Lancet Oncol:多药联合治疗前列腺癌的一项研究

2015-03-05 赵洲译 MedSci原创

据统计,2013年美国和欧洲地区与超过12万人死于转移性去势抗性前列腺癌。有多种机制可以导致去势抗性基因型,包括雄激素受体、睾丸素的自分泌产物、细胞循环激活和平行通路活化。 2004年起,多烯紫杉醇成为了首个有效的治疗转移性去势抗性前列腺癌的化疗药物,自此起多烯紫杉醇成为了治疗这一疾病的标准药物。早先研究表明以多烯紫杉醇为基础,结合其他药物如一些靶标作用在骨骼、血管生成和维生素D代谢的药物有可能

据统计,2013年美国和欧洲地区与超过12万人死于转移性去势抗性前列腺癌。有多种机制可以导致去势抗性基因型,包括雄激素受体、睾丸素的自分泌产物、细胞循环激活和平行通路活化。

2004年起,多烯紫杉醇成为了首个有效的治疗转移性去势抗性前列腺癌的化疗药物,自此起多烯紫杉醇成为了治疗这一疾病的标准药物。早先研究表明以多烯紫杉醇为基础,结合其他药物如一些靶标作用在骨骼、血管生成和维生素D代谢的药物有可能提高患者生存率。然而,直到现在仍没有药物与多烯紫杉醇或者强的松联合使用可以在三期临床延长寿命。在前列腺癌试验中,沙利度胺可以提高存活率。临床期试验表明,来那度胺可以增强免疫应答并可抑制微血管生成。

为了研究联合用药是否有效,研究人员进行了随机、双盲、安慰剂对照的三期临床试验。试验共召集了1059人,并随机分成两组。其中533人随机分配到来那利度组(实际有525人参与试验),526人(实际有521人参与)分配到对照组。经过评价8个月的跟踪随访,221人死亡,其中129人来自来那利度组,92人来自对照组。总体的存活时间为17.7个月。

试验结果表明,多烯紫杉醇联用来那度胺、强的松并不能有效提高存活率。事实上,安慰剂对照组的存活率明显高于联合用药组。对于这种联合用药的进一步研究也就没必要进行了。

原始出处:

Daniel P Petrylak et al.Docetaxel and prednisone with or without lenalidomide in chemotherapy-naive patients with metastatic castrationresistant prostate cancer (MAINSAIL): a randomised, double-blind, placebo-controlled phase 3 trial.Lancet Oncol.2015

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    2015-07-25 howi
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    2015-04-14 minlingfeng
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    2015-05-16 ljjj1053

    很不错学习了

    0

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