Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press61310.17650/1726-9776-2016-12-3-87-95PROSTATE CANCERРАК ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫSecond-line hormonal therapy with the enzalutamid in patients with castrate-resistant prostate cancerГормональная терапия второй линии с применением препарата энзалутамид у больных кастрационно-резистентным раком предстательной железыAlekseevB. Ya.АлексеевБ. Я.
Russian Federation

3 2nd Botkinskiy Proezd, Moscow, 125284

Москва, 125284, 2-й Боткинский пр-д, 3 

NyushkoK. M.НюшкоК. М.
Russian Federation

3 2nd Botkinskiy Proezd, Moscow, 125284

Москва, 125284, 2-й Боткинский пр-д, 3 

KalpinskiyA. S.КалпинскийА. С.
Russian Federation

3 2nd Botkinskiy Proezd, Moscow, 125284

Москва, 125284, 2-й Боткинский пр-д, 3 

KaprinA. D.КапринА. Д.
Russian Federation

3 2nd Botkinskiy Proezd, Moscow, 125284

Москва, 125284, 2-й Боткинский пр-д, 3 

Moscow Research Oncological Institute named after P.A. Herzen – affiliated by the Federal State Budgetary Institution “National Medical Research Radiological Center”, Russian Ministry of HealthМосковский научно-исследовательский онкологический институт им. П.А. Герцена – филиал ФГБУ НМИРЦ Минздрава России3009201612387950110201601102016https://oncourology.abvpress.ru/oncur/article/view/613

Prostate cancer (PC) is an actual problem of modern oncourology due to the continuing high rates of this disease morbidity and mortality. Despite improvements in diagnostic techniques, incidence of common forms of the disease remain to be high. Metastatic castrate-resistant prostate cancer (mCRPC) is a disease with an extremely poor prognosis, in which standard methods of hormonal treatment are ineffective. Heterogeneity of CRPC patient population requires differentiated approach to the administration of therapy based on the availability of various prognostic factors. Not so long ago chemotherapy with docetaxel was the main treatment for this group of patients. Second-line hormonal therapy was introduced into clinical practice in 2011 with the advent of new drugs aimed at the complete suppression of testosterone production. Enzalutamid, a new drug for second-line hormonal therapy, has essentially different mechanism of action. It is able to block androgen receptors selectively and disrupt translocation of the signal from the receptor into the cell and into the cell nucleus. Large randomized trials that studied the effectiveness of this drug allowed to register it for clinical use, including our country. An article presents a review of the literature on clinical trials devoted to the use of a drug in CRPC patients. 

Рак предстательной железы (РПЖ) является актуальной проблемой современной онкоурологии по причине сохраняющихся высоких показателей заболеваемости и смертности от данной патологии. Несмотря на улучшение методов диагностики, частота выявления распространенных форм заболевания остается высокой. Метастатический кастрационно-резистентный РПЖ (КРРПЖ) является заболеванием с крайне неблагоприятным прогнозом, при котором стандартные методы гормонального воздействия являются неэффективными. Гетерогенность популяции больных КРРПЖ требует дифференцированного подхода при назначении терапии с учетом наличия тех или иных факторов прогноза. Не так давно химиотерапия с применением доцетаксела являлась основным методом лечения данного контингента больных. Гормональная терапия во 2-й линии введена в клиническую практику в 2011 г. с появлением новых лекарственных средств, направленных на полное подавление продукции тестостерона. Принципиально иным механизмом действия обладает новый препарат для гормональной терапии 2-й линии энзалутамид, который способен селективно блокировать андрогеновые рецепторы и нарушать транслокацию сигнала от рецептора внутрь клетки и клеточное ядро. Крупные рандомизированные исследования, изучавшие эффективность данного препарата, позволили зарегистрировать его для клинического применения, в том числе в нашей стране. В статье представлен обзор литературы, освещающий исследования по применению препарата энзалутамид у больных КРРПЖ. 

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