medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2016-10-34-37medsovet-1402Research ArticleОнкологияOncologyЭволюция изучения и клинического применения антиандрогенов в лечении распространенного рака предстательной железыDEVELOPMENT AND CLINICAL EFFECTIVENESS OF ANTIANDROGENS IN THE TREATMENT OF ADVANCED PROSTATE CANCERМИШУГИНС. В.MISHUGINS. V.

к.м.н.

Москва

PhD in medicine

Moscow

ГРИЦКЕВИЧА. А.GRITSKEVICHA. A.

к.м.н.

Москва

PhD in medicine

Moscow

РУСАКОВИ. Г.RUSAKOVI. G.

д.м.н., профессор

Москва

MD

Moscow

Городская клиническая больница им. Д.Д. ПлетневаРоссияCity Clinical Hospital №57Russian FederationИнститут хирургии им. А.В. ВишневскогоРоссияVishnevsky Institute of SurgeryRussian FederationМосковский научно-исследовательский онкологический институт им. П.А. ГерценаРоссияМНИОИ им. П.А. ГерценаRussian Federation2016301220160103437Copyright © МИШУГИН С.В., ГРИЦКЕВИЧ А.А., РУСАКОВ И.Г., 20162016МИШУГИН С.В., ГРИЦКЕВИЧ А.А., РУСАКОВ И.Г.MISHUGIN S.V., GRITSKEVICH A.A., RUSAKOV I.G.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/1402

Рак предстательной железы (РПЖ) является гормончувствительной опухолью. Благодаря открытию андрогенного рецептора (АР) в клинической практике появились препараты группы антиандрогенов, воздействующие на связывание тестостерона с АР. На протяжении ряда лет появилось несколько поколений данных препаратов и значительно изменились возможности применения данных препаратов. Первые поколения препаратов данной группы (ципротерон, флутамид и бикалутамид) используются в основном при лечении распространенного гормончувствительного РПЖ в комбинации с кастрационной терапией. Однако применение данных препаратов не приводит к увеличению выживаемости у пациентов с РПЖ и не показано при наступлении кастрационной резистентности. Появление энзалутамида (антиандроген II поколения), действующего на уровне ядра опухолевой клетки, позволило достоверно увеличить выживаемость пациентов с метастатическим кастрационно-резистентным РПЖ (мКРРПЖ) и значительно улучшить результаты лечения пациентов с мКРРПЖ. В настоящее время идет изучение возможности применения энзалутамида вместе с кастрационной терапией у пациентов с гормончувствительным РПЖ.

Prostate cancer (PCa) is a hormonsensitive tumor. Due to the discovery of the androgen receptor (AR) it became possible to implement the antiandrogens as drugs blocking testosterone Binding to the AR into routine clinical practice. There have been discovered several generations of the antiandrogens over the years and the possibility of using these drugs in clinical practice has significantly changed. First generations of the antiandrogens (cyproterone, flutamid, bicalutamid) are used mainly for the treatment of advanced hormonsensitive PCa in combination with castration therapy. However these drugs do not increase survival in patients with PCa and are not indicated in terms of castration resistant PCa. Discovery of the enzalutamide (antiandrogen of 2’d generation), acting on the nuclear level of the tumor cell, allowed to increase significantly survival in patients with metastatic castration-resistant prostate cancer (mCRPC) and improve treatment results in patients with mCRPC. At the moment enzalutamide is being studied in combination with castration therapy in patients with hormonsensitive PCa.

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The authors declare that there are no conflicts of interest present.