MODERN APPROACHES TO DRUG THERAPY OF PATIENTS WITH METASTATIC CASTRATION- REFRACTORY PROSTATE CANCER


A.D. Kaprin, B.Ya. Alekseev, K .M. Nyushko, A.S. Kalpinsky

FSBI "Moscow Scientific Research Institute n.a. P.A. Herzen" of RMPH, Moscow
Prostate cancer (PC) is one of the most urgent problems of modern oncology due to the high incidence worldwide. Annualy, over 900 thousand new cases of prostate cancer are registered in the world. The basic treatment for locally advanced and/or metastatic prostate cancer is hormone therapy. Androgenic deprivation allows to achieve stabilization of disease in more than 90% of patients; however, median time to progression after hormonal therapy is about 2 years old, then patients with tumor progression and persistent castration levels of testosterone are being grounded to the stage so-called castration-refractory prostate cancer (CRPC). Advanced CRPC is not only prognostically unfavorable disease: it significantly impairs the quality of life of patients. The main mechanisms of development of CRPC include intraprostatic conversion of androgens in the testosterone, and the intratumoral androgen synthesis due to increased expression of steroidogenic enzymes such as cytochrome P450S17 (CYP17). The article presents an overview of new therapies for patients with the use of 2nd line chemotherapy of CRPC with cabazitaxel, therapy with selective CYP17 inhibitor abiraterone, superselectiveantiandrogenenzalutamide, and vaccinotherapy with sipuleucel-T and PROSTVAC.

About the Autors


A.D. Kaprin – MD, Professor, Corresponding Member of RAS, Director of FSBI "Moscow Scientific Research Institute n.a. P.A. Herzen"
B.Ya. Alekseev – MD, Professor, Deputy Director for Science of FSBI "Moscow Scientific Research Institute n.a. P.A. Herzen"
K.M. Nyushko – PhD in Medical Sciences, Leading Researcher at the Department of Oncourology FSBI "Moscow Scientific Research Institute n.a. P.A. Herzen"
A.S. Kalpinsky - PhD in Medical Sciences, Senior Researcher at the Department of Oncourology FSBI "Moscow Scientific Research Institute n.a. P.A. Herzen"
e-mail: dr.kalpinskiy@gmail.com


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