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去勢抗性攝護腺癌治療進展

Advance in the Treatment of Castration-resistant Prostate Cancer

摘要


臺灣男性攝護腺癌發病率逐漸增加,2020年攝護腺癌位居我國男性癌症死因第6位。雄性素去除療法一直是晚期或轉移性攝護腺癌初始治療的標準。初始雄性素去除療法雖效果明顯,但治療1-2年後,攝護腺癌可能會對雄性素去除療法產生耐受,進展為去勢抗性攝護腺癌,治療上相對棘手。過去十年已有多種藥物核准上市用於治療去勢抗性攝護腺癌,包括:化學治療、內分泌治療、免疫治療、靶向治療、骨轉移治療。本文重點介紹與去勢抗性攝護腺癌治療相關的藥物臨床試驗。

並列摘要


In Taiwan, the incidence of prostate cancer in men is gradually increasing. Prostate cancer is the sixth leading cause of cancer deaths in Taiwanese men in 2020. Androgen deprivation therapy (ADT) has been the standard of care for initial treatment of advanced or metastatic prostate cancer. Although initial ADT is effective, after one to two years of treatment, the cancer may become resistant to ADT and progress to castration-resistant prostate cancer (CRPC), which is relatively difficult to treat. A number of drugs have been approved for the treatment of CRPC in the last decade, including: chemotherapy, endocrine therapy, immunotherapy, targeted therapy and bone metastasis therapy. This article focuses on clinical trials of drugs related to the treatment of CRPC.

參考文獻


Lin PH, Chang SW, Tsai LH, et al.: Increasing incidence of prostate cancer in Taiwan: a study of related factors using a nationwide health and welfare database. Medicine (Baltimore) 2020;99:e22336.
Ministry of Health and Welfare in Taiwan. 2020 statistics of causes of death. Available at: https://dep.mohw.gov.tw/DOS/cp-5069-62791-113.html. Accessed February 21, 2022.
Huggins C, Hodges CV: Studies on prostatic cancer. I. The effect of castration, of estrogen and androgen injection on serum phosphatases in metastatic carcinoma of the prostate. CA Cancer J Clin 1972;22:232-40.
Cornford P, van den Bergh RCN, Briers E, et al.: EAU-EANM-ESTRO-ESUR-SIOG Guidelines on prostate cancer. Part II-2020 update: treatment of relapsing and metastatic prostate cancer. Eur Urol 2021;79:263-82.
Nuhn P, De Bono JS, Fizazi K, et al.: Update on systemic prostate cancer therapies: management of metastatic castration-resistant prostate cancer in the era of precision oncology. Eur Urol 2019;75:88-99.

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