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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
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Overview of systemic therapies for metastatic castration-resistant prostate cancer (CRPC)

Overview of systemic therapies for metastatic castration-resistant prostate cancer (CRPC)
Approach Indications Route,
schedule		 Steroids Symptoms,
disease burden		 Contraindications PSA response to treatment Median overall survival benefit for males with advanced disease*
Abiraterone Metastatic CRPC Oral, daily Required – Severe liver dysfunction, hypokalemia, heart failure Yes

Post-docetaxel: 4.6 months[1] compared with prednisone alone (HR for death 0.53, 95% CI 0.45-0.62)

Chemotherapy naïve: 4.4 months[2] compared with prednisone alone (HR for death 0.81, 95% CI 0.70-0.93)
Enzalutamide Metastatic CRPC Oral, daily Not required – Seizures Yes 4.8 months[3]
Sipuleucel-T Metastatic CRPC, pre- or post-docetaxel IV, every 2 weeks for 3 doses Possibly contraindicated Asymptomatic or minimally symptomatic Steroids, opioids for cancer-related pain, GM-CSF, liver metastases, rapidly progressive disease No 4.1 months[4]
Docetaxel Metastatic CRPC IV, every 3 weeks Required – Moderate liver dysfunction, cytopenias Yes 2.5 months[5]
Cabazitaxel Post-docetaxel, metastatic CRPC IV, every 3 weeks Required – Moderate liver dysfunction, cytopenias Yes 2.4 months[6] compared with mitoxantrone/prednisone (HR for death 0.70, 95% CI 0.64-0.86)
Radium-223 Symptomatic bone metastases with no known visceral metastases IV, every 4 weeks Not required Symptomatic bone metastases Visceral metastases Not reported 3.6 months[7]
Lutetium Lu-177 vipivotide tetraxetan Metastatic PSMA-expressing CRPC IV, every 6 weeks Not required – None Yes 4 months compared with glucocorticoids or androgen signaling inhibitors[8]

CRPC: castration-resistant prostate cancer; PSA: prostate-specific antigen; HR: hazard ratio; IV: intravenous; GM-CSF: granulocyte-macrophage colony-stimulating factor; PSMA: prostate-specific membrane antigen.

* Docetaxel is also indicated for castration-sensitive disease in combination with androgen deprivation therapy for metastatic prostate cancer.
References:
  1. Fizazi K, Scher HI, Molina A, et al. Abiraterone acetate for treatment of metastatic castration-resistant prostate cancer: Final overall survival analysis of the COU-AA-301 randomised, double-blind, placebo-controlled phase 3 study. Lancet Oncol 2012; 13:983.
  2. Ryan CJ, Smith MR, Fizazi K, et al. Abiraterone acetate plus prednisone versus placebo plus prednisone in chemotherapy-naive men with metastatic castration-resistant prostate cancer (COU-AA-302): Final overall survival analysis of a randomised, double-blind, placebo-controlled phase 3 study. Lancet Oncol 2015; 16:152.
  3. Scher HI, Fizazi K, Saad F, et al. Increased survival with enzalutamide in prostate cancer after chemotherapy. N Engl J Med 2012; 367:1187.
  4. Kantoff PW, Higano CS, Shore ND, et al. Sipuleucel-T immunotherapy for castration-resistant prostate cancer. N Engl J Med 2010; 363:411.
  5. Berthold DR, Pond GR, Soban F, et al. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer: Updated survival in the TAX 327 study. J Clin Oncol 2008; 26:242.
  6. de Bono JS, Oudard S, Ozguroglu M, et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: A randomised open-label trial. Lancet 2010; 376:1147.
  7. Parker C, Nilsson S, Heinrich D, et al. Alpha emitter radium-223 and survival in metastatic prostate cancer. N Engl J Med 2013; 369:213.
  8. Sartor O, de Bono J, Chi KN, et al. Lutetium-177-PSMA-617 for metastatic castration-resistant prostate cancer. N Engl J Med 2021; 385:1091.
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