III期临床试验证明恩杂鲁胺与雄激素剥夺疗法(ADT)联合使用明显改善转移性前列腺癌的存活率

2019-02-18 不详 MedSci原创

III期ARCHES试验的结果显示,恩杂鲁胺与雄激素剥夺疗法(ADT)联合使用显着降低了转移性前列腺癌的进展和死亡风险。

III期ARCHES试验的结果显示,恩杂鲁胺与雄激素剥夺疗法(ADT)联合使用显着降低了转移性前列腺癌的进展和死亡风险。

前列腺细胞不受控制生长就会进展为前列腺癌。细胞通常生长缓慢不会引起问题,但是随着时间的推移,在某些男性中,这些细胞生长迅速引起癌细胞的扩散,则需要及时治疗以阻止其在前列腺以外的扩散。

当前列腺癌细胞扩散到前列腺以外的部位,就被认为是转移性的前列腺癌。若疾病症状在采用药物或手术降低睾丸激素水平后会有所缓解,则认为是对激素敏感的前列腺癌患者。

恩杂鲁胺是雄激素受体拮抗剂,其阻断雄激素结合雄激素受体并防止配体 - 受体复合物的核移位和共激活剂募集。

杜克癌症研究所前列腺和泌尿系统癌症中心的研究主任Andrew Armstrong博士说:"ARCHES试验表明,恩杂鲁胺联合标准激素治疗延缓了疾病进展,一旦获批,该疗法有可能成为已经扩散且激素敏感的前列腺癌患者的重要治疗选择。"

Enzalutamide目前在欧洲被批准用于治疗成人男性的转移性和高风险非转移性去势抵抗性前列腺癌(CRPC),并且在美国和日本也已经批准用于治疗CRPC。

该研究的结果将在旧金山举行的2019年泌尿生殖系统癌症研讨会上公布。

原始出处:


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createdBy=45b2276, createdName=839640778, createdTime=Sat Feb 01 08:49:00 CST 2020, time=2020-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1818952, encodeId=f98d181895210, content=<a href='/topic/show?id=6b4c98688cb' target=_blank style='color:#2F92EE;'>#雄激素剥夺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98688, encryptionId=6b4c98688cb, topicName=雄激素剥夺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=524d95, createdName=zhaozhouchifen, createdTime=Tue Apr 16 00:49:00 CST 2019, time=2019-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1916070, encodeId=41c119160e0e4, content=<a href='/topic/show?id=c5a89550ff' target=_blank style='color:#2F92EE;'>#III#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, 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content=<a href='/topic/show?id=7bbf93405a5' target=_blank style='color:#2F92EE;'>#转移性前列腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93405, encryptionId=7bbf93405a5, topicName=转移性前列腺癌)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/656F31B644588474D1C46903A7F84373/100, createdBy=4e842500199, createdName=ms24272190615788285182, createdTime=Wed Feb 20 09:49:00 CST 2019, time=2019-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1477966, encodeId=4e3714e79668e, content=<a href='/topic/show?id=dd832018bd' target=_blank style='color:#2F92EE;'>#ADT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2018, encryptionId=dd832018bd, topicName=ADT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=87be7387847, createdName=124984e7m85暂无昵称, createdTime=Wed Feb 20 09:49:00 CST 2019, time=2019-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1524675, encodeId=024915246e563, content=<a href='/topic/show?id=4ba395994d' target=_blank style='color:#2F92EE;'>#II期临床#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9599, encryptionId=4ba395994d, topicName=II期临床)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=139811614978, createdName=guihongzh, createdTime=Wed Feb 20 09:49:00 CST 2019, time=2019-02-20, status=1, ipAttribution=)]
    2019-12-18 juliusluan78
  5. 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  6. 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  7. 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CLIN CANCER RES:恩杂鲁胺对卡巴他赛药代动力学的影响

在转移性去势抵抗前列腺癌的临床研究中,目前正在探索紫杉烷类联合AR靶向药物,即恩杂鲁胺和阿比特龙的治疗效果是否可以得到增强。因为恩杂鲁胺可以诱导CYP3A4酶而紫杉烷类药物由这种酶代谢,需要研究其潜在的药物之间的相互作用。CLIN CANCER RES近期发表了一篇文章研究这一问题。

JCO:阿比特龙单独或联合恩杂鲁胺治疗转移性去势抵抗前列腺癌

有种理论认为雄激素升高导致恩杂鲁胺耐药,这种耐药可以通过联合阿比特龙进行克服。PLATO临床试验为随机双盲的对照试验,旨在验证这一假说。JCO近期发表了一篇文章,报道了PLATO临床试验的结果。

N Engl J Med:恩杂鲁胺有效延缓未转移前列腺癌病情进展

对于那些未转移的去势抵抗性前列腺癌患者来说,如果出现PSA的迅速升高,则很可能预示着患者存在较高的转移风险,前期的研究已经证实,恩杂鲁胺可以延长转移性去势抵抗性前列腺癌患者的总体生存期,那么它是否能够同样有效于未转移的去势抵抗性前列腺癌呢?其对延缓此类患者的肿瘤转移时间和PSA升高情况能否起到更多的帮助呢?近日,Maha Hussain等人报道了他们关于此方面的临床研究[1],为此类病人的化疗

CLIN CANCER RES:阻断神经内分泌分化和巨噬细胞反馈回路可以改善恩杂鲁胺对前列腺癌治疗效果

去势治疗(ADT)会导致前列腺癌产生耐药。ADT耐药与神经内分泌分化和肿瘤相关巨噬细胞有关。CLIN CANCER RES近期发表了一篇文章,研究恩杂鲁胺诱导的神经内分泌分化和肿瘤相关巨噬细胞及其机制。

Eur Urol:一线阿比特龙/恩杂鲁胺疗效与DNA修复基因胚系遗传突变相关

越来越多的证据表明进展期前列腺癌有遗传性DNA修复基因突变背景。研究发现,约7%~12%的转移性前列腺癌存在DNA损伤修复基因,如BRCA1/2、ATM等的遗传性突变。但是,DNA损伤修复基因的遗传突变对晚期前列腺癌,尤其是接受新一代内分泌治疗(next-generation hormonal therapy, NHT)患者预后方面的研究甚少。

Sci Rep:肉盘菌内酯能够抑制STAT/AR信号途径和抑制恩杂鲁胺抗性前列腺癌

大多数前列腺癌患者会在雄激素阻断治疗后恶化发展到去势抵抗性(CRPC)状态,尽管新的有效的抗雄激素药物的开发,比如恩杂鲁胺(ENZ)能够延长CRPC患者的生存,但是ENZ抗性会很快产生。雄激素受体(AR)的重新激活是抗性产生的一个主要机制。最近,有研究人员通过其体内来源的ENZ抗性模型,发现STAT3转录因子不仅在核定位中增加,同时能够结合和促进AR活性。研究人员观察到了在ENZ抗性细胞中STAT