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\"\"<\/figure>\n\n\n\n

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\"\"<\/figure>\n\n\n\n

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\"\"<\/figure>\n\n\n\n

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\u591a\u897f\u4ed6\u8d5b\u5c5e\u4e8e\u7d2b\u6749\u7c7b\u836f\u7269\uff0c\u673a\u5236\u662f\u7a33\u5b9a\u764c\u7ec6\u80de\u5185\u7684\u5fae\u7ba1\u7ed3\u6784\u2014\u2014\u76f8\u5f53\u4e8e\u7ed9\u7ec6\u80de\u5206\u88c2\u7684\u8fc7\u7a0b\u88c5\u4e0a\u5239\u8f66\uff0c\u8ba9\u5feb\u901f\u589e\u6b96\u7684\u80bf\u7624\u7ec6\u80de\u505c\u6ede\u5728\u6709\u4e1d\u5206\u88c2\u4e2d\u8d70\u5411\u51cb\u4ea1\u30022010\u5e74\uff0c\u540c\u4e3a\u7d2b\u6749\u7c7b\u7684\u5361\u5df4\u4ed6\u8d5b<\/strong>\u83b7\u6279\uff0c\u4e3a\u591a\u897f\u4ed6\u8d5b\u8010\u836f\u540e\u7684\u60a3\u8005\u63d0\u4f9b\u4e86\u4e8c\u7ebf\u9009\u62e9<\/strong>\u3002<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

\u56fe4\uff1a\u591a\u897f\u4ed6\u8d5b\u3001\u5361\u5df4\u4ed6\u8d5b\uff08\u7d2b\u6749\u7c7b\u5316\u7597\u836f\uff09\u6cbb\u7597\u53bb\u52bf\u62b5\u6297\u524d\u5217\u817a\u764c\uff08CRPC\uff09\u7684\u4f5c\u7528\u673a\u5236[6]<\/sup>\u3002\u836f\u7269\u7ed3\u5408 \u03b2- \u5fae\u7ba1\u86cb\u767d\u7a33\u5b9a\u5fae\u7ba1\uff0c\u963b\u6ede\u80bf\u7624\u7ec6\u80de G2\/M \u7ec6\u80de\u5468\u671f\u5e76\u8bf1\u5bfc\u51cb\u4ea1\uff1b\u540c\u65f6\u53ef\u901a\u8fc7 FOXO1 \u901a\u8def\u6291\u5236 AR \u8f6c\u5f55\u6d3b\u6027\uff0c\u8fd8\u53ef\u8c03\u63a7 Bcl \u5bb6\u65cf\u86cb\u767d\u6fc0\u6d3b\u5185\u6e90\u6027\u51cb\u4ea1\uff0c\u591a\u91cd\u673a\u5236\u6291\u5236 CRPC \u7ec6\u80de\u5b58\u6d3b\u3002<\/p>\n\n\n\n

\u65f6\u81f3\u4eca\u65e5\uff0c\u7d2b\u6749\u7c7b\u5316\u7597\u4f9d\u7136\u662f\u524d\u5217\u817a\u764c\u6cbb\u7597\u7684\u57fa\u77f3\u4e4b\u4e00\uff0c\u5e76\u5df2\u524d\u79fb\u81f3\u8f6c\u79fb\u6027\u6fc0\u7d20\u654f\u611f\u9636\u6bb5\uff08mHSPC\uff09\uff0c\u4e0e ADT\u3001\u65b0\u578b\u5185\u5206\u6ccc\u836f\u7269\u8054\u5408\u4f7f\u7528\u3002\u4f46\u5316\u7597\u7684\u8f6f\u808b\u540c\u6837\u660e\u663e\uff1a\u5b83\u4e0d\u533a\u5206\u597d\u574f\u7ec6\u80de\uff0c\u9aa8\u9ad3\u6291\u5236\u3001\u795e\u7ecf\u6bd2\u6027\u3001\u8131\u53d1\u7b49\u526f\u4f5c\u7528\u9650\u5236\u4e86\u5176\u5728\u8001\u5e74\u60a3\u8005\u4e2d\u7684\u4f7f\u7528\u3002\u533b\u5b66\u9700\u8981\u66f4\u7cbe\u51c6\u7684\u6b66\u5668\u2014\u2014\u800c\u524d\u63d0\uff0c\u662f\u5148\u641e\u6e05\u695a\u4e00\u4e2a\u95ee\u9898\uff1a\u777e\u916e\u5df2\u7ecf\u88ab\u538b\u5230\u53bb\u52bf\u6c34\u5e73\uff0c\u764c\u7ec6\u80de\u5230\u5e95\u9760\u4ec0\u4e48\u6d3b\u7740\uff1f<\/strong><\/p>\n\n\n\n

\u7b2c\u4e09\u5e55\uff1a\u65b0\u578b\u5185\u5206\u6ccc\u6cbb\u7597<\/strong>\u2014\u2014\u628a\u96c4\u6fc0\u7d20\u901a\u8def\u201c\u62e7\u5230\u5e95\u201d\uff082011\u20132020\uff09<\/h5>\n\n\n\n

