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Small extracellular vesicles: Roles and clinical application in prostate cancer. 细胞外小泡:前列腺癌的作用和临床应用。
Pub Date : 2024-01-01 Epub Date: 2024-06-12 DOI: 10.1016/bs.acr.2024.05.008
Caleb Smack, Benjamin Johnson, Julius O Nyalwidhe, O John Semmes, Lifang Yang

Prostate cancer is a significant health problem in the United States. It is remarkably heterogenous, ranging from slow growing disease amenable to active surveillance to highly aggressive forms requiring active treatments. Therefore, being able to precisely determine the nature of disease and appropriately match patients to available and/or novel therapeutics is crucial to improve patients' overall outcome and quality of life. Recently small extracellular vesicles (sEVs), a subset of nanoscale membranous vesicles secreted by various cells, have emerged as important analytes for liquid biopsy and promising vehicles for drug delivery. sEVs contain various biomolecules such as genetic material, proteins, and lipids that recapitulate the characteristics and state of their donor cells. The application of existing and newly developed technologies has resulted in an increased depth of knowledge about biophysical structures, biogenesis, and functions of sEVs. In prostate cancer patients, tumor-derived sEVs can be isolated from biofluids, commonly urine and blood. They mediate intercellular signaling within the tumor microenvironment and distal organ-specific sites, supporting cancer initiation, progression, and metastasis. A mounting body of evidence suggests that sEV components can be potent biomarkers for prostate cancer diagnosis, prognosis, and prediction of disease progression and treatment response. Due to enhanced circulation stability and bio-barrier permeability, sEVs can be also used as effective drug delivery carriers to improve the efficacy and specificity of anti-tumor therapies. This review discusses recent studies on sEVs in prostate cancer and is focused on their role as biomarkers and drug delivery vehicles in the clinical management of prostate cancer.

前列腺癌是美国的一个重大健康问题。前列腺癌具有显著的异质性,既有生长缓慢、适合积极监测的疾病,也有需要积极治疗的高度侵袭性疾病。因此,能够精确地确定疾病的性质,并将患者与现有的和/或新型疗法进行适当匹配,对于改善患者的总体预后和生活质量至关重要。细胞外小泡(sEVs)是由各种细胞分泌的纳米级膜泡的一个子集,近来已成为液体活检的重要分析物和很有前景的给药载体。现有技术和新开发技术的应用使人们对 sEVs 的生物物理结构、生物生成和功能有了更深入的了解。在前列腺癌患者中,可以从生物流体(通常是尿液和血液)中分离出肿瘤衍生的 sEVs。它们在肿瘤微环境和远端器官特异性部位介导细胞间信号传导,支持癌症的发生、发展和转移。越来越多的证据表明,sEV 成分可以成为前列腺癌诊断、预后以及疾病进展和治疗反应预测的有效生物标记物。由于增强了循环稳定性和生物屏障渗透性,sEV 还可用作有效的给药载体,以提高抗肿瘤疗法的疗效和特异性。本综述讨论了有关前列腺癌中 sEVs 的最新研究,重点是它们在前列腺癌临床治疗中作为生物标记物和给药载体的作用。
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引用次数: 0
Unraveling the complexity: Advanced methods in analyzing DNA, RNA, and protein interactions. 揭示复杂性:分析 DNA、RNA 和蛋白质相互作用的先进方法。
Pub Date : 2024-01-01 Epub Date: 2024-07-20 DOI: 10.1016/bs.acr.2024.06.010
Maria Leonor Peixoto, Esha Madan

Exploring the intricate interplay within and between nucleic acids, as well as their interactions with proteins, holds pivotal significance in unraveling the molecular complexities steering cancer initiation and progression. To investigate these interactions, a diverse array of highly specific and sensitive molecular techniques has been developed. The selection of a particular technique depends on the specific nature of the interactions. Typically, researchers employ an amalgamation of these different techniques to obtain a comprehensive and holistic understanding of inter- and intramolecular interactions involving DNA-DNA, RNA-RNA, DNA-RNA, or protein-DNA/RNA. Examining nucleic acid conformation reveals alternative secondary structures beyond conventional ones that have implications for cancer pathways. Mutational hotspots in cancer often lie within sequences prone to adopting these alternative structures, highlighting the importance of investigating intra-genomic and intra-transcriptomic interactions, especially in the context of mutations, to deepen our understanding of oncology. Beyond these intramolecular interactions, the interplay between DNA and RNA leads to formations like DNA:RNA hybrids (known as R-loops) or even DNA:DNA:RNA triplex structures, both influencing biological processes that ultimately impact cancer. Protein-nucleic acid interactions are intrinsic cellular phenomena crucial in both normal and pathological conditions. In particular, genetic mutations or single amino acid variations can alter a protein's structure, function, and binding affinity, thus influencing cancer progression. It is thus, imperative to understand the differences between wild-type (WT) and mutated (MT) genes, transcripts, and proteins. The review aims to summarize the frequently employed methods and techniques for investigating interactions involving nucleic acids and proteins, highlighting recent advancements and diverse adaptations of each technique.

