New endocrine therapy helps to standardize the management of prostate cancer mHSPC.

First, prostate cancer: the incidence of male common malignant tumor prostate cancer is one of the common malignant tumors in men, is the most common malignant tumor in men in Europe and the United States, in the tumor-related death ranked 2nd.
the incidence of prostate cancer in China is lower than that in Europe and the United States, but in recent years, its detection rate has increased year by year, and has become an important malignant tumor threatening the health of men in China.
contrast with the prostate cancer population in Europe and the United States, the proportion of patients with advanced and metastatic prostate cancer (mPC) in china is higher and the prognosis is worse.
metastatic prostate cancer includes mHSPC and mcRPC.
mHSPC refers to metastatic prostate cancer that has an effective response to androgen deprivation therapy (ADT).
mCRPC refers to metastatic prostate cancer, or metastatic degenerative prostate cancer, which continues to progress after ADT.
patients enter the MCRPC stage, the prognostication is generally poor.
2. Accurate identification of mPC high-risk factors, timely and effective intervention in the mHSPC stage, is the key to the long-term benefits of mPC in Beijing, Shanghai and Guangzhou, a study showed that the new diagnosis of prostate cancer patients in China, 54% of patients have been diagnosed with distant metastasis (including bone and abdominal organ metastasis), about 38% of patients have developed to the mcrPC stage, equivalent to late stage.
patients with distant metastasis, the five-year relative survival rate never metastasies 80 percent to 30 percent, and the progression-free survival time is half that of non-transferable patients.
mHSPC belongs to the advanced stage of prostate cancer, if you can accurately identify the high-risk factors of mPC, timely and effective intervention in the mHSPC stage to prevent the progression of the disease to mcRPC, is a key factor for the long-term benefits of mPC.
and domestic guidelines in recent years have concluded that the main therapeutic objective of the mHSPC phase is to delay progress and prolong survival.
3, Abitron: A new endocrine drug that blocks androgen biosynthesis is prostate cancer, an androgen-sensitive tumor, and endocrine therapy is an important treatment for prostate cancer throughout the course of the disease.
Abitron effectively blocks the synthesis of androgens in testicular, adrenal and prostate tumor tissue by inhibiting the activity of the key enzyme CYP17 in the androgen synthesis path, reducing testosterone levels in the blood and bone marrow of prostate cancer patients to the lower detection limit and continuing until the end of treatment to achieve a complete blocking of androgen synthesis in the body.
As a representative of new endocrine therapy drugs, Abitron has made a breakthrough in the treatment of advanced prostate cancer, and several authoritative guidelines at home and abroad recommend Abitron for mHSPC and mcRPC first-line/standard solutions.
, LATITUDE Study: Abitron Can Bring Comprehensive Benefits to High-Risk mHSPC Patients Abitron Combined Pnython Treatment High-Risk mHSPC LATITUDE Results Confirmed: Abbitron United Pnython s/ADT Compared to Placebo Group (AAP-ADT) significantly extended the patient's mid-OS to 53.3 months, reducing the risk of death by 34 percent, and patients with no imaging progression survival time (rPFS) of 33 months, reducing the risk of imaging progression or death by 53 percent.
Abitron United Pnython and ADT (AAP-ADT) significantly extended the patient's mid-level OS to 53.3 months, reducing the risk of death by 34%, and Abitron's joint Ponicon-ADT significantly extended the patient's mid-level rPFS to 33 months, making the image Academic progression or risk of death decreased by 53%, start-up therapy based on the Abitron programme significantly delayed the progression of the mid-PSA to 33.2 months, reducing the risk of PSA progression by 70%, and Abitron-based first-line therapy was an important starting point for high-risk mHSPC to gain long-term survival benefits, and patient benefits continued.
LATITUDE study ushered in a new era of mHSPC therapy, with Abitron-based first-line therapy being an important starting point for high-risk mHSPC to gain long-term survival benefits that patients continue to benefit from.
the findings were first presented at the ASCO conference in July 2017, Abitron has been strongly recommended for treatment with high-risk mHSPC by consensus among authoritative guidelines at home and abroad.
5, STAMPEDE Study: Abitron's role in the wider mHSPC patients recently published in the European Journal of Urology, a new paper, has attracted wide attention from experts and scholars in the field of prostate cancer. the
paper, entitled Abitron's Role in "High Risk" and "Low Risk" Metastatic Hormone Sensitive Prostate Cancer (mHSPC), is a follow-up to the STAMPEDE study, which revealed that Abitron's treatment value for mHSPC patients may be higher than thought in the past, with a broader range of treatments, and benefits both high- and low-risk mHSPC patients.
