medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-20-130-136medsovet-6590Research ArticleОНКОУРОЛОГИЯONCOUROLOGYЭффективность препарата энзалутамид у пациентов с метастатическим гормоночувствительным и кастрационно-рефрактерным раком предстательной железы: собственный опытEfficacy of enzalutamide in patients with metastatic hormone-sensitive and castration-refractory prostate cancer: authors’ experiencehttps://orcid.org/0000-0002-2061-0522УстиноваТ. В.UstinovaT. V.

врач-онколог отделения химиотерапии отдела лекарственного лечения опухолей, 

125284, Москва, 2-й Боткинский проезд, д. 3

Oncologist, Department of Chemotherapy, Department of Drug Treatment of Tumors, 

3, 2nd Botkinskiy Proezd, Moscow, 125284

t.v.rafeyenko@gmail.comhttps://orcid.org/0000-0003-4879-2687БолотинаЛ. В.BolotinaL. V.

д.м.н., заведующая отделением химиотерапии отдела лекарственного лечения опухолей, 

125284, Москва, 2-й Боткинский проезд, д. 3

Dr. Sci. (Med.), Head of the Department of Chemotherapy, Department of Drug Treatment of Tumors, 

3, 2nd Botkinskiy Proezd, Moscow, 125284

lbolotina@yandex.ruhttps://orcid.org/0000-0001-7912-8055ПайчадзеА. А.PaichadzeA. A.

к.м.н., научный сотрудник отделения химиотерапии отдела лекарственного лечения опухолей, 

125284, Москва, 2-й Боткинский проезд, д. 3

Cand. Sci. (Med.), Researcher, Chemotherapy Department, Department of Tumor Drug Treatment, 

3, 2nd Botkinskiy Proezd, Moscow, 125284

paiann@mail.ruhttps://orcid.org/0000-0001-5530-3234КачмазовА. А.KachmazovA. A.

младший научный сотрудник отделения химиотерапии отдела лекарственного лечения опухолей, 

125284, Москва, 2-й Боткинский проезд, д. 3

Junior Researcher, Department of Chemotherapy, Department of Drug Treatment of Tumors, 

3, 2nd Botkinskiy Proezd, Moscow, 125284

andrewkachmazov@gmail.comhttps://orcid.org/0000-0003-4927-5585ФеденкоА. А.FedenkoA. A.

д.м.н., руководитель отдела лекарственного лечения опухолей, 

125284, Москва, 2-й Боткинский проезд, д. 3

Dr. Sci. (Med.), Head of the Department of Tumor Drug Treatment, 

3, 2nd Botkinskiy Proezd, Moscow, 125284

fedenko@eesg.ruhttps://orcid.org/0000-0001-8784-8415КапринА. Д.KaprinA. D.

академик РАН, профессор, генеральный директор, 

125284, Москва, 2-й Боткинский проезд, д. 3

Acad. RAS, Professor, General Director, 

3, 2nd Botkinskiy Proezd, Moscow, 125284

kaprin@mail.ruМосковский научно-исследовательский онкологический институт имени П.А. Герцена – филиал Национального медицинского исследовательского центра радиологииРоссияHertzen Moscow Oncology Research Institute – branch of the National Medical Research Center of RadiologyRussian FederationМосковский научно-исследовательский онкологический институт имени П.А. Герцена – филиал Национального медицинского исследовательского центра радиологииРоссияHertzen Moscow Oncology Research Institute – branch of the National Medical Research Center of RadiologyRussian FederationМосковский научно-исследовательский онкологический институт имени П.А. Герцена – филиал Национального медицинского исследовательского центра радиологииРоссияHertzen Moscow Oncology Research Institute – branch of the National Medical Research Center of RadiologyRussian Federation202111122021020130136Copyright © Устинова Т.В., Болотина Л.В., Пайчадзе А.А., Качмазов А.А., Феденко А.А., Каприн А.Д., 20212021Устинова Т.В., Болотина Л.В., Пайчадзе А.А., Качмазов А.А., Феденко А.А., Каприн А.Д.Ustinova T.V., Bolotina L.V., Paichadze A.A., Kachmazov A.A., Fedenko A.A., Kaprin A.D.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/6590

Рак предстательной железы (РПЖ) в настоящее время является одним из наиболее часто встречающихся злокачественных новообразований у мужчин. В структуре онкологической заболеваемости в России среди мужского населения РПЖ занимает 2-е место после рака легкого и 3-е место в структуре смертности. РПЖ у лиц моложе 40 лет отмечается редко, в среднем возраст заболевших составляет 50–70 лет. В течение последнего десятилетия опции лекарственного лечения пациентов с метастатическим РПЖ (мРПЖ) значительно расширились. Несмотря на то что андроген-депривационная терапия (АДТ) по-прежнему остается основным вариантом лечения, добавление цитотоксических и гормональных препаратов нового поколения улучшает онкологические результаты лечения пациентов с  метастатическим гормоночувствительным (мГЧРПЖ) и  кастрационнорефрактерным РПЖ (КРРПЖ). Согласно результатам двух крупных рандомизированных исследований ARCHES и ENZAMET, на  сегодняшний день препарат энзалутамид является стандартом лекарственной терапии не  только при метастатическом и неметастатическом КРРПЖ, но и при мГЧРПЖ. В данной статье приведены клинические наблюдения, демонстрирующие высокую эффективность энзалутамида при различных формах РПЖ. В первом клиническом случае энзалутамид применялся при лечении метастатического гормоночувствительного РПЖ. На фоне данной терапии пациент без признаков прогрессирования заболевания находится 11 мес. Во втором клиническом случае энзалутамид применялся при лечении КРРПЖ, где также показал свою эффективность. На фоне данного варианта лечения отмечены положительная динамика по уровню ПСА, стабилизация процесса по данным радиологического обследования. Хотелось бы отметить, что без признаков прогрессирования заболевания пациент находится 9 мес. На сегодняшний день на фоне данного варианта лечения отмечен более длительный контроль над болезнью по сравнению с предыдущими опциями лекарственной терапии. 

Prostate cancer is one of the most common neoplasms in men. It currently ranks second in Russian Federation amongst male population in overall number of cases after only lung cancer and third in cancer mortality. Prostate cancer is rarely diagnosed in patients younger than 40 years old, with overage age of diagnosis being between 50 and 70 years. A lot of different new treatment options were developed in the last decade for patients with metastatic prostate cancer (mPC). Despite androgen-deprivation remaining the standard of therapy, it has been proven that the addition of cytotoxic and hormonal drugs of new generation improves overall survival of patients with castration-sensitive and castration-resistant metastatic disease. Recently, enzalutamide became the new standard of care not only in castration-resistant mPC, but also in the setting of metastatic castration-sensitive prostate cancer, due to the data acquired in two large randomized trials ARCHES and ENZAMET. This article provides clinical examples demonstrating the effectiveness of enzalutamide in various forms of prostate cancer. In the first clinical case enzalutamide was used in the treatment of castration-sensitive mPC. Currently, patient continues to receive this therapy with progression-free interval exceeding 11  months. In  the  second clinical case, enzalutamide has shown its efficacy in  the  setting of  castration-resistant PC. Stable disease was achieved and as of  right now patient has shown no signs of  progression for 9 months, which is already a significantly better result in comparison with previous lines of treatment. 

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