tailieunhanh - Báo cáo y học: "Progression of metastatic castrate-resistant prostate cancer: impact of therapeutic intervention in the post-docetaxel space"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Progression of metastatic castrate-resistant prostate cancer: impact of therapeutic intervention in the post-docetaxel space. | Sartor Journal of Hematology Oncology 2011 4 18 http content 4 1 18 JOURNAL OF HEMATOLOGY ONCOLOGY REVIEW Open Access Progression of metastatic castrate-resistant prostate cancer impact of therapeutic intervention in the post-docetaxel space A Oliver Sartor Abstract Despite the proven success of hormonal therapy for prostate cancer using chemical or surgical castration most patients eventually will progress to a phase of the disease that is metastatic and shows resistance to further hormonal manipulation. This has been termed metastatic castrate-resistant prostate cancer mCRPC . Despite this designation however there is evidence that androgen receptor AR -mediated signaling and gene expression can persist in mCRPC even in the face of castrate levels of androgen. This may be due in part to the upregulation of enzymes involved in androgen synthesis the overexpression of AR or the emergence of mutant ARs with promiscuous recognition of various steroidal ligands. The therapeutic options were limited and palliative in nature until trials in 2004 demonstrated that docetaxel chemotherapy could significantly improve survival. These results established first-line docetaxel as the standard of care for mCRPC. After resistance to further docetaxel therapy develops treatment options were once again limited. Recently reported results from phase 3 trials have shown that additional therapy with the novel taxane cabazitaxel with prednisone or treatment with the antiandrogen abiraterone with prednisone could improve survival for patients with mCRPC following docetaxel therapy. Compared with mitoxantrone prednisone cabazitaxel prednisone significantly improved overall survival with a 30 reduction in rate of death in patients with progression of mCRPC after docetaxel therapy in the TROPIC trial. Similarly abiraterone acetate an inhibitor of androgen biosynthesis plus prednisone significantly decreased the rate of death by 35 compared with placebo plus prednisone in .

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