In terms of high-risk or high tumor load mHSPC, Abitron can reduce the risk of death, Abitron combined with pson-ADT can reduce the risk of death in high-risk mHSPC patients by 46%, and Abitron combined with pson-ADT can reduce the risk of death in patients with high tumor load mHSPC by 40%.
Abitron reduces the risk of death in low-risk patients.
The Abitron combination of panisson and ADT therapy showed a significant survival advantage in the low-risk patient group, which significantly reduced the relative risk of death by 34% compared to the control group (HR-0.66, 95% CI 0.44-0.98).
summary of the latest results of this STAMPEDE study shows that ADT-AAP therapy, including Abitron, is suitable for a wider range of mHSPC patients than has been thought in the past.
, Hitting Hard remains the core strategy for high-risk mHSPC treatment for high-risk mHSPC patients due to faster progression and faster metastasis.
LATITUDE (4-5) study showed that patients with high-risk mHSPC were treated with traditional ADT, with a median progression time of only 7.4 months and a median OS of only 34.7 months, and that once the treatment failed, they entered the more difficult stage of metastatic degenerative resistance prostate cancer (mCRPC).
therefore, such patients need more attention and more active treatment options.
The current clinical advocacy of the "hit hard" strategy, refers to the high-risk mHSPC patients should take a step-by-step, hammering treatment, early use of more safe and effective new endocrine therapy, so that its condition as early as possible to control, to avoid or delay the transfer to the MCRPC stage.
a large number of studies have shown that Abitron is effective in delaying the progression of patients and improving the quality of life of patients with high-risk mHSPC patients.
therefore, for this group of patients, the concept of "hitting hard" treatment should continue to be pursued to their greater benefit.
7. Many disadvantages of traditional anti-male drugs, recurrent resistance to traditional anti-male drugs as a similar substance, blocking the androgen receptors (AR)-lipens activation process, inhibiting AR subposing to the nucleus and downstream signaling path expression, but this method can not completely block AR activity. More than
comparative studies of post-drug testosterone levels in patients with advanced prostate cancer showed that the ADT-bicarumin group, the ADT-flutamin/bicarumamine group, although lower than the testosterone levels in the ADT group alone, could not be completely reduced to zero.
and traditional anti-male drugs are prone to drug resistance.
Generally believed that these drug resistance mechanisms are mainly due to AR amplification, point mutation, AR shear mutation expression, tumor endocrine androgen and other reasons, resulting in ar signal conduction of alternative mechanisms, and ultimately the vast majority of prostate cancer patients within a few years of recurrence.
addition, an in-body study confirmed that the long-term use of bicarumin, the antagonist effect of bikarumin on androgens, translates into an agitant effect.
and when converted to an agitant state, it can lead to degenerative changes in the tumor, further proliferation and deterioration.
8, 2020 AUA "Advanced Prostate Cancer Guidelines" recently released, mHSPC treatment major update recently, the American Society of Urology (AUA) issued evidence-based guidelines for advanced prostate cancer, the guidelines in addition to the refinement of prostate-specific antigen (PSA), imaging testing and other measures to assist diagnosis and efficacy monitoring, for the treatment of advanced prostate cancer also gave guidance.
AUA guidelines states in Articles 15 and 17 that clinicians should conduct continuous androgen deprivation therapy (ADT) combined androgen signaling path to treatment for patients with metastatic desensitive prostate cancer (mHSPC) (ADT) Proteisone, apetamine, erythropoietamin) or chemotherapy (docetaxal), and traditional anti-male drugs (bicarumin, flutamin, nirumet) should not be used in combination with progesterone-releasing hormone (LHRH) an agitant (highly recommended; Level A evidence).
in summary, the latest AAUA for the advanced treatment of prostate cancer provides a number of recommendations, the new endocrine treatment drug Abitron industry has become mHSPC first-line standard treatment program, for more Chinese metastatic hormone-sensitive prostate cancer patients to provide new treatment options.
Zu Xiongbing, Chief Physician, Doctoral Mentor, Director of Urology, Xiangya Hospital, Central South University, Deputy Director of the Department of Surgery, Director of the Institute of Men's Medicine, Central South University, Deputy Director of the Institute of Urology, Special Professor of Sublimation Scholars, 531 Talents, Young Key Teachers of Hunan Province, 225 High-Level Health Talents, 121 Innovative Talents, Chairing the National Natural Sciences Fund 4, ministry of science and technology key research and development program sub-topic 1, Hunan Province Jieqing, key projects, key research and development plan each 1, presided over the Hunan Province Science and Technology Progress Award 2nd and 3rd prize each 1, Hunan Province Medical Science and Technology Award 1, 2, 3rd prize each 1, the first or newsletter author in EU, EMBO Reports, Oncogene, JU and other magazines published 51 SCI articles.
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