Introduction

The addition of the androgen-signaling inhibitors (ASI) apalutamide, enzalutamide and abiraterone acetate or docetaxel to standard androgen deprivation therapy (ADT) has been demonstrated to improve overall survival in men with hormone-sensitive metastatic prostate cancer (HSMPC).

Areas covered

The majority of men presenting with metastatic prostate cancer will now benefit from the addition of either a novel ASI or docetaxel to standard ADT. In the absence of comparative studies of these agents, clinicians are left with assessing the individual studies and attempting to individualize therapy.

Expert opinion

ADT with either docetaxel or androgen-signaling inhibitors (ASI) have changed the treatment landscape of HSMPC with clinically meaningful improvement in overall survival compared to ADT alone. Among the factors to consider in the selection of the optimal agent include the volume of disease, performance status and comorbidities, toxicity profile cost and drug availability, and further resistance or sequencing options.

中文翻译：

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激素敏感性转移性前列腺癌的治疗：个性化治疗时应考虑的因素。

介绍

已证明在标准雄激素剥夺疗法（ADT）中添加雄激素信号抑制剂（ASI）阿帕鲁胺，enzalutamide和乙酸阿比特龙酯或多西紫杉醇可改善荷尔蒙敏感性转移性前列腺癌（HSMPC）男性的整体生存率。

覆盖区域

现在，大多数患有转移性前列腺癌的男性将从标准ADT中添加新型ASI或多西紫杉醇中受益。在缺乏这些药物的比较研究的情况下，临床医生只能评估各个研究并尝试个体化治疗。

专家意见

与单用ADT相比，使用多西他赛或雄激素信号抑制剂（ASI）的ADT改变了HSMPC的治疗方式，在总体生存率方面具有临床上有意义的改善。选择最佳药物时要考虑的因素包括疾病的体积，生产状况和合并症，毒性概况成本和药物可用性以及进一步的耐药性或测序选择。