探索核酸内部和核酸之间错综复杂的相互作用,以及核酸与蛋白质之间的相互作用,对于揭示引导癌症发生和发展的分子复杂性具有举足轻重的意义。为了研究这些相互作用,人们开发了一系列高度特异和灵敏的分子技术。特定技术的选择取决于相互作用的具体性质。通常情况下,研究人员会综合使用这些不同的技术,以全面、整体地了解涉及 DNA-DNA、RNA-RNA、DNA-RNA 或蛋白质-DNA/RNA 的分子间和分子内相互作用。对核酸构象的研究揭示了传统核酸构象之外的其他二级结构,这些二级结构对癌症的发病途径具有影响。癌症的突变热点往往位于容易采用这些替代结构的序列中,这凸显了研究基因组内和转录组内相互作用(尤其是突变背景下的相互作用)对于加深我们对肿瘤学的理解的重要性。除了这些分子内相互作用外,DNA 和 RNA 之间的相互作用还会形成 DNA:RNA 杂交体(称为 R 环),甚至 DNA:DNA:RNA 三重结构,两者都会影响生物过程,最终对癌症产生影响。蛋白质与核酸的相互作用是细胞的固有现象,在正常和病理情况下都至关重要。尤其是基因突变或单一氨基酸变异会改变蛋白质的结构、功能和结合亲和力,从而影响癌症的发展。因此,了解野生型(WT)和突变型(MT)基因、转录本和蛋白质之间的差异势在必行。本综述旨在总结研究核酸与蛋白质相互作用的常用方法和技术,重点介绍每种技术的最新进展和不同适应性。
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引用次数: 0
Modular formation of in vitro tumor models for oncological research/therapeutic drug screening. 用于肿瘤研究/治疗药物筛选的体外肿瘤模型的模块化形成。
Pub Date : 2024-01-01 Epub Date: 2024-07-17 DOI: 10.1016/bs.acr.2024.06.011
Weiwei Wang, Hongjun Wang

In recognition of the lethal nature of cancer, extensive efforts have been made to understand the mechanistic causation while identifying the effective therapy modality in hope to eradicate cancerous cells with minimal damage to healthy cells. In search of such effective therapeutics, establishing pathophysiologically relevant in vitro models would be of importance in empowering our capabilities of truly identifying those potent ones with significantly reduction of the preclinical periods for rapid translation. In this regard, wealthy progresses have been achieved over past decades in establishing various in vitro and in vivo tumor models. Ideally, the tumor models should maximally recapture the key pathophysiological attributes of their native counterparts. Many of the current models have demonstrated their utilities but also showed some noticeable limitations. This book chapter will briefly review some of the mainstream platforms for in vitro tumor models followed by detailed elaboration on the modular strategies to form in vitro tumor models with complex structures and spatial organization of cellular components. Clearly, with the ability to modulate the building modules it becomes a new trend to form in vitro tumor models following a bottom-up approach, which offers a high flexibility to satisfy the needs for pathophysiological study, anticancer drug screening or design of personalized treatment.

由于认识到癌症的致命性,人们一直在努力了解其机理成因,同时确定有效的治疗模式,希望在根除癌细胞的同时,尽量减少对健康细胞的损害。在寻找有效疗法的过程中,建立与病理生理学相关的体外模型非常重要,它能增强我们的能力,真正找出有效的治疗方法,并大大缩短临床前的研究时间,实现快速转化。在这方面,过去几十年来,我们在建立各种体外和体内肿瘤模型方面取得了巨大进展。理想情况下,肿瘤模型应能最大限度地再现其原生对应物的关键病理生理学属性。目前的许多模型已经证明了它们的实用性,但也显示出一些明显的局限性。本书的这一章将简要回顾一些体外肿瘤模型的主流平台,然后详细阐述形成具有复杂结构和细胞成分空间组织的体外肿瘤模型的模块化策略。显然,由于可以对构建模块进行调节,采用自下而上的方法建立体外肿瘤模型已成为一种新趋势,这种方法具有高度的灵活性,可以满足病理生理学研究、抗癌药物筛选或个性化治疗设计的需要。
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引用次数: 0
Systemic therapy landscape of advanced prostate cancer. 晚期前列腺癌的系统治疗前景。
Pub Date : 2024-01-01 Epub Date: 2024-04-27 DOI: 10.1016/bs.acr.2024.04.004
Asit K Paul, John W Melson, Samina Hirani, Selvaraj Muthusamy

