Re-induction of hormone sensitivity to diethylstilboestrol in androgen refractory prostate cancer patients following chemotherapy

Cox, Robert A.; Sundar, Santhanam

doi:10.1038/sj.bjc.6604052

Cited by 10 publications

(9 citation statements)

References 4 publications

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“…It was postulated that the chemotherapy may have altered the subsequent behavior of the disease, particularly as a large proportion of patients with second response to estrogen therapy had been resistant to this hormone treatment immediately before chemotherapy. Similar observations have been reported after docetaxel and prednisolone therapy (10).…”

Section: Introductionsupporting

confidence: 77%

Recovery of hormone sensitivity after salvage brachytherapy for hormone refractory localized prostate cancer

Smith

Plowman

2010

Int. braz j urol.

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Purpose: Recent work has demonstrated the return of hormone sensitivity after palliative chemotherapy in androgen independent prostate cancer. We wished to establish whether a similar phenomenon existed in patients with no exposure to chemotherapy. Materials and Methods: A review of "hormone resistant" patients who had received salvage brachytherapy for localized prostate cancer after previous external beam radiotherapy was undertaken. Three patients with subsