第3期16卷 426-431页

作者： Oliver Sartor Silke Gillessen Department of Medicine and Urology Tulane University School of Medicine New Orleans Louisiana USA Department of Medical Oncology Kantonsspital St. Gallen St. Gallen Switzerland.

Six different treatments have demonstrated improved survival in phase III trials targeted to patients with metastatic castration-resistant prostate cancer （mCRPC）. Front-line therapeutic options for mCRPC include docetaxel, sipuleuceI-T, abiraterone and radium-223. Post-docetaxel options include cabazitaxel, abiraterone, enzalutamide and radium-223. Despite much progress in recent years, much is yet unknown and debates occur over optimal treatment choices and sequences. None of the new agents have been compared to one another, thus physicians in practice today must make choices based on non-randomized comparisons, toxicity considerations and various assumptions. Abiraterone is now moving into the front line mCRPC space given recent regulatory approvals and enzalutamide will follow soon. Both of the hormonal agents have less toxicity when compared to chemotherapeutic options and both of these hormonal agents are expected to be used in a considerable number of mCRPC patients in the years ahead. Little data are available for the post-abiraterone or post-enzalutamide setting. In this review the currently available sequencing data are summarized and interpreted. It is now clear that cross resistance is a potential issue between various treatments, especially those agents that target the androgen axis. This review highlights the need for additional studies to optimize the current treatments for these patients.

关键词： abiraterone cabazitaxel castrate-resistant docetaxel enzalutamide~ radium-223 sipuleuceI-T

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Twists and turns on the way to progress in metastatic castrate-resistant prostate cancer

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Asian Journal of Andrology 2010年第6期12卷 790-792页

作者： Oliver Sartor Department of Medicine and Urology Tulane University New Orleans Louisiana 70115 USA

Harnessing the body＇s immune system for the treatment of metastatic cancer has been a dream since the late 19th century [1]. Since that time progress has been intermittent and mostly disappointing. Interferon and Interleukin-2 represented steps forward but in retrospect the steps were not large and rarely are these agents used in the clinic today except as the control arm of randomized studies designed to demonstrate that a new drug is better.

关键词： Twists turns to progress metastatic castrate-resistant

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Reappraisal of glucocorticoids in castrate-resistant prostate cancer

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Asian Journal of Andrology 2014年第5期16卷 666-666页

作者： Oliver Sartor Christopher C Parker Johann de Bono Department of Urology and Medicine Tulane MedicalSchool Tulane New Orleans Louisiana USA Department of Urology The Royal Marsden NHSFoundation Trust Sutton UK

Recent reports and discussions of .preclinical prostate cancer models have emphasized the possibility that enzalutamide resistance may be mediated by glucocorticoid receptors （GR）.In both in vitro and xenograft animal studies, it is possible to show that the GR is up-regulated in prostate cancer cell lines and that dexamethasone reverses enzalutamide induced growth inhibition. In these model systems, GR agonists can induce a subset of androgen receptor target genes including prostate-specific antigen. These investigators also report a correlation between GR expression in patient-derived prostate cancer specimens and clinical response to enzalutamide. The authors discuss the possibility that these findings have important clinical relevance. We note that the current clinical evidence for GR mediating drug resistance or disease progression in patients with castrate-resistant prostate cancer （CRPC） is very limited at best.

关键词： Reappraisal glucocorticoids castrate-resistant

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