Diethylstilboestrol for the treatment of prostate cancer: past, present and future

Abstract

The aim of this review was to discuss the most recent data from current trials of diethylstilboestrol (DES) to identify its present role in advanced prostate cancer treatment as new hormonal therapies emerge. The most relevant clinical studies using DES in castration-refractory prostate cancer (CRPC) were identified from the literature. The safety, efficacy, outcomes and mechanisms of action are summarized. In the age of chemotherapy this review highlights the efficacy of oestrogen therapy in CRPC. The optimal point in the therapeutic pathway at which DES should be prescribed remains to be established.

Prostate Cancer, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology

“…The mechanism of action of DES remains uncertain because a 1-mg dose does not render some men castrate, and DES produces responses when used in CRPC. 170 Transdermal estradiol may provide similar cancer control with fewer side effects. 171 The ongoing PATCH clinical trial demonstrated similar rates of castrate levels of testosterone, PSA response, and side effects in 85 men treated with LHRH agonist and 168 men treated with 100 mcg/24-hour estrogen patches twice weekly.…”

Consensus statements on the management of metastatic prostate cancer from the Hong Kong Urological Association and Hong Kong Society of Uro‐Oncology

“…After reviewing several major references , the panel recommended against the use of anti‐androgen monotherapy or oestrogen as first‐line treatment of castration‐naïve mPCa because, compared with ADT, inferior efficacy was observed from clinical settings.…”

Immune Relevant and Immune Deficient Mice: Options and Opportunities in Translational Research

“…For example, estrogens (and synthetic estrogens such as diethylstilbestrol) and androgens have immunosuppressive effects that affect both adaptive and innate immunity. [217][218][219][220] Nanoparticles, usually studied as a drug delivery method or biomedical imaging tool (e.g., metallic nanoparticles), are typically taken up by macrophage/monocyte cells and may act either as immunostimulants or as immunosuppressants and may have additional immune effects related to imaging methods such as MRI or μCT. 221 The unique physicochemical characteristics of nanoparticles influence their interactions with host's immune system and determine the overall immunotoxicologic profile.…”