名字里有什么？晚期前列腺癌患者的用词为何很重要

IF 25.3 1区医学 Q1 UROLOGY & NEPHROLOGY

European urology Pub Date : 2024-10-29 DOI:10.1016/j.eururo.2024.10.017

William K. Oh, Neeraj Agarwal, Alan Bryce, Pedro Barata, Courtney Bugler, Sigrid V. Carlsson, Brad Cornell, William Dahut, Daniel George, Stacy Loeb, Bruce Montgomery, David Morris, Lorelei A. Mucci, Aurelius Omlin, Ganesh Palapattu, Irbaz Bin Riaz, Charles Ryan, Martin W. Schoen, Samuel L. Washington, Silke Gillessen

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引用次数: 0

摘要

转移性荷尔蒙敏感性前列腺癌（mHSPC）关于 "阉割 "一词的科学准确性和对患者的负面含义的争论之前已经讨论过[3]、[4]，这显然是上述正面和负面力量的一个突出例子。特别是，我们认为 "阉割 "一词让患者、伴侣和家人难以接受，因此在描述这种晚期前列腺癌疾病状态时应避免使用。 mHSPC 是新诊断出的抗雄激素前列腺癌（ARPC）患者的最常用术语，其中一个广泛使用的术语是 "阉割耐药 "前列腺癌。雄激素受体通路抑制剂（ARPI）雄激素受体（AR）通路抑制剂（如醋酸阿比特龙、阿帕鲁胺、达罗鲁胺、恩扎鲁胺）似乎有很多名字，最早的 "抗雄激素"（如比卡鲁胺）可追溯到几十年前。目前，AR 信号抑制剂（ARSI）、新型激素疗法（NHT）、AR 靶向药物（ARTA）、第二代或下一代激素疗法等各种术语都在使用。mHSPC的联合疗法（ADT加ARPI+/-多西他赛）多项随机试验表明，在ADT基础上加用ARPI（"双联疗法"）或在ADT和多西他赛化疗基础上加用ARPI（"三联疗法"）可提高mHSPC的总生存率[6], [7]。将由两种或三种药物组成的治疗方案描述为双联或三联疗法可能具有描述性，但很容易造成误解。例如，一些研究者用 mHSPC 中的 "三联疗法 "来描述 ADT + ARPI + 前列腺放疗。未来

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What’s in a Name? Why Words Matter in Advanced Prostate Cancer

Section snippets

Metastatic hormone-sensitive prostate cancer (mHSPC)

The debate concerning the scientific accuracy and negative connotations of the word “castration” for patients has been discussed previously [3], [4] and is clearly a prominent example of the powers—positive and negative—mentioned above. In particular, we believe that the word “castration” is difficult for patients, partners, and families to hear and should be avoided when we describe this advanced prostate cancer disease state. mHSPC is the most common term for patients with newly diagnosed

Androgen deprivation–resistant prostate cancer (ARPC)

One widely used term is “castration-resistant” prostate cancer. Since all patients with this disease state are resistant to androgen deprivation, we propose a new term: androgen deprivation–resistant prostate cancer (ARPC).

Androgen receptor pathway inhibitors (ARPI)

The class of androgen receptor (AR) pathway inhibitors (eg, abiraterone acetate, apalutamide, darolutamide, enzalutamide) appears to have many names, going back decades to the first “anti-androgens” such as bicalutamide. Currently, various terms such as AR signaling inhibitors (ARSI), novel hormonal therapies (NHT), AR-targeted agents (ARTA), and second- or next-generation hormonal therapies are all used. Unfortunately, this nomenclature is not only confusing but is also prone to becoming

Combination therapy for mHSPC (ADT plus ARPI +/- docetaxel)

Multiple randomized trials have demonstrated superior overall survival in mHSPC with the addition of an ARPI to ADT (“doublet therapy”) or an ARPI to ADT and docetaxel chemotherapy (“triplet therapy”) [6], [7]. Describing regimens comprising two or three drugs as doublets or triplets may be descriptive but can easily be misinterpreted. For instance, the term “triplet therapy” in mHSPC has been used to describe ADT + ARPI + radiation therapy to the prostate by some investigators. Future

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来源期刊

European urology 医学-泌尿学与肾脏学

CiteScore

43.00

自引率

2.60%

发文量

1753

审稿时长

23 days

期刊介绍： European Urology is a peer-reviewed journal that publishes original articles and reviews on a broad spectrum of urological issues. Covering topics such as oncology, impotence, infertility, pediatrics, lithiasis and endourology, the journal also highlights recent advances in techniques, instrumentation, surgery, and pediatric urology. This comprehensive approach provides readers with an in-depth guide to international developments in urology.