Prostate cancer is the most commonly diagnosed cancer in American men and 2nd leading cause of cancer-related deaths in the United States. Androgen deprivation therapy (ADT) is the backbone of treatment for advanced prostate cancer. Over the past several decades a number of new therapeutics, such as novel androgen receptor pathway inhibitors, targeted agents and radionuclide therapies, have been introduced for the treatment of prostate cancers. These agents have been demonstrated to improve clinical outcomes of prostate cancer patients in randomized clinical trials. In addition, new therapeutic strategies, such as early intensification of ADT, novel treatment combinations, and treatment sequencing, are expected to improve outcomes further. In this clinical review, we discuss the changing treatment landscape for advanced prostate cancer with a focus on new therapeutics.

前列腺癌是美国男性最常确诊的癌症,也是美国癌症相关死亡的第二大原因。雄激素剥夺疗法(ADT)是治疗晚期前列腺癌的主要手段。过去几十年来,许多新疗法,如新型雄激素受体通路抑制剂、靶向药物和放射性核素疗法,已被引入前列腺癌的治疗中。随机临床试验证明,这些药物可改善前列腺癌患者的临床疗效。此外,早期加强 ADT、新型治疗组合和治疗排序等新的治疗策略有望进一步改善疗效。在这篇临床综述中,我们将以新疗法为重点,讨论晚期前列腺癌不断变化的治疗形势。
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引用次数: 0
Melanoma redox biology and the emergence of drug resistance. 黑色素瘤氧化还原生物学和耐药性的出现。
Pub Date : 2024-01-01 Epub Date: 2024-07-02 DOI: 10.1016/bs.acr.2024.06.004
Therese Featherston, Martina Paumann-Page, Mark B Hampton

Melanoma is the deadliest form of skin cancer, with the loss of approximately 60,000 lives world-wide each year. Despite the development of targeted therapeutics, including compounds that have selectivity for mutant oncoproteins expressed only in cancer cells, many patients are either unresponsive to initial therapy or their tumors acquire resistance. This results in five-year survival rates of below 25%. New strategies that either kill drug-resistant melanoma cells or prevent their emergence would be extremely valuable. Melanoma, like other cancers, has long been described as being under increased oxidative stress, resulting in an increased reliance on antioxidant defense systems. Changes in redox homeostasis are most apparent during metastasis and during the metabolic reprogramming associated with the development of treatment resistance. This review discusses oxidative stress in melanoma, with a particular focus on targeting antioxidant pathways to limit the emergence of drug resistant cells.

黑色素瘤是最致命的皮肤癌,全世界每年约有 60,000 人因此丧生。尽管开发出了靶向治疗药物,包括对只在癌细胞中表达的突变肿瘤蛋白具有选择性的化合物,但许多患者要么对初始治疗无反应,要么肿瘤产生抗药性。这导致五年生存率低于 25%。能够杀死耐药黑色素瘤细胞或防止其出现的新策略将极具价值。黑色素瘤与其他癌症一样,长期以来一直被描述为氧化应激增加,导致对抗氧化防御系统的依赖性增加。氧化还原平衡的变化在转移过程中以及与耐药性发展相关的代谢重编程过程中最为明显。本综述将讨论黑色素瘤中的氧化应激,尤其侧重于靶向抗氧化途径以限制耐药细胞的出现。
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引用次数: 0
Data enhancement in the age of spatial biology. 空间生物学时代的数据增强。
Pub Date : 2024-01-01 Epub Date: 2024-07-09 DOI: 10.1016/bs.acr.2024.06.008
Linbu Liao, Patrick C N Martin, Hyobin Kim, Sanaz Panahandeh, Kyoung Jae Won

Unveiling the intricate interplay of cells in their native environment lies at the heart of understanding fundamental biological processes and unraveling disease mechanisms, particularly in complex diseases like cancer. Spatial transcriptomics (ST) offers a revolutionary lens into the spatial organization of gene expression within tissues, empowering researchers to study both cell heterogeneity and microenvironments in health and disease. However, current ST technologies often face limitations in either resolution or the number of genes profiled simultaneously. Integrating ST data with complementary sources, such as single-cell transcriptomics and detailed tissue staining images, presents a powerful solution to overcome these limitations. This review delves into the computational approaches driving the integration of spatial transcriptomics with other data types. By illuminating the key challenges and outlining the current algorithmic solutions, we aim to highlight the immense potential of these methods to revolutionize our understanding of cancer biology.

