References

medsovet

Медицинский Совет

Meditsinskiy sovet = Medical Council

2079-701X2658-5790

REMEDIUM GROUP Ltd.

10.21518/2079-701X-2017-6-104-109

medsovet-1894

Research Article

Онкоурология

Oncourology

МЕСТО ЭНЗАЛУТАМИДА В ПОСЛЕДОВАТЕЛЬНОМ ЛЕЧЕНИИ КАСТРАЦИОННО-РЕЗИСТЕНТНОГО РАКА ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫ

THE PLACE OF ENZALUTAMIDE IN THE SERIAL TREATMENT OF TREATMENT-RESISTANT PROSTATE CANCER

ГРИЦКЕВИЧ

А. А.

GRITSKEVICH

A. A.

к.м.н.

PhD in medicine

МИШУГИН

С. В.

MISHUGIN

S. V.

к.м.н.

PhD in medicine

РУСАКОВ

И. Г.

RUSAKOV

I. G.

д.м.н., профессор

MD, Prof.

Институт хирургии им. А.В. ВишневскогоРоссияVishnevsky Institute of SurgeryRussian Federation

Городская клиническая больница №57РоссияCity Clinical Hospital No. 57Russian Federation

Городская клиническая больница №57 Национальный медицинский исследовательский радиологический центрРоссияCity Clinical Hospital No. 57 National Medical Research and Radiological CenterRussian Federation

2017

20062017

06104109

2017

ГРИЦКЕВИЧ А.А., МИШУГИН С.В., РУСАКОВ И.Г.

GRITSKEVICH A.A., MISHUGIN S.V., RUSAKOV I.G.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.med-sovet.pro/jour/article/view/1894

Рак предстательной железы первоначально отвечает на андроген-депривационную терапию, но у большинства пациентов в конечном итоге развивается кастрационно-резистентная форма заболевания. Энзалутамид является суперселективным ингибитором андрогенного рецептора (AР), который блокирует несколько этапов сигнального пути AР. Препарат показал значительную эффективность в лечении метастатического кастрационно-резистентного рака предстательной железы (КРРПЖ) как в 1-й линии терапии, так и во 2-й линии после предшествующей цитотоксической терапии доцетакселом. Чтобы обеспечить оптимальное лечение, важно понять последствия применения энзалутамида в контексте других методов лечения, так как недавние исследования показали, что перекрестная резистентность возникает между классами препаратов и внутри них. Мутации и сплайс-варианты AР также влияют на течение рака предстательной железы. Будущие стратегии лечения, включающие энзалутамид, должны учитывать предшествующий уровень воздействия таксанов или антиандрогенной терапии и наличие вариантов АР, которые могут повлиять на эффективность.

Prostate cancer initially responds to androgen-deprivation therapy, but most patients eventually develop a castration-resistant form of disease. Enzalutamid is the superselective inhibitor of the androgen receptor (AR), which blocks several stages of the AR signal path. The drug showed significant effectiveness in the treatment of metastatic castration-resistant prostate cancer (MCRPC) in both the first line therapy and the second line therapy after the previous cytotoxic therapy of Docetaxel. To ensure optimum treatment, it is important to understand the impact of Enzalutamide in the context of other therapies, as recent studies have shown that cross-resistance occurs between and within classes of drugs. Mutations and AR splice-variants also affect prostate cancer. Future treatment strategies, including enzalutamide, should take into account the previous level of exposure to taxanes or anti-androgen therapy and the existence of variants of AR that may affect efficiency.

метастатический рак предстательной железыэнзалутамидабиратерона ацетаткастрационная резистентность.

metastatic cancerEnzalutamideabiraterone acetatecastration resistance

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