Importance of continued testicular suppression in hormone-refractory prostate cancer.

Taylor, Catherine; Elson, Paul; Trump, Donald L.

doi:10.1200/jco.1993.11.11.2167

Cited by 181 publications

(88 citation statements)

References 27 publications

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“…Treatment options for metastatic Hormone Refractory Prostate Cancer (MHRPC) include second-line hormone manipulations, palliative chemotherapy, bisphosphonates, radio-isotopes, or best supportive care. The role of continued androgen suppression following diagnosis of MHRPC is controversial, although there is evidence suggestive of a moderate survival benefit for this approach (2). Options for hormonal manipulations include the addition of anti-androgens, followed by withdrawal, corticosteroids or oestrogen.…”

Section: Introductionmentioning

confidence: 99%

Docetaxel chemotherapy for metastatic hormone refractory prostate cancer as first-line palliative chemotherapy and subsequent re-treatment: Birmingham experience

Ansari¹

1994

Oncol Rep

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Abstract. Three-weekly docetaxel chemotherapy with prednisolone is now considered standard of care for patients with metastatic hormone refractory prostate cancer (MHRPC). This study reports the efficacy and toxicity of first-line docetaxel chemotherapy followed subsequently by re-treatment on biochemical disease progression (BDP). Forty-two patients with MHRPC were treated with three-weekly docetaxel chemotherapy 75 mg/m 2 and 10 mg of prednisolone daily. Median age 73 years (range 58-87) and median initial PSA 182 ng/ml (range 19.9-1500). Of these patients, 10 were re-treated with the same regimen (second-line chemotherapy) on BDP. A further 3 out of these 10 patients received 2nd re-treatment (third-line chemotherapy) with docetaxel chemotherapy on BDP. Fifty-four percent of patients responded to first-line docetaxel chemotherapy and all re-treated patients responded again with a PSA reduction >50%. Median treatment-free interval prior to second and third-line chemotherapy was 24 and 26 weeks, respectively. Grade 3 or 4 neutropenia occurred in 2.5, 7 and 12% of the total number of cycles in patients receiving first-, second-and third-line docetaxel chemotherapy, respectively. Median survival was 13 months (range 3-35) and one-year overall survival 52%. This is the first report of three-weekly docetaxel chemotherapy re-treatment in patients with MHRPC and demonstrates that patients who initially respond to docetaxel chemotherapy maintain their sensitivity to subsequent retreatment without a significant rise in haematological toxicity.

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Section: Introductionmentioning

confidence: 99%

Docetaxel chemotherapy for metastatic hormone refractory prostate cancer as first-line palliative chemotherapy and subsequent re-treatment: Birmingham experience

Ansari¹

1994

Oncol Rep

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“…Continuing maximal testicular androgen suppression is debatable in this situation (9). These data have been argued by 2 studies that established only a survival advantage in patients continuing GnRH analogues during second-and third-line therapies in case of failure (10,11). The modest potential benefits of a continuing castration outweigh the minimal risk of treatment despite lack of prospective data in the literature.…”

Section: Discussionmentioning

confidence: 89%

Medical management in locally advanced and metastatic prostate cancer: Does changes in treatment policy have any specific effect on PSA levels?

Bağcıoğlu

Surcel

Özcan

et al. 2017

Arch Ital Urol Androl

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Objective: Androgen deprivation therapy (ADT) is commonly used as a first-line treatment for locally advanced and metastatic prostatic cancer (Pca). There is no consensus about which alternative treatment should be used after the failure of initial ADT. We aimed to investigate the effect of changes in treatment on PSA and testosterone levels. Material and methods: A total of 120 patients with an established diagnosis of either locally advanced or metastatic Pca in two different centers. Depending on the type of medical and/or surgical management protocol planned at initial presentation, all cases were divided into three main groups as follows. Group 1 (n: 80) included the patients who underwent medical management during whole follow-up period in whom the initial management protocol was later on switched to another medical treatment with different agents, Group 2 (n: 20) included patients who were initially treated with a medical management protocol and switched to surgical castration during follow-up evaluation and lastly Group 3 (n: 20) included the patients undergoing treated surgical castration as initial treatment modality without any further medical management protocol. Results: Evaluation of our data did clearly demonstrate a statistically significant difference between the initial and final PSA as well as testosterone levels in Group 1 cases. Mean PSA and testosterone levels increased significantly in these cases despite a change in hormonal therapy by using another agent for androgen deprivation. Cases in Group 2 and 3 cases did not show any statistically significant difference with respect to the mean PSA as well as testosterone values during the same follow-up period. Conclusions: Our data clearly indicated that in case of a biochemical progression, switching into another alternative medical treatment was not effective enough in limiting the rising PSA levels in a statistically significant manner when compared with the approaches of switching to surgical castration after initial medical treatment or continuing with regular and close follow-up after initial surgical castration alone.