\u4e16\u7eaa\u4e4b\u4ea4\u7684\u5206\u5b50\u751f\u7269\u5b66\u7814\u7a76\u7ed9\u51fa\u4e86\u7b54\u6848\uff1aCRPC \u5e76\u975e \u201c\u4e0d\u4f9d\u8d56\u96c4\u6fc0\u7d20\u201d\uff0c\u800c\u662f\u96c4\u6fc0\u7d20\u53d7\u4f53\uff08AR\uff09\u901a\u8def\u88ab\u91cd\u65b0\u6fc0\u6d3b<\/strong>\u2014\u2014 \u80bf\u7624\u53ef\u901a\u8fc7\u57fa\u56e0\u6269\u589e\u3001\u4f4d\u70b9\u7a81\u53d8\u3001\u5f02\u5e38\u526a\u63a5\u3001\u7624\u5185\u6fc0\u7d20\u5408\u6210\u3001\u65c1\u8def\u4ee3\u507f\u7b49\u591a\u91cd\u91cd\u53e0\u673a\u5236\uff0c\u5728\u6781\u4f4e\u96c4\u6fc0\u7d20\u73af\u5883\u4e0b\u91cd\u542f AR \u901a\u8def\uff0c\u6700\u7ec8\u5bfc\u81f4\u6cbb\u7597\u8010\u836f\u3001\u75be\u75c5\u8fdb\u5c55[7]<\/sup>\u3002\u6362\u53e5\u8bdd\u8bf4\uff1a\u7cae\u9053\u867d\u65ad\uff0c\u764c\u7ec6\u80de\u5b66\u4f1a\u4e86\u5728\u81ea\u5df1\u8eab\u4e0a\u79cd\u7cae\u3002<\/strong><\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

\u56fe5\uff1aCRPC\u80bf\u7624AR\u901a\u8def\u518d\u6fc0\u6d3b\u7684\u516d\u5927\u6838\u5fc3\u673a\u5236\u3002<\/p>\n\n\n\n

\u7406\u89e3\u4e86\u673a\u5236\uff0c\u836f\u7269\u5c31\u987a\u7406\u6210\u7ae0\u30022011\u5e74\u8d77\uff0c\u65b0\u578b\u5185\u5206\u6ccc\u6cbb\u7597\uff08NHT\uff09<\/strong>\u65f6\u4ee3\u5f00\u542f\uff0c\u4e24\u6761\u8def\u7ebf\u5e76\u884c\uff1a<\/p>\n\n\n\n

\u258d\u4e00\u6761\u8def\u7ebf\uff1a\u91dc\u5e95\u62bd\u85aa\u3002<\/strong>\u918b\u9178\u963f\u6bd4\u7279\u9f99\uff082011 \u5e74\u83b7\u6279\uff09\u6291\u5236 CYP17 \u9176<\/strong>\u2014\u2014 \u8fd9\u662f\u96c4\u6fc0\u7d20\u5408\u6210\u7684\u9650\u901f\u9176\u3002\u53ef\u540c\u65f6\u963b\u65ad\u777e\u4e38\u3001\u80be\u4e0a\u817a\u3001\u80bf\u7624\u7ec6\u80de\u81ea\u8eab\u7684\u4e09\u6761\u96c4\u6fc0\u7d20\u5408\u6210\u901a\u8def\u3002\u4e34\u5e8a\u9700\u540c\u6b65\u8054\u7528\u7cd6\u76ae\u8d28\u6fc0\u7d20\uff0c\u62b5\u6d88 CYP17 \u6291\u5236\u5e26\u6765\u7684\u76d0\u76ae\u8d28\u6fc0\u7d20\u76f8\u5173\u4e0d\u826f\u53cd\u5e94\u3002\u5173\u952e\u8bc1\u636e\u94fe\uff1aCOU-AA-301\uff08\u5316\u7597\u540e mCRPC\uff09\u3001COU-AA-302\uff08\u5316\u7597\u524d mCRPC\uff09\u3001LATITUDE\uff08\u9ad8\u5371 mHSPC \u4e00\u7ebf\uff09\u3002<\/p>\n\n\n\n

\u258d\u53e6\u4e00\u6761\u8def\u7ebf\uff1a\u7acb\u4f53\u5c01\u9501\u3002<\/strong>\u6069\u624e\u5362\u80fa\uff082012 \u5e74\u83b7\u6279\uff09\u662f\u7b2c\u4e8c\u4ee3 AR \u62ee\u6297\u5242<\/strong>\uff0c\u5b9e\u73b0\u4e86\u5bf9 AR \u4fe1\u53f7\u7684\u4e09\u91cd\u963b\u65ad\uff1a\u963b\u6b62\u96c4\u6fc0\u7d20\u4e0e\u53d7\u4f53\u7ed3\u5408\u3001\u963b\u6b62\u53d7\u4f53\u5411\u7ec6\u80de\u6838\u8f6c\u8fd0\u3001\u963b\u6b62\u53d7\u4f53\u4e0e DNA \u7ed3\u5408\u3002\u4ece AFFIRM\uff08\u5316\u7597\u540e mCRPC\uff09\u3001PREVAIL\uff08\u5316\u7597\u524d mCRPC\uff09\u5230 PROSPER\uff08nmCRPC\uff09\u3001ARCHES \u4e0e ENZAMET\uff08mHSPC\uff09\uff0c\u6069\u624e\u5362\u80fa\u7684\u9002\u5e94\u75c7\u4e00\u8def\u524d\u79fb\uff0c\u66fe\u767b\u9876\u5168\u7403\u524d\u5217\u817a\u764c\u836f\u7269\uff0c\u5e74\u9500\u552e\u989d\u5cf0\u503c\u8d85 40 \u4ebf\u7f8e\u5143\uff0c\u582a\u79f0\u524d\u5217\u817a\u764c\u9886\u57df\u7684 \u201c\u836f\u738b\u201d\u3002<\/p>\n\n\n\n

\u968f\u540e\u7684 \u201cAR \u6291\u5236\u5242\u4e09\u5251\u5ba2\u201d \u8865\u5168\u4e86\u7248\u56fe\uff1a\u963f\u5e15\u4ed6\u80fa\uff08SPARTAN\u3001TITAN \u7814\u7a76\uff09\u3001\u8fbe\u7f57\u4ed6\u80fa<\/strong>\uff08ARAMIS \u7814\u7a76\uff1bARASENS \u7814\u7a76\u66f4\u786e\u7acb\u4e86 ADT + \u8fbe\u7f57\u4ed6\u80fa + \u591a\u897f\u4ed6\u8d5b\u7684 \u201c\u4e09\u8054\u7597\u6cd5\u201d \u5730\u4f4d\uff09\u3002<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

\u56fe6\uff1a\u65b0\u578b\u5185\u5206\u6ccc\u836f\u7269\u4f5c\u7528\u673a\u5236\u793a\u610f\u56fe[6]<\/sup>\u3002\u963f\u6bd4\u7279\u9f99\u901a\u8fc7\u6291\u5236 CYP17\uff0c\u963b\u65ad\u96c4\u6fc0\u7d20\u5408\u6210\uff1b\u6069\u624e\u5362\u80fa\u3001\u963f\u5e15\u4ed6\u80fa\u3001\u8fbe\u7f57\u4ed6\u80fa\u4f5c\u4e3a\u7b2c\u4e8c\u4ee3 AR \u62ee\u6297\u5242\uff0c\u76f4\u63a5\u7ed3\u5408\u96c4\u6fc0\u7d20\u53d7\u4f53\uff08AR\uff09\uff0c\u963b\u65ad AR \u5165\u6838\u4e0e\u57fa\u56e0\u8f6c\u5f55\uff0c\u6291\u5236 CRPC \u80bf\u7624\u589e\u6b96\u3002\u56fe\u4e2d\u540c\u65f6\u5c55\u793a AR \u526a\u63a5\u53d8\u4f53 AR-V7\uff0c\u5b83\u4e0d\u4f9d\u8d56\u914d\u4f53\u5373\u53ef\u6fc0\u6d3b\u4e0b\u6e38\u4fe1\u53f7\uff0c\u662f\u8fd9\u7c7b\u836f\u7269\u7684\u91cd\u8981\u8010\u836f\u539f\u56e0\u3002<\/p>\n\n\n\n

\u8fd9\u4e2a\u65f6\u4ee3\u6700\u91cd\u8981\u7684\u4e34\u5e8a\u54f2\u5b66\u8f6c\u53d8\u662f\uff1a\u6cbb\u7597\u7a97\u53e3\u5168\u9762\u524d\u79fb<\/strong> \u2014\u2014 \u4ece mCRPC \u5230 nmCRPC\uff0c\u518d\u5230 mHSPC\u3002\u4e09\u5927 nmCRPC \u7814\u7a76\uff08PROSPER\u3001SPARTAN\u3001ARAMIS\uff09\u5171\u540c\u8bc1\u660e\uff1a\u5728 \u201c\u5f71\u50cf\u5b66\u4e0a\u8fd8\u770b\u4e0d\u89c1\u8f6c\u79fb\u201d \u7684\u9ad8\u5371\u9636\u6bb5\u5c31\u5e72\u9884\uff0c\u53ef\u4ee5\u628a\u8f6c\u79fb\u7684\u5230\u6765\u63a8\u8fdf\u6570\u5e74\uff0c\u5e76\u8f6c\u5316\u4e3a\u603b\u751f\u5b58\u83b7\u76ca\u3002\u8d8a\u65e9\u51fa\u624b\uff0c\u8d62\u5f97\u8d8a\u591a\u3002<\/p>\n\n\n\n

\u7b2c<\/strong>\u56db\u5e55\uff1a\u7cbe\u51c6\u9776\u5411<\/strong>\u2014\u2014\u57fa\u56e0\u68c0\u6d4b\u6539\u5199\u6cbb\u7597\u89c4\u5219\uff082020\u2013\uff09<\/h5>\n\n\n\n

\u5982\u679c\u8bf4\u524d80\u5e74\u7684\u4e3b\u9898\u662f\u201c\u6309\u5206\u671f\u7528\u836f\u201d\uff0c2020\u5e74\u4e4b\u540e\uff0c\u89c4\u5219\u53d8\u6210\u4e86\u201c\u5206\u671f + \u57fa\u56e0\u5206\u578b<\/strong>\u201d\u3002<\/p>\n\n\n\n

\u8ba4\u77e5\u7684\u8d77\u70b9\u662f\u4e00\u7ec4\u6d41\u884c\u75c5\u5b66\u6570\u636e\uff1amCRPC \u80bf\u7624\u666e\u904d\u5b58\u5728\u57fa\u56e0\u7ec4\u5f02\u5e38\uff1b\u5176\u4e2d\u7ea6 20%~30% \u643a\u5e26\u540c\u6e90\u91cd\u7ec4\u4fee\u590d\uff08HRR\uff09\u81f4\u75c5\u6027\u7a81\u53d8\uff0cBRCA1\/2 \u7a81\u53d8\u6700\u4e3a\u5173\u952e \u2014\u2014 \u643a\u5e26 BRCA \u7a81\u53d8\u7684 mCRPC \u60a3\u8005\uff0c\u80bf\u7624\u7279\u5f02\u6027\u751f\u5b58\u65f6\u95f4\u7ea6\u4e3a\u975e\u7a81\u53d8\u8005\u7684\u4e00\u534a\uff08PROREPAIR-B \u7814\u7a76\uff1a17.4 \u4e2a\u6708 vs 33.2 \u4e2a\u6708\uff09[8][9]<\/sup>\u3002<\/p>\n\n\n\n

\u4f46\u7a81\u53d8\u4e5f\u53ef\u4ee5\u662f\u8f6f\u808b\u3002\u8fd9\u91cc\u9700\u8981\u89e3\u91ca\u4e00\u4e2a\u7cbe\u5999\u7684\u751f\u7269\u5b66\u6982\u5ff5\u2014\u2014\u201c\u5408\u6210\u81f4\u6b7b\u201d<\/strong>\uff1a<\/p>\n\n\n\n

