攝護腺癌抗癌藥物治療指引 Men with High-Volume, ADT-naïve, Metastatic Disease (neoadjuvant or adjuvant) Docetaxel without with ADT Docetaxel 75 1 Q3W 6 1 Docetaxel 30-35 1 QW 3 Men with Symptomatic mcrpc First-line Therapy Docetaxel with/without prednisolone Docetaxel 75 1 Q3W 6 1 5 mg PO BID Docetaxel 30-35 1 QW 3 5 mg PO BID Alternative chemotherapy Mitoxantrone + Mitoxantrone 12 1 Q3W 10 2 5 mg PO BID Cabazitaxel + Cabazitaxel 20-25 1 Q3W 10 4, 5 10 mg PO QD
參考文獻 1. Http://centerformenshealth.com/center-4-mens-health/new-treatment-now-available-that-extends-life -in-men-with-highly-advanced-prostate-cancer The study results of ECOG 3805 demonstrating OS benefit with early docetaxel chemotherapy may change standard of care in patients with extensive disease metastatic prostate cancer. 2. Tannock IF, de Wit R, Berry WR, et al. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med 2004;351:1502-1512. 3. Takahiro Kojima, Toru Shimazui, Mizuki Onozawa, Sadamu Tsukamoto, Shiro Hinotsu, et al. Weekly Administration of Docetaxel in Patients with Hormonerefractory Prostate Cancer: a Pilot Study on Japanese Patients. 4. de Bono JS, Oudard S, Ozguroglu M, et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Lancet 2010;376:1147-1154. 5. Eisenberger M, Hardy-Bessard AC1, Kim CS, et al. Phase III Study Comparing a Reduced Dose of Cabazitaxel (20 mg/m 2 ) and the Currently Approved Dose (25 mg/m2) in Postdocetaxel Patients With Metastatic Castration-Resistant Prostate Cancer-PROSELICA. J Clin Oncol. 2017;35(28):3198-3206.
膀胱癌抗癌藥物治療指引 Perioperative Chemotherapy of Bladder Cancer (neoadjuvant or adjuvant) Gemcitabine + Cisplatin Gemcitabine 1000 1, 8 Q3W 4 1, 2 Cisplatin 70 1 Q3W 4 Gemcitabine 1000 1, 8 Q3W 4 1, 2 Cisplatin 35 1, 8 Q3W 4 Gemcitabine 1000 1, 8 Q3W 4 1, 2 Cisplatin 35 1, 2 Q3W 4 Gemcitabine 1000 1, 8, 15 Q4W 4 1, 2 Cisplatin 70 1 Q4W 4 CMV Methotrexate 30 1, 8 Q3W 12 3 Vinblastine 4 1, 8 Q3W 12 Cisplatin 100 2 Q3W 12 Folinic acid 15 mg Q6H 2, 9 Q3W 12 Adjuvant Intravesical Treatment BCG 81 mg 1 QW 6 4 Mitomycin 20-40 mg 1 QW 6 5-7 Doxorubicin 40 mg 1 QW 6 8 Intravesical MDP regimen Mitomycin 30 mg 1 Q3W 2 8 Doxorubicin 30 mg 8 Q3W 2 Cisplatin 30 mg 15 Q3W 2
Chemotherapy for Metastatic Disease First-line Therapy Gemcitabine + Ciaplatin Gemctabine 800-1000 1, 8 Q3W 4 2, 9 Cisplatin 50-70 2 Q3W Gemcitabine + Ciaplatin Gemctabine 800-1000 1, 8 Q3W 4 2, 9 Carboplatin 4-5 AUC 1 Q3W DDMVAC Methotrexate 30 1 or 2 Q2W 3-4 10, 11 Vinblastine 3 1 or 2 Q2W 3-4 Doxorubicin 20-30 1 or 2 Q2W 3-4 Cisplatin 50-70 1 Q2W 3-4 Methotrexate 30 1 or 2 Q2W 3-4 10, 11 Vinblastine 3 1 or 2 Q2W 3-4 Doxorubicin 20-30 1 or 2 Q2W 3-4 Carboplatin* 4-5 AUC 1 Q2W 3-4 PD-1 inhibitor (cisplatin ineligible) *For Ccr<60 ml/hr only Atezolizumab 1200 mg 1 Q3W 12 Pembrolizumab 200 mg 1 Q3W 13
Radiosensitizing Chemotherapy Regimens for Bladder-Preserving Chemoradiation Following a Maximal TURBT First-line Therapy Cisplatin + 5-FU Cisplatin 15 1-3 QW 3 15 5-FU 400 1-3 QW 3 5-FU + Motomycin C Motomycin C 12 1 14 5-FU 500 1-5, 16-20 Cisplatin + Paclitaxel Cisplatin 15 1-3 QW 3 15 Paclitaxel 50 1-3 QW 3 參考文獻 1. Dash A, Pettus JA, Herr HW, et al. A role for neoadjuvant gemcitabine plus cisplatin in muscle-invasive urothelial carcinoma of the bladder: a retrospective experience. Cancer 2008;113:2471-2477. 2. Von der Maase H, Hansen SW, Roberts JT, et al. Gemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: results of a large, randomized, multinational, multicenter, phase III study. J Clin Oncol 2000;18:3068-3077. 