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“…Az LH RH agonisták és antagonisták alkalmazása a betegség mindkét szakaszában szükséges, mivel retrospektív vizsgálatok alapján ezzel megnövelhető a betegek túlélése [14].…”

Section: Lh Rh Antagonistaunclassified

Androgénreceptor mediálta folyamatok metasztatikus kasztrációrezisztens prosztatadaganatban

et al. 2017

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A metasztatikus kasztrációrezisztens prosztatadaganat kezelésében az elmúlt hat évben öt új hatóanyag került törzs-könyvezésre. E szerek szekvenciális alkalmazásával ebben a továbbra is gyógyíthatatlan betegségben jelentős túlélést lehet elérni, jó életminőség mellett. Az elmúlt évtized kutatásainak köszönhetően, egyértelművé vált, hogy a betegség progressziójának középpontjában az androgénreceptor mediálta folyamatok állnak. Az androgénreceptort érintő hormonális mechanizmusok a betegség késői stádiumáig funkcióképesek maradhatnak. Ezeknek a mechanizmusoknak még pontosabb megismerése vezetett a nómenklatúra megváltoztatásához, az új endokrin terápiák bevezetésé-hez. Az új terápiák során jelentkező primer, illetve szekunder rezisztencia hátterében álló androgénreceptor-mutációk identifikálása, remodellezése újabb, még hatékonyabb androgénreceptor-gátló kezelésekhez nyithat utat. A szerzők ismertetik az androgénreceptorszignál-tengely patofiziológiáját, receptoriális szinten bemutatják a már engedélyezett gyógyszereket, valamint felhívják a figyelmet a legígéretesebbnek tűnő fejlesztésekre is. Orv. Hetil., 2017, 158(2), 42-49.Kulcsszavak: kasztrációrezisztens prosztatadaganat, androgénreceptor, abirateron, enzalutamid, ARV7, galeteron Androgen receptor-mediated processes in castrate-resistant metastatic prostate cancerIn the past six years, five new drugs have been approved by the FDA for the treatment of metastatic castrate-resistant prostate cancer. While the disease itself still remains incurable, the sequential use of these drugs can significantly prolong survival while maintaining good quality of life. Research from the past decade made it clear that androgen receptor-mediated processes play a central part in the progression of the disease. Hormonal mechanisms related to androgen-receptors can remain active until late stages of the disease. A deeper understanding of these mechanisms has led to the introduction of new endocrine therapies, which resulted in a change of the nomenclature. The identification and remodelling of androgen receptor mutations that are responsible for primary and secondary resistance developing during the new therapies can pave the way to new and more efficient androgen receptor inhibitor treatments. The aim of the review is to present the pathophysiology of the androgen receptor signaling axis at the receptor level, to review FDA-approved drugs and to draw attention to the most promising developments in the treatment of this disease.

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Importance of continued testicular suppression in hormone-refractory prostate cancer.

Cited by 181 publications

References 27 publications

Docetaxel chemotherapy for metastatic hormone refractory prostate cancer as first-line palliative chemotherapy and subsequent re-treatment: Birmingham experience

Docetaxel chemotherapy for metastatic hormone refractory prostate cancer as first-line palliative chemotherapy and subsequent re-treatment: Birmingham experience

Medical management in locally advanced and metastatic prostate cancer: Does changes in treatment policy have any specific effect on PSA levels?

Androgénreceptor mediálta folyamatok metasztatikus kasztrációrezisztens prosztatadaganatban

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