揭示细胞在其原生环境中错综复杂的相互作用是了解基本生物过程和揭示疾病机制的核心,尤其是在癌症等复杂疾病中。空间转录组学(ST)为研究组织内基因表达的空间组织提供了一个革命性的视角,使研究人员有能力研究健康和疾病中的细胞异质性和微环境。然而,目前的表观基因组学技术往往在分辨率或同时分析的基因数量方面受到限制。将 ST 数据与单细胞转录组学和详细的组织染色图像等补充来源进行整合,是克服这些局限性的强大解决方案。本综述深入探讨了推动空间转录组学与其他数据类型整合的计算方法。通过阐明关键挑战和概述当前的算法解决方案,我们旨在强调这些方法在彻底改变我们对癌症生物学的理解方面所具有的巨大潜力。
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引用次数: 0
Recent advances and progress in immunotherapy of solid cancers. 实体癌免疫疗法的最新进展。
Pub Date : 2024-01-01 Epub Date: 2024-05-31 DOI: 10.1016/bs.acr.2024.05.004
Amit Kumar, Luni Emdad, Swadesh K Das, Paul B Fisher

Adoptive cell therapy using chimeric antigen receptor (CAR) technology has become mainstream by employing advanced engineering platforms to promote cancer immunotherapy. CAR T cells have shown remarkable efficacy in the treatment of hematological malignancies; however, the value of this therapy remains inconclusive in the context of solid tumors. Immunotherapy of solid tumors is restrained by several obstacles including the presence of an immunosuppressive tumor microenvironment (TME), limited tumor trafficking, inhibited immune cell infiltration, absence of tumor-specific antigens, and off-target toxicity and adverse events associated with these therapies. Despite recent advances in CAR T cell construction, including the integration of co-stimulatory domains and the creation of armed CAR T cells, with promising outcomes in the treatment of some solid tumors, there are still many unresolved obstacles that need to be overcome. To surmount these impediments to effective CAR T cell therapies, other immune cells, such as natural killer cells and macrophages, have been engineered to serve as appealing alternatives for successful cancer immunotherapy of solid tumors. CAR NK cells demonstrate significant clinical advantages due to their ready availability and minimal toxicity. CAR macrophage (M) cells provide considerable therapeutic potential due to their ability to penetrate the TME of solid tumors. In this review, we comprehensively examine the latest developments and prospects of engineered immune cell-based cancer immunotherapies specifically designed for treating solid tumors. In addition, we provide a concise overview of current clinical trials that are examining the safety and effectiveness of modified immune cells, such as CAR T, CAR NK, and CAR M, in their ability to specifically target solid tumors and promote improved therapeutic outcomes in patients with diverse solid cancers.

采用嵌合抗原受体(CAR)技术的适应性细胞疗法通过采用先进的工程平台促进癌症免疫疗法,已成为主流疗法。CAR T 细胞在治疗血液恶性肿瘤方面已显示出显著疗效,但在实体瘤方面,这种疗法的价值仍无定论。实体瘤的免疫疗法受到多种障碍的制约,包括存在免疫抑制性肿瘤微环境(TME)、肿瘤贩运受限、免疫细胞浸润受抑制、缺乏肿瘤特异性抗原,以及与这些疗法相关的脱靶毒性和不良反应。尽管最近在 CAR T 细胞构建方面取得了进展,包括整合共刺激域和创建武装 CAR T 细胞,并在治疗某些实体瘤方面取得了可喜的成果,但仍有许多尚未解决的障碍需要克服。为了克服有效 CAR T 细胞疗法的这些障碍,其他免疫细胞,如自然杀伤细胞和巨噬细胞,已被设计成具有吸引力的替代品,用于成功治疗实体瘤的癌症免疫疗法。CAR NK 细胞由于随时可用且毒性极低,在临床上具有显著优势。CAR 巨噬细胞(M)能够穿透实体瘤的 TME,因此具有相当大的治疗潜力。在这篇综述中,我们全面探讨了专为治疗实体瘤而设计的基于工程免疫细胞的癌症免疫疗法的最新进展和前景。此外,我们还简要概述了目前的临床试验,这些临床试验正在研究 CAR T、CAR NK 和 CAR M 等改良免疫细胞的安全性和有效性,这些细胞能够特异性地靶向实体瘤,促进改善各种实体瘤患者的治疗效果。
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引用次数: 0
The glycosylation landscape of prostate cancer tissues and biofluids. 前列腺癌组织和生物流体的糖基化图谱
Pub Date : 2024-01-01 Epub Date: 2024-04-25 DOI: 10.1016/bs.acr.2024.04.005
Jordan Hartig, Lyndsay E A Young, Grace Grimsley, Anand S Mehta, Joseph E Ippolito, Robin J Leach, Peggi M Angel, Richard R Drake