3. Griffiths G, Hall R, Sylvester R, et al. International phase III trial assessing neoadjuvant cisplatin, methotrexate, and vinblastine chemotherapy for muscle-invasive bladder cancer: long-term results of the BA06 30894 trial. J Clin Oncol 2011;29:2171-2177. 4. Lamm DL1, Blumenstein BA, Crissman JD, et al. Maintenance bacillus Calmette-Guerin immunotherapy for recurrent TA, T1 and carcinoma in situ transitional cell carcinoma of the bladder: a randomized Southwest Oncology Group Study. J Urol. 2000; 163: 1124-9 5. Lundholm C1, Norlén BJ, Ekman P, et al. A randomized prospective study comparing long-term intravesical instillations of mitomycin C and bacillus Calmette-Guerin in patients with superficial bladder carcinoma. J Urol. 1996; 156: 372-6 6. Solsona E, Iborra I, Ricos JV, et al: Effectiveness of a single immediate mitomycin C instillation in patients with low risk superficial bladder cancer: short and long-term followup. J Urol 1999; 161:1120-1123.
7. Witjes JA1, v d Meijden AP, Collette L, et al. Long-term follow-up of an EORTC randomized prospective trial comparing intravesical bacille Calmette-Guérin-RIVM and mitomycin C in superficial bladder cancer. EORTC GU Group and the Dutch South East Cooperative Urological Group. European Organisation for Research and Treatment of Cancer Genito-Urinary Tract Cancer Collaborative Group. Urology. 1998 ; 52: 403-10 8. Chung-Hsin Chen, Hung-Ju Yang, Chia-Tung Shun, et al. A cocktail regimen of intravesical mitomycin-c, doxorubicin, and cisplatin (MDP) for non-muscle-invasive bladder cancer. 9. Von der Maase H, Sengelov L, Roberts JT, et al. Long-term survival results of a randomized trial comparing gemcitabine plus cisplatin, with methotrexate, vinblastine, doxorubicin, plus cisplatin in patients with bladder cancer. J Clin Oncol 2005;23:4602-4608. 10. Sternberg CN, de Mulder PH, Schornagel JH, et al. Randomized phase III trial of high-dose-intensity methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) chemotherapy and recombinant human granulocyte colony-stimulating factor versus classic MVAC in advanced urothelial tract tumors: European Organization for Research and Treatment of Cancer Protocol no. 30924. J Clin Oncol 2001;19:2638-2646. 11. Sternberg CN, de Mulder P, Schornagel JH, et al. Seven year update of an EORTC phase III trial of high-dose intensity M-VAC chemotherapy and G-CSF versus classic M-VAC in advanced urothelial tract tumours. Eur J Cancer 2006;42:50-54. 12. Balar AV, Galsky MD, Rosenberg JE, et al. Atezolizumab as first-line treatment in cisplatin-ineligible patients with locally advanced and metastatic urothelial carcinoma: a single-arm, multicentre, phase 2 trial. Lancet 2017;389:67-76. 13. Balar AV, Castellano DE, O'Donnell PH, et al. Pembrolizumab as first-line therapy in cisplatin-ineligible advanced urothelial cancer: Results from the total KEYNOTE-052 study population. Clin Oncol 2017;6S:Abstract 284. 14. James ND, Hussain SA, Hall E, et al; BC2001 Investigators. Radiotherapy with or without chemotherapy in muscle-invasive bladder cancer. N Engl J Med 2012;366:1477-1488 15. Mitin T, Hunt D, Shipley W, et al. Transurethral surgery and twice-daily radiation plus paclitaxel-cisplatin or fluorouracil-cisplatin with selective bladder preservation and adjuvant chemotherapy for patients with muscle invasive bladder cancer (RTOG 0233): a randomized multicentre phase 2 trial. Lancet Oncol 2013;14:863-872.