\u6b63\u5e38\u7ec6\u80de\u6709\u4e24\u5957DNA\u4fee\u590d\u7cfb\u7edf\uff1aBRCA2\u86cb\u767d\u8d1f\u8d23DNA\u53cc\u94fe\u65ad\u88c2\u7684\u4fee\u590d\uff08\u5982\u540c\u4e00\u4f4d\u7cbe\u5bc6\u7684\u201c\u710a\u63a5\u5de5\u7a0b\u5e08\u201d\uff09\uff0cPARP\u9176\u8d1f\u8d23DNA\u5355\u94fe\u635f\u4f24\u7684\u4fee\u590d\uff08\u597d\u6bd4\u65e5\u5e38\u201c\u4fee\u8865\u5320\u201d\uff09\u3002BRCA\u7a81\u53d8\u7684\u764c\u7ec6\u80de\u5df2\u7ecf\u5931\u53bb\u4e86\u53cc\u94fe\u4fee\u590d\u80fd\u529b\uff0c\u5168\u9760PARP\u515c\u5e95\u2014\u2014\u6b64\u65f6\u7528PARP\u6291\u5236\u5242\u628a\u5355\u94fe\u4fee\u590d\u4e5f\u5835\u6b7b\uff0c\u4e24\u6761\u8def\u540c\u65f6\u65ad\uff0c\u764c\u7ec6\u80de\u5185\u79ef\u7d2f\u7684DNA\u635f\u4f24\u8fbe\u5230\u6781\u9650\uff0c\u53ea\u80fd\u6b7b\u4ea1\u3002\u800c\u6b63\u5e38\u7ec6\u80de\u56e0\u4e3aBRCA\u529f\u80fd\u5b8c\u597d\uff0c\u53d7\u5230\u7684\u4f24\u5bb3\u5c0f\u5f97\u591a\u3002\u8fd9\u5c31\u662f\u201c\u5408\u6210\u81f4\u6b7b\u201d\uff1a\u4e24\u4e2a\u5355\u72ec\u4e0d\u81f4\u547d\u7684\u7f3a\u9677\uff0c\u7ec4\u5408\u5728\u4e00\u8d77\u5c31\u662f\u7edd\u8def<\/strong>[6]<\/strong><\/sup>\u3002<\/strong><\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

\u56fe7\uff1aPARP \u6291\u5236\u5242\u6cbb\u7597\u53bb\u52bf\u62b5\u6297\u6027\u524d\u5217\u817a\u764c\u7684\u5408\u6210\u81f4\u6b7b\u673a\u5236\u3002<\/p>\n\n\n\n

2020\u5e74\uff0c\u5965\u62c9\u5e15\u5229<\/strong>\u7684PROfound<\/strong>\u7814\u7a76\u767b\u4e0a\u300a\u65b0\u82f1\u683c\u5170\u533b\u5b66\u6742\u5fd7\u300b\u2014\u2014\u8fd9\u662f\u9996\u4e2a\u57fa\u4e8e\u751f\u7269\u6807\u5fd7\u7269\u5206\u578b\u53d6\u5f97\u6210\u529f\u7684\u524d\u5217\u817a\u764cIII\u671f<\/strong>\u8bd5\u9a8c<\/strong>[8][9]<\/sup>\u3002\u7ed3\u679c\uff1a<\/p>\n\n\n\n

    \n
  • BRCA\u7a81\u53d8\u4e9a\u7ec4\uff1a\u5f71\u50cf\u5b66\u65e0\u8fdb\u5c55\u751f\u5b58\u671f\uff08rPFS\uff099.8\u4e2a\u6708 vs 3.0\u4e2a\u6708<\/strong>\uff08HR 0.22\uff09\uff0c\u603b\u751f\u5b58\u671f20.1\u4e2a\u6708 vs 14.4\u4e2a\u6708<\/strong>\uff1b<\/li>\n\n\n\n
  • \u5965\u62c9\u5e15\u5229\u7ec4\u5ba2\u89c2\u7f13\u89e3\u738743.9%\uff0c\u5bf9\u7167\u7ec4\u51e0\u4e4e\u65e0\u7f13\u89e3[9]<\/sup>\u3002<\/li>\n<\/ul>\n\n\n\n

    \u968f\u540e\u7684PROpel<\/strong>\u7814\u7a76\u8fdb\u4e00\u6b65\u8bc1\u660e\uff0c\u5965\u62c9\u5e15\u5229\u8054\u5408\u963f\u6bd4\u7279\u9f99\u4e00\u7ebf\u6cbb\u7597\uff08\u4e0d\u9650HRR\u72b6\u6001\uff09\u4e5f\u80fd\u5e26\u6765\u5168\u4eba\u7fa4\u83b7\u76ca\uff08rPFS 24.8 vs 16.6\u4e2a\u6708\uff09[10]<\/sup>\u3002\u201c\u5408\u6210\u81f4\u6b7b\u201d\u7684\u7406\u5ff5\uff0c\u4eceBRCA\u7a81\u53d8\u4eba\u7fa4\u6269\u5c55\u5230\u4e86\u66f4\u5e7f\u6cdb\u7684\u8054\u5408\u6cbb\u7597\u7b56\u7565\u3002<\/p>\n\n\n\n

    \u540c\u671f\u7684\u514d\u75ab\u6cbb\u7597\u5219\u7ed9\u4e86\u4e00\u8bb0\u63d0\u9192\uff1a\u5e15\u535a\u5229\u73e0\u5355\u6297<\/strong>\u4ec5\u5728MSI-H\/dMMR<\/strong>\u7b49\u6781\u5c0f\u4f17\u4eba\u7fa4\u4e2d\u83b7\u6279\u2014\u2014\u524d\u5217\u817a\u764c\u6574\u4f53\u4e0a\u4ecd\u662f\u514d\u75ab\u201c\u51b7\u80bf\u7624\u201d\uff08\u65e9\u57282010\u5e74\uff0c\u5168\u7403\u9996\u4e2a\u6cbb\u7597\u6027\u80bf\u7624\u75ab\u82d7Sipuleucel-T\u5c31\u8bde\u751f\u4e8e\u8fd9\u4e2a\u7624\u79cd\uff0c\u4f46\u540e\u7eed\u514d\u75ab\u7a81\u7834\u6709\u9650\uff09[11]<\/sup>\u3002\u8fd9\u6070\u6070\u53cd\u886c\u51fa\uff1a\u5728\u8fd9\u4e2a\u7624\u79cd\uff0c\u7cbe\u51c6\u7684\u9776\u70b9\u6bd4\u70ed\u95f9\u7684\u8d5b\u9053\u66f4\u91cd\u8981\u3002\u81ea\u6b64\uff0c\u57fa\u56e0\u68c0\u6d4b\uff08\u80da\u7cfb+\u4f53\u7ec6\u80deHRR\u68c0\u6d4b\uff09\u6210\u4e3a\u665a\u671f\u524d\u5217\u817a\u764c\u7684\u6807\u51c6\u8bca\u7597\u6d41\u7a0b\u3002\u6cbb\u7597\u51b3\u7b56\u7b2c\u4e00\u6b21\u7531\u201c\u80bf\u7624\u7684\u57fa\u56e0\u201d\u8bf4\u4e86\u7b97\u3002<\/p>\n\n\n\n