An overview of the role of glycosylation in prostate cancer (PCa) development and progression is presented, focusing on recent advancements in defining the N-glycome through glycomic profiling and glycoproteomic methodologies. Glycosylation is a common post-translational modification typified by oligosaccharides attached N-linked to asparagine or O-linked to serine or threonine on carrier proteins. These attached sugars have crucial roles in protein folding and cellular recognition processes, such that altered glycosylation is a hallmark of cancer pathogenesis and progression. In the past decade, advancements in N-glycan profiling workflows using Matrix Assisted Laser Desorption/Ionization Mass Spectrometry Imaging (MALDI-MSI) technology have been applied to define the spatial distribution of glycans in PCa tissues. Multiple studies applying N-glycan MALDI-MSI to pathology-defined PCa tissues have identified significant alterations in N-glycan profiles associated with PCa progression. N-glycan compositions progressively increase in number, and structural complexity due to increased fucosylation and sialylation. Additionally, significant progress has been made in defining the glycan and glycopeptide compositions of prostatic-derived glycoproteins like prostate-specific antigen in tissues and biofluids. The glycosyltransferases involved in these changes are potential drug targets for PCa, and new approaches in this area are summarized. These advancements will be discussed in the context of the further development of clinical diagnostics and therapeutics targeting glycans and glycoproteins associated with PCa progression. Integration of large scale spatial glycomic data for PCa with other spatial-omic methodologies is now feasible at the tissue and single-cell levels.

本文概述了糖基化在前列腺癌(PCa)发生和发展中的作用,重点介绍了通过糖轮廓分析和糖蛋白组学方法确定N-糖粒的最新进展。糖基化是一种常见的翻译后修饰,其典型特征是寡糖与载体蛋白上的天冬酰胺N-连接或与丝氨酸或苏氨酸O-连接。这些连接的糖在蛋白质折叠和细胞识别过程中起着至关重要的作用,因此糖基化改变是癌症发病和进展的标志。在过去的十年中,使用基质辅助激光解吸/电离质谱成像(MALDI-MSI)技术的N-糖剖析工作流程取得了进步,可用于确定PCa组织中糖的空间分布。多项研究将 N-聚糖 MALDI-MSI 技术应用于病理学定义的 PCa 组织,发现了与 PCa 进展相关的 N-聚糖特征的显著变化。由于岩藻糖基化和硅烷基化的增加,N-糖组成的数量和结构复杂性逐渐增加。此外,在确定组织和生物流体中前列腺特异性抗原等前列腺衍生糖蛋白的聚糖和糖肽组成方面也取得了重大进展。参与这些变化的糖基转移酶是治疗 PCa 的潜在药物靶点,本报告总结了这一领域的新方法。这些进展将在进一步开发针对与 PCa 进展相关的聚糖和糖蛋白的临床诊断和治疗方法的背景下进行讨论。在组织和单细胞水平上整合 PCa 的大规模空间糖学数据和其他空间组学方法现在是可行的。
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引用次数: 0
Redox pathways in melanoma. 黑色素瘤的氧化还原途径
Pub Date : 2024-01-01 Epub Date: 2024-06-24 DOI: 10.1016/bs.acr.2024.06.002
Jie Zhang, Zhi-Wei Ye, Danyelle M Townsend, Kenneth D Tew

Cases of melanoma are doubling every 12 years, and in stages III and IV, the disease is associated with high mortality rates concomitant with unresectable metastases and therapeutic drug resistance. Despite some advances in treatment success, there is a marked need to understand more about the pathology of the disease. The present review provides an overview of how melanoma cells use and modulate redox pathways to facilitate thiol homeostasis and melanin biosynthesis and describes plausible redox targets that may improve therapeutic approaches in managing malignant disease and metastasis. Melanotic melanoma has some unique characteristics. Making melanin requires a considerable dedication of cellular energy resources and utilizes glutathione and glutathione transferases in certain steps in the biosynthetic pathway. Melanin is an antioxidant but is also functionally important in hematopoiesis and influential in various aspects of host immune responses, giving it unique characteristics. Together with other redox traits that are specific to melanoma, a discussion of possible therapeutic approaches is also provided.

