到2024年,全球估计将有1,466,718例前列腺癌(PC)确诊病例。其中299,010例估计来自美国。PC的典型临床方法包括常规筛查,诊断,和标准的治疗路线。然而,并非所有患者都对治疗有反应,随后被诊断为紧急治疗神经内分泌前列腺癌(NEPC).目前对于这种形式的侵袭性PC没有批准的治疗方法。在这次审查中,提供了使用新靶标和/或组合方法治疗晚期NEPC的临床试验方案的汇编。评估的新目标包括DLL3,EZH2,B7-H3,Aurora激酶A(AURKA),受体酪氨酸激酶,PD-L1和PD-1。其中,服用药物阿利塞替布或卡博替尼的试验,靶向AURKA或受体酪氨酸激酶,分别,似乎有希望的结果。效果最差的试验似乎是针对免疫检查点途径PD-1/PD-L1的试验。许多有希望的临床试验目前正在进行中。因此,NEPC成功治疗方案的前景极为有限.这些试验结果和有关该主题的文献强调需要新的预防措施,诊断,疾病特异性生物标志物,以及对NEPC的全面临床了解。
In 2024, there will be an estimated 1,466,718 cases of prostate cancer (PC) diagnosed globally, of which 299,010 cases are estimated to be from the US. The typical clinical approach for PC involves routine screening, diagnosis, and standard lines of treatment. However, not all patients respond to therapy and are subsequently diagnosed with treatment emergent neuroendocrine prostate cancer (NEPC). There are currently no approved treatments for this form of aggressive PC. In this review, a compilation of the clinical trials regimen to treat late-stage NEPC using novel targets and/or a combination approach is presented. The novel targets assessed include DLL3, EZH2, B7-H3, Aurora-kinase-A (AURKA), receptor tyrosine kinases, PD-L1, and PD-1. Among these, the trials administering drugs Alisertib or Cabozantinib, which target AURKA or receptor tyrosine kinases, respectively, appear to have promising results. The least effective trials appear to be ones that target the immune checkpoint pathways PD-1/PD-L1. Many promising clinical trials are currently in progress. Consequently, the landscape of successful treatment regimens for NEPC is extremely limited. These trial results and the literature on the topic emphasize the need for new preventative measures, diagnostics, disease specific biomarkers, and a thorough clinical understanding of NEPC.