    \u7b2c\u4e94\u5e55\uff1a\u6838\u7d20\u6cbb\u7597<\/strong>\u2014\u2014\u201c\u7cbe\u51c6\u7206\u7834\u201d\u65f6\u4ee3\uff082013\u20132026\uff09<\/h5>\n\n\n\n

    \u5c06\u8fd180\u5e74\u7684\u836f\u7269\u8fdb\u5316\u8d70\u5230\u8fd9\u91cc\uff0c\u51fa\u73b0\u4e86\u4e00\u4e2a\u5168\u65b0\u7684\u601d\u8def\uff1a\u65e2\u7136\u5c0f\u5206\u5b50\u548c\u6297\u4f53\u5df2\u7ecf\u5982\u6b64\u7cbe\u51c6\uff0c\u80fd\u4e0d\u80fd\u628a\u201c\u653e\u5c04\u7ebf\u201d\u4e5f\u7cbe\u786e\u5730\u9001\u5230\u6bcf\u4e00\u4e2a\u764c\u7ec6\u80de\uff1f<\/p>\n\n\n\n

    \u524d\u5217\u817a\u764c\u6070\u597d\u63d0\u4f9b\u4e86\u4e00\u4e2a\u8fd1\u4e4e\u5b8c\u7f8e\u7684\u9776\u70b9\uff1aPSMA\uff08\u524d\u5217\u817a\u7279\u5f02\u6027\u819c\u6297\u539f\uff09<\/strong>\u2014\u2014\u4e00\u79cd\u572880%\u4ee5\u4e0a\u524d\u5217\u817a\u764c\u75c5\u7076\u4e2d\u9ad8\u5ea6\u8868\u8fbe\u7684\u8de8\u819c\u86cb\u767d\u3002<\/p>\n\n\n\n

    \u5148\u58f0\u662f\u956d-223<\/strong>\uff082013\u5e74\u83b7\u6279\uff09\uff1a\u8fd9\u79cd\u653e\u5c04\u6027\u540c\u4f4d\u7d20\u6a21\u62df\u9499\u79bb\u5b50\uff0c\u9009\u62e9\u6027\u5730\u6c89\u79ef\u5728\u9aa8\u8f6c\u79fb\u7076\u91ca\u653e\u03b1\u5c04\u7ebf\uff0c\u6210\u4e3a\u9996\u4e2a\u5ef6\u957fmCRPC\u9aa8\u8f6c\u79fb\u60a3\u8005\u751f\u5b58\u7684\u653e\u5c04\u6027\u836f\u7269\u3002<\/p>\n\n\n\n

    \u771f\u6b63\u7684\u8303\u5f0f\u786e\u7acb\u8005\u662f\u8bfa\u534e\u7684\u9565[177Lu]-PSMA<\/strong>\uff08Pluvicto\uff0c\u56fd\u5185\u5546\u54c1\u540d\u201c\u6d3e\u5a01\u59a5\u201d\uff09\uff1a\u5c06\u9ad8\u4eb2\u548c\u529bPSMA\u914d\u4f53\u4e0e\u53d1\u5c04\u03b2\u7c92\u5b50\u7684\u9565-177\u5076\u8054\u3002\u836f\u7269\u5165\u8840\u540e\u50cf\u5bfc\u5f39\u4e00\u6837\u9501\u5b9a\u5168\u8eab\u8868\u8fbePSMA\u7684\u75c5\u7076\uff0c\u5185\u541e\u8fdb\u5165\u7ec6\u80de\u540e\uff0c\u9565-177\u91ca\u653e\u7684\u03b2\u5c04\u7ebf\uff08\u6700\u5927\u7ec4\u7ec7\u4e2d\u5c04\u7a0b\u7ea62mm\uff09\u6253\u65adDNA\u53cc\u94fe\uff0c\u6740\u6b7b\u764c\u7ec6\u80de\u3002\u7531\u4e8e\u5c04\u7ebf\u5c04\u7a0b\u6781\u77ed\uff0c\u5468\u56f4\u6b63\u5e38\u7ec4\u7ec7\u4f24\u5bb3\u6709\u9650\uff1b\u800c2mm\u7684\u5c04\u7a0b\u8fd8\u80fd\u5f62\u6210\u201c\u4ea4\u53c9\u706b\u529b\u201d\uff0c\u8fde\u4e0d\u8868\u8fbePSMA\u7684\u90bb\u8fd1\u764c\u7ec6\u80de\u4e00\u5e76\u6740\u4f24\u2014\u2014\u5de7\u5999\u5e94\u5bf9\u4e86\u80bf\u7624\u7684\u5f02\u8d28\u6027[12]<\/sup>\u3002<\/p>\n\n\n\n

    \"\"<\/figure>\n\n\n\n

    \u56fe8\uff1aFDA \u6279\u51c6\u7684\u53bb\u52bf\u62b5\u6297\u6027\u524d\u5217\u817a\u764c\uff08CRPC\uff09\u6cbb\u7597\u673a\u5236\uff1a\u9776\u5411\u6838\u836f\u4e0e\u514d\u75ab\u6cbb\u7597\u3002<\/p>\n\n\n\n

