центр для пенсионеров в красногвардейского р-на спб
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центр для пенсионеров в красногвардейского р-на спб, Metastatic Hormone-Sensitive Prostate Cancer (mHSPC): Advances and , Metastatic prostate cancer - Diagnosis and treatment - Mayo Clinic, mHSPC - UroToday, Metastatic Hormone-Sensitive Prostate Cancer: Toward an Era of Adaptive , Systemic treatment of metastatic hormone-sensitive prostate cancer , Newly Diagnosed mHSPC: First-Line Treatment Options, Management of Metastatic Hormone-Sensitive Prostate Cancer - PubMed.
a Mechanism of action of androgen deprivation therapy (ADT) and approved systemic therapies. The testes produce 90–95% of the total circulating testosterone, while the adrenal glands produce the remainder of the circulating androgens. Androgens, usually dihydrotestosterone (DHT), bind to the androgen receptor (AR), dissociating chaperone proteins. Ligand-bound AR molecules dimerise and translocate to the nucleus where they bind to androgen response elements and act as transcription factors to signal downstream targets. Apart from acting as AR antagonists, second-generation antiandrogens, such as enzalutamide, apalutamide and darolutamide, also prevent the translocation of AR to the nucleus. Abiraterone acetate, as a cytochrome P450 17A1 (CYP17) and α-hydroxylase inhibitor, largely prevents androgen biosynthesis. The detailed sites of action of abiraterone are not depicted in this diagram. GnRH Gonadotropin-releasing hormone, ACTH adrenocorticotrophic hormone, LH luteinising hormone. b Conventional treatment pathway of prostate cancer. mHSPC Metastatic hormone-sensitive prostate cancer, nmCRPC non-metastatic castration-resistant prostate cancer, mCRPC metastatic castration-resistant prostate cancer. *Cabazitaxel can be given in first-line treatment of mCRPC if docetaxel is given in the hormone-sensitive setting. Dates in parenthesis indicate month of US Food and Drug Administration approval; only drugs approved since 2018 have date of approval indicatedUnfortunately, mHSPC treated with ADT often transitions into a metastatic castrate-resistant state (mCRPC), defined by disease progression despite ADT with castrate testosterone levels (Fig. b). This may present in a variety of ways, including a continuous rise in serum prostate specific antigen (PSA) levels, progression of pre-existing disease and/or appearance of new metastatic deposits []. mCRPC is associated with a median survival of approximately 3 years []. Over the years, efforts were made to prolong the hormone-sensitive phase of treatment. The addition of first-generation antiandrogens, such as bicalutamide, to ADT was a commonly employed strategy to prolong the hormone-sensitive phase; this combination is often referred to as maximal androgen blockade. However, the benefit of this approach results in a low improvement rate of only 2–3% in 5-year survival alongside increased side effects []., The treatment landscape of metastatic hormone-sensitive prostate cancer (mHSPC) has changed radically in recent years. Androgen deprivation therapy (ADT) alone was for decades the standard of care for treating mHSPC. This changed when studies showed , Metastatic prostate cancer diagnosis often involves blood tests and imaging tests. A metastatic prostate cancer is an advanced cancer that has spread to other parts of the body..
The treatment landscape of advanced prostate cancer continues to evolve, particularly over the last 5+ years. Although there are several treatment options, including both ADT-based doublet and triplet combinations, available for men with metastatic hormone sensitive prostate cancer (mHSPC) that have showed an OS benefit versus ADT alone, there , The advent of more effective treatment combinations for metastatic hormone-sensitive prostate cancer (mHSPC) has been built on successes in therapy development for metastatic, castration-resistant prostate cancer (mCRPC). Both disease phases hold similar In this review, we take stock of the current landscape of treatment for metastatic hormone-sensitive prostate cancer, including , Annually, >1.2 million new cases of prostate cancer are diagnosed and global prostate cancer-related deaths exceed 350 000 per annum, making it one of the leading causes of cancer-associated death in men.1 Despite major improvements in the systemic treatment of advanced prostate cancer, metastatic prostate cancer remains an incurable disease with an overall survival (OS) of only 30% at 5 years , Evan Y. Yu, MD, discusses how systemic therapy options for newly diagnosed metastatic hormone-sensitive prostate cancer include androgen deprivation therapy (ADT) combined with chemotherapy or androgen receptor pathway inhibitors (ARPIs) such as abiraterone or enzalutamide, with the choice of frontline treatment depending on factors such as disease burden and patient characteristics, while , Abstract Combination systemic therapy is now standard of care for all men with metastatic, hormone-sensitive prostate cancer (mHSPC). Patients with mHSPC should be treated with standard androgen deprivation therapy (ADT) and abiraterone acetate with prednisone or docetaxel (chemohormoanl therapy) unless there are contraindications to combination therapy. Based on the Chemohormonal Therapy , This Guideline Amendment provides a framework designed to improve a clinician’s ability to treat patients diagnosed with advanced prostate cancer with the most current evidence-based information. Further research and publication of high-quality clinical trials will be essential to continue to improve the quality of care for these patients..