黑色素瘤病例每 12 年翻一番,在 III 期和 IV 期,该病死亡率高,同时伴有无法切除的转移和治疗耐药性。尽管在治疗成功率方面取得了一些进展,但人们仍明显需要对该疾病的病理有更多的了解。本综述概述了黑色素瘤细胞如何利用和调节氧化还原途径来促进硫醇平衡和黑色素的生物合成,并描述了可能改善治疗方法以控制恶性疾病和转移的似是而非的氧化还原靶点。黑色素瘤具有一些独特的特征。制造黑色素需要大量的细胞能量资源,并在生物合成途径的某些步骤中利用谷胱甘肽和谷胱甘肽转移酶。黑色素是一种抗氧化剂,但在造血过程中也具有重要功能,并对宿主免疫反应的各个方面产生影响,因此具有独特的特性。本文还讨论了黑色素瘤特有的其他氧化还原特性以及可能的治疗方法。
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引用次数: 0
Advances in prostate cancer treatment: Radionuclide therapy for prostate cancer. 前列腺癌治疗的进展:前列腺癌的放射性核素治疗。
Pub Date : 2024-01-01 Epub Date: 2024-08-05 DOI: 10.1016/bs.acr.2024.07.004
Jeffrey Zhong, Albert Jang, Jorge Garcia, Norbert Avril, Qiubai Li, Patrick Wojtylak, Neal Shore, Scott Tagawa, Pedro Barata

The optimal treatment of metastatic castration-resistant prostate cancer (mCRPC) continues to be challenging, given the multitude of life prolonging treatment options. Radionuclide therapy delivers concentrated doses of radiation via ionizing particles chelated to ligands or antibody-based molecules with specific tumor targets and is approved for patients with treatment resistant mCRPC. Variations of radionuclide therapies within the continuum of prostate cancer treatment are being investigated. Landmark phase III clinical trials of beta-emitting 177Lu-PSMA radionuclide therapy have demonstrated the utility of 177Lu-PSMA in the treatment of mCRPC. Further research into alpha-emitting radionuclide therapy and vectors may provide alternative treatments for patients with treatment resistant mCRPC. As radionuclide therapy treatment options evolve, assessing appropriate patient selection for radionuclide therapy is important and may be facilitated by advances in imaging and blood-based biomarkers. Exploration of other approved life prolonging therapies in combination with radionuclide therapy has shown increasing interest as a potential method of combatting radionuclide therapy resistance. In this chapter, we review various types of radionuclide therapies for mCRPC, patient selection for radionuclide therapy from outcome predictions, ongoing clinical trials of radiopharmaceuticals for treatment of prostate cancer, and the resistance mechanisms and challenges to radionuclide therapy.

鉴于有多种延长生命的治疗方案,转移性抗性前列腺癌(mCRPC)的最佳治疗方法仍然具有挑战性。放射性核素疗法通过与具有特定肿瘤靶点的配体或抗体分子螯合的电离粒子提供集中剂量的辐射,已被批准用于治疗耐药 mCRPC 患者。目前正在对前列腺癌连续治疗过程中的各种放射性核素疗法进行研究。具有里程碑意义的β发射177Lu-PSMA放射性核素疗法III期临床试验证明了177Lu-PSMA在治疗mCRPC方面的实用性。对α-发射型放射性核素疗法和载体的进一步研究可能会为治疗耐药的mCRPC患者提供替代疗法。随着放射性核素疗法治疗方案的不断发展,评估适当的放射性核素疗法患者选择非常重要,而成像和血液生物标记物的进步可能会促进这种评估。作为消除放射性核素治疗耐药性的一种潜在方法,探索其他已获批准的延长生命疗法与放射性核素治疗的联合应用已显示出越来越大的兴趣。在本章中,我们将回顾治疗mCRPC的各类放射性核素疗法、从结果预测中选择接受放射性核素治疗的患者、正在进行的治疗前列腺癌的放射性药物临床试验,以及放射性核素疗法的耐药机制和挑战。
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引用次数: 0
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Advances in cancer research
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