前列腺癌中的雄激素受体途径抑制剂和药物相互作用。
Androgen receptor pathway inhibitors and drug-drug interactions in prostate cancer.
发表日期:2024 Oct 18
作者:
H Bolek, S C Yazgan, E Yekedüz, M D Kaymakcalan, R R McKay, S Gillessen, Y Ürün
来源:
ESMO Open
摘要:
前列腺癌是一项重大的全球健康挑战,需要有效的治疗策略。雄激素受体途径抑制剂 (ARPIs) 已成为前列腺癌治疗的核心,在转移性和非转移性环境中均显示出显着的有效性。醋酸阿比特龙通过抑制雄激素合成,剥夺癌细胞生长所需的雄激素,而第二代雄激素受体 (AR) 拮抗剂则通过阻断 AR 结合来破坏 AR 信号传导,从而阻止肿瘤进展。鉴于前列腺癌在老年人中占主导地位,而且老年人经常出现多种合并症,需要复杂的药物治疗方案,因此 ARPI 之间药物间相互作用的可能性是一个关键问题。这些相互作用,特别是通过阿比特龙抑制 CYP2D6 以及恩杂鲁胺和阿帕鲁胺诱导 CYP3A4 等途径,需要彻底了解以优化治疗结果并尽量减少不良反应。本综述旨在描述 ARPI 在前列腺癌管理中的功效,并阐明其与常见药物的相互作用,强调警惕药物管理对于优化患者护理的重要性。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。
Prostate cancer represents a major global health challenge, necessitating efficacious therapeutic strategies. Androgen receptor pathway inhibitors (ARPIs) have become central to prostate cancer treatment, demonstrating significant effectiveness in both metastatic and non-metastatic contexts. Abiraterone acetate, by inhibiting androgen synthesis, deprives cancer cells androgens necessary for growth, while second-generation androgen receptor (AR) antagonists disrupt AR signaling by blocking AR binding, thereby impeding tumor progression. Given the predominance of prostate cancer in the elderly, who often present with multiple comorbidities requiring complex pharmacological regimens, the potential for drug-drug interactions with ARPIs is a critical concern. These interactions, particularly through pathways like CYP2D6 inhibition by abiraterone and CYP3A4 induction by enzalutamide and apalutamide, necessitate a thorough understanding to optimize therapeutic outcomes and minimize adverse effects. This review aims to delineate the efficacy of ARPIs in prostate cancer management and elucidate their interaction with common medications, highlighting the importance of vigilant drug management to optimize patient care.Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.