    \u5173\u952e\u8bc1\u636e\u6765\u81eaVISION<\/strong> III\u671f\u7814\u7a76\uff08\u7ecfAR\u6291\u5236\u5242\u548c\u7d2b\u6749\u7c7b\u5316\u7597\u540e\u8fdb\u5c55\u7684PSMA\u9633\u6027mCRPC\uff09[12]<\/sup>\uff1a<\/p>\n\n\n\n

      \n
    • \u603b\u751f\u5b58\u671f15.3\u4e2a\u6708 vs 11.3\u4e2a\u6708<\/strong>\uff0c\u6b7b\u4ea1\u98ce\u9669\u964d\u4f4e38%\uff1b<\/li>\n\n\n\n
    • \u5ba2\u89c2\u7f13\u89e3\u738730% vs 2%<\/strong>\u3002:<\/li>\n<\/ul>\n\n\n\n

      \u6cbb\u7597\u524d\u768468Ga-PSMA PET\u663e\u50cf\u5219\u6784\u6210\u201c\u4f34\u968f\u8bca\u65ad\u201d\u2014\u2014\u5148\u770b\u6e05\u75c5\u7076\u662f\u5426\u8868\u8fbePSMA\uff0c\u518d\u51b3\u5b9a\u662f\u5426\u7528\u836f\uff0c\u5f62\u6210\u8bca\u7597\u4e00\u4f53\u5316\u95ed\u73af<\/strong>\u3002\u8fd9\u5728\u5168\u7403\u80bf\u7624\u836f\u7269\u5f00\u53d1\u4e2d\u90fd\u662f\u6837\u677f\u7ea7\u7684\u8303\u5f0f\u3002<\/p>\n\n\n\n

      \u5546\u4e1a\u6570\u636e\u540c\u6837\u5370\u8bc1\u4e86\u4e34\u5e8a\u4ef7\u503c\uff1aPluvicto\u4e0a\u5e02\u9996\u5e74\u9500\u552e2.8\u4ebf\u7f8e\u5143\uff0c2025\u5e74\u5df2\u8fbe19.94\u4ebf\u7f8e\u5143\uff0c\u8fde\u7eed\u4e09\u5e74\u589e\u901f\u8d8540%\uff0c\u662f\u9996\u4e2a\u7a81\u783410\u4ebf\u7f8e\u5143\u5927\u5173\u7684\u6838\u836f\u54c1\u79cd\u30022026\u5e748\u6708\uff0c\u5b83\u5728\u4e2d\u56fd\u83b7\u6279\u7b2c\u4e09\u9879\u9002\u5e94\u75c7\u2014\u2014\u8054\u5408\u96c4\u6fc0\u7d20\u53d7\u4f53\u901a\u8def\u6291\u5236\u5242\u6cbb\u7597PSMA\u9633\u6027\u8f6c\u79fb\u6027\u6fc0\u7d20\u654f\u611f\u6027\u524d\u5217\u817a\u764c\uff08\u57fa\u4e8ePSMAddition\u7814\u7a76\uff1a\u5f71\u50cf\u5b66\u8fdb\u5c55\u6216\u6b7b\u4ea1\u98ce\u9669\u964d\u4f4e33%\uff09\uff0c\u6cbb\u7597\u7a97\u53e3\u518d\u6b21\u524d\u79fb\u3002<\/p>\n\n\n\n

      \u4ece\u201c\u7cfb\u7edf\u7ed9\u836f\u7684\u6740\u4f24\u201d\u5230\u201c\u5206\u5b50\u6c34\u5e73\u7684\u5b9a\u5411\u7206\u7834\u201d\uff0c80\u5e74\u7684\u8fdb\u5316\u62b5\u8fbe\u4e86\u65b0\u7684\u9ad8\u5ea6\u3002<\/p>\n\n\n\n

      \u5c3e\u58f0\uff1a\u4e2d\u56fd\u529b\u91cf\u4e0e\u4e0b\u4e00\u4ee3\u6280\u672f\uff08\u8fdb\u884c\u65f6\uff09<\/strong><\/h5>\n\n\n\n

      \u8fd9\u6bb5\u5386\u53f2\u8fd8\u5728\u52a0\u901f\u4e66\u5199\uff0c\u800c\u4e2d\u56fd\u6b63\u4ece\u65c1\u89c2\u8005\u53d8\u4e3a\u53c2\u4e0e\u8005\u3002<\/p>\n\n\n\n

      \u6052\u745e\u533b\u836f\u81ea\u4e3b\u7814\u53d1\u7684\u7b2c\u4e8c\u4ee3AR\u6291\u5236\u5242\u745e\u7ef4\u9c81\u80fa<\/strong>\uff0c\u51ed\u501fCHART\u7814\u7a76\uff08\u4e2d\u56fd\u60a3\u8005\u5360\u6bd4\u8d8590%\uff09\u2014\u2014\u4e0e\u6807\u51c6\u6cbb\u7597\u76f8\u6bd4\uff0c\u6b7b\u4ea1\u98ce\u9669\u964d\u4f4e42%\u3001\u75be\u75c5\u8fdb\u5c55\u98ce\u9669\u964d\u4f4e54%\u2014\u2014\u4e8e2026 \u7248 EAU \u524d\u5217\u817a\u764c\u6307\u5357\u5c06\u745e\u7ef4\u9c81\u80fa\u5217\u5165\u9ad8\u7624\u8d1f\u8377 mHSPC \u4e00\u7ebf\u53ef\u9009\u63a8\u8350\uff08ADT \u8054\u5408\uff09<\/strong>\uff0c\u5e76\u5df2\u5728\u6b27\u76df\u7533\u62a5\u4e0a\u5e02\u3002\u8fd9\u662f\u4e2d\u56fd\u539f\u7814\u524d\u5217\u817a\u764c\u836f\u7269\u9996\u6b21\u6df1\u5ea6\u53c2\u4e0e\u5168\u7403\u6cbb\u7597\u6807\u51c6\u7684\u6784\u5efa\u3002\u6d77\u521b\u836f\u4e1a\u7684\u6c18\u4ee3\u836f\u7269\u5fb7\u6069\u9c81\u80fa\u3001\u5f00\u62d3\u836f\u4e1a\u7684\u666e\u514b\u9c81\u80fa\uff0c\u4e5f\u5728\u5404\u81ea\u7684\u8d5b\u9053\u63a8\u8fdb\u3002<\/p>\n\n\n\n

