Выбор варианта лечения при метастатическом гормоночувствительном раке предстательной железы

Арсенал имеющихся средств и методов лечения метастатического гормоночувствительного рака предстательной железы существенно увеличился за последние 5 лет. Хотя андроген-депривационная терапия по-прежнему остается основой лечения, добавление доцетаксела, абиратерона, энзалутамида, апалутамида или локальной дистанционной лучевой терапии улучшает результаты лечения пациентов с метастатическим гормоночувствительным раком предстательной железы (мГЧРПЖ) и становится стандартом лечения. Выбор терапии для улучшения результатов лечения пациентов с мГЧРПЖ становится все более сложной задачей, поскольку появились различные варианты для этой стадии заболевания. В настоящей статье представлен обзор клинических исследований, включавших андроген-депривационную терапию (АДТ) в сочетании с химиотерапией, новой гормональной и лучевой терапией. Также мы рассмотрим последние достижения в выборе лечения мужчин с диагностированным мГЧРПЖ и влияние предшествующей терапии на последующую биологию заболевания. Варианты включают химиогормональную терапию, терапию, направленную на андрогенные рецепторы (АР), в дополнение к АДТ или – реже – только АДТ. Выбор лечения должен основываться на рассмотрении клинических характеристик и характеристик заболевания, а также учете предпочтений пациента, территориальных ограничений и финансовых возможностей.

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