      \u66f4\u8fdc\u5904\uff0c\u4e0b\u4e00\u4ee3\u6280\u672f\u5df2\u7ecf\u9732\u5934\uff1a<\/p>\n\n\n\n

        \n
      • AR PROTAC\u86cb\u767d\u964d\u89e3\u5242<\/strong>\uff1a\u4e0d\u518d\u201c\u5360\u4f4d\u6291\u5236\u201d\u96c4\u6fc0\u7d20\u53d7\u4f53\uff0c\u800c\u662f\u7ed9\u53d7\u4f53\u6253\u4e0a\u201c\u9500\u6bc1\u6807\u7b7e\u201d\uff0c\u8ba9\u7ec6\u80de\u7684\u86cb\u767d\u9176\u4f53\u628a\u81f4\u764c\u86cb\u767d\u5f7b\u5e95\u5206\u89e3\u2014\u2014\u7518\u674e\u836f\u4e1a\u7684GLR2037\u5df2\u8fdb\u5165I\u671f\u4e34\u5e8a\uff1b<\/li>\n\n\n\n
      • RIPTAC\u5168\u65b0\u673a\u5236<\/strong>\uff1a\u4e0d\u964d\u89e3\u4e5f\u4e0d\u62ee\u6297 AR\uff0c\u800c\u662f \u201c\u7ed1\u67b6\u201d \u53e6\u4e00\u4e2a\u80bf\u7624\u751f\u5b58\u5fc5\u9700\u86cb\u767d\u5f62\u6210\u81f4\u6b7b\u590d\u5408\u7269 \u2014\u2014 \u5f3a\u751f\u6536\u8d2d Halda \u83b7\u5f97\u7684 HLD-0915\uff0c\u76f8\u5173\u6570\u636e\u767b\u9646 ESMO 2026 \u5e74\u4f1a\uff1b<\/li>\n\n\n\n
      • PSMA\u9776\u5411ADC\u3001\u53cc\u7279\u5f02\u6027\u6297\u4f53<\/strong>\u7b49\u65b0\u5206\u5b50\u5f62\u6001\uff0c\u4e5f\u5728\u5bc6\u96c6\u63a8\u8fdb\u3002<\/li>\n<\/ul>\n\n\n\n

        \u56de\u671b\u8fd980\u4f59\u5e74\uff1a\u4ece\u5207\u6389\u777e\u4e38\u5230\u4fee\u9970\u53d7\u4f53\uff0c\u4ece\u201c\u6328\u997f\u201d\u5230\u201c\u7206\u7834\u201d\uff0c\u4ece\u6309\u5206\u671f\u7528\u836f\u5230\u6309\u57fa\u56e0\u9009\u836f\u2014\u2014\u6bcf\u4e00\u6b21\u6b66\u5668\u7684\u5347\u7ea7\uff0c\u80cc\u540e\u90fd\u662f\u4e00\u6b21\u8ba4\u77e5\u7684\u5347\u7ea7\u3002<\/strong>\u524d\u5217\u817a\u764c\u836f\u7269\u8fdb\u5316\u53f2\u7684\u672c\u8d28\uff0c\u662f\u4e00\u90e8\u4eba\u7c7b\u4e0d\u65ad\u52a0\u6df1\u5bf9\u80bf\u7624\u751f\u7269\u5b66\u7406\u89e3\u7684\u5386\u53f2\u3002\u800c\u4e0b\u4e00\u4e2a80\u5e74\uff0c\u624d\u521a\u521a\u5f00\u59cb\u3002<\/p>\n\n\n\n

        \u9644\uff1a\u524d\u5217\u817a\u764c\u516d\u5927\u7c7b\u836f\u7269<\/strong>\u6c47\u603b<\/strong>\u8868<\/strong><\/h5>\n\n\n\n
        \u7c7b\u522b<\/strong><\/td>\u4ee3\u8868\u836f\u7269<\/strong><\/td>\u4e3b\u8981\u9002\u7528\u9636\u6bb5<\/strong><\/td>\u4ee3\u8868\u6027III\u671f\u8bd5\u9a8c<\/strong><\/td><\/tr>
        \u4f20\u7edf\u5185\u5206\u6ccc\uff08ADT\uff09<\/td>\u6208\u820d\u745e\u6797\u3001\u4eae\u4e19\u745e\u6797\u3001\u5730\u52a0\u745e\u514b<\/td>\u5404\u9636\u6bb5\u57fa\u77f3<\/td>CHAARTED\u3001CS21\u7b49<\/td><\/tr>
        \u5316\u7597<\/td>\u591a\u897f\u4ed6\u8d5b\u3001\u5361\u5df4\u4ed6\u8d5b<\/td>mCRPC\u3001\u9ad8\u7624\u8d1f\u8377mHSPC\u8054\u5408\u65b9\u6848<\/td>TAX327\u3001SWOG9916\u3001ARASENS<\/td><\/tr>
        \u65b0\u578b\u5185\u5206\u6ccc\uff08NHT\uff09<\/td>\u6069\u624e\u5362\u80fa\u3001\u963f\u6bd4\u7279\u9f99\u3001\u963f\u5e15\u4ed6\u80fa\u3001\u8fbe\u7f57\u4ed6\u80fa\u3001\u745e\u7ef4\u9c81\u80fa<\/td>mHSPC \/ nmCRPC \/ mCRPC<\/td>PREVAIL\u3001COU-AA-301\u3001SPARTAN\u3001ARAMIS\u3001CHART\u7b49<\/td><\/tr>
        PARP\u6291\u5236\u5242<\/td>\u5965\u62c9\u5e15\u5229\u3001\u5362\u5361\u5e15\u5229<\/td>HRR\/BRCA\u7a81\u53d8mCRPC<\/td>PROfound\u3001PROpel<\/td><\/tr>
        \u653e\u5c04\u6027\u6838\u7d20<\/td>\u956d-223\u3001\u9565[177<\/sup>Lu]-PSMA<\/td>\u956d – 223\uff1amCRPC \u4f34\u9aa8\u8f6c\u79fb\uff1b\u9565 [\u00b9\u2077\u2077Lu]-PSMA\uff1aPSMA \u9633\u6027 mCRPC\u3001mHSPC<\/td>ALSYMPCA\u3001VISION\u3001PSMAddition<\/td><\/tr>
        \u514d\u75ab\u4e0e\u9aa8\u9776\u5411<\/td>Sipuleucel-T\u3001\u5e15\u535a\u5229\u73e0\u5355\u6297\u3001\u5730\u8212\u5355\u6297<\/td>\u7279\u5b9a\u4eba\u7fa4<\/td>IMPACT\u3001KEYNOTE-199\u7b49<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

        \u6e29\u99a8\u63d0\u793a\uff1a\u672c\u6587\u4ec5\u4e3a\u75be\u75c5\u77e5\u8bc6\u79d1\u666e\uff0c\u4e0d\u6784\u6210\u4efb\u4f55\u7528\u836f\u5efa\u8bae\u3002\u5177\u4f53\u8bca\u7597\u65b9\u6848\u8bf7\u52a1\u5fc5\u54a8\u8be2\u4e3b\u6cbb\u533b\u751f\uff0c\u5e76\u4ee5NCCN\u3001EAU\u3001CSCO\u6700\u65b0\u7248\u6307\u5357\u4e3a\u51c6\u3002<\/em><\/p>\n\n\n\n

        \u53c2\u8003\u6587\u732e<\/strong><\/h5>\n\n\n\n
          \n
        1. Huggins C, Hodges CV. Studies on prostatic cancer: I. The effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate. Cancer Res. 1941;1:293-297.<\/li>\n\n\n\n
        2. Lehtonen M, Kellokumpu-Lehtinen P-L. The past and present of prostate cancer and its treatment and diagnostics: A historical review[J\/OL]. Sage Open Medicine, 2023.<\/li>\n\n\n\n
        3. \u53f6\u5b9a\u4f1f\uff0c\u7b49\u3002\u524d\u5217\u817a\u764c\u777e\u916e\u7ba1\u7406\u4e2d\u56fd\u4e13\u5bb6\u5171\u8bc6 (2026 \u7248)[J]. \u4e2d\u534e\u80bf\u7624\u6742\u5fd7\uff0c2026.<\/li>\n\n\n\n
        4. Mottet N, Omlin A. Considerations for the use of gonadotropin-releasing hormone agonists and antagonists in patients with prostate cancer. International Journal of Urology, 2020, 27(9):768\u2013777. DOI\uff1a10.1111\/iju.14303.<\/li>\n\n\n\n
        5. Heinlein CA, Chang C. Androgen receptor in prostate cancer. Endocr Rev. 2004;25(2):276-308.<\/li>\n\n\n\n
        6. Rahman, M.; Akter, K.; Ahmed, K.R.; Fahim, M.M.H.; Aktary, N.; Park, M.N.; Shin, S.-W.; Kim, B. Synergistic Strategies for Castration-Resistant Prostate Cancer: Targeting AR-V7, Exploring Natural Compounds, and Optimizing FDA-Approved Therapies. Cancers 2024, 16, 2777.<\/li>\n\n\n\n
        7. Guo J, Wu K, Ma Z, Guo S, Wang F and Lu L (2026) Androgen receptor reactivation in castration-resistant prostate cancer: mechanisms, epigenetic adaptation, and therapeutic vulnerabilities. Front. Oncol. 16:1837998. doi: 10.3389\/fonc.2026.1837998.<\/li>\n\n\n\n
        8. Maslov DV, Sember Q, Cham J and Bhangoo M (2023) A review of treatments targeting DNA-repair gene defects in metastatic castration resistant prostate cancer. Front. Oncol. 13:1150777. doi: 10.3389\/fonc.2023.1150777.<\/li>\n\n\n\n
        9. Saad F, Armstrong AJ, Shore N, George DJ, Oya M, Sugimoto M, McKay RR, Hussain M, Clarke NW. Olaparib Monotherapy or in Combination with Abiraterone for the Treatment of Patients with Metastatic Castration-Resistant Prostate Cancer (mCRPC) and a BRCA Mutation. Target Oncol. 2025 May;20(3):445-466. doi: 10.1007\/s11523-025-01146-4. Epub 2025 May 21. PMID: 40397306; PMCID: PMC12106333.<\/li>\n\n\n\n
        10. Clarke N, et al. Olaparib plus abiraterone versus placebo plus abiraterone in metastatic castration-resistant prostate cancer (PROpel): final prespecified overall survival results of a randomised, double-blind, phase 3 trial[J]. Lancet Oncol,2023,24(10):1149-1161.<\/li>\n\n\n\n
        11. Kantoff P W, et al. Sipuleucel-T immunotherapy for castration-resistant prostate cancer [J]. N Engl J Med, 2010,363 (5):411-422.<\/li>\n\n\n\n
        12. Sartor O, et al. Lutetium-177-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer[J]. N Engl J Med,2021,385(11):1091-1103.<\/li>\n<\/ol>\n\n\n\n

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          \u64b0\u6587\uff1a\u79e6\u96e8<\/p>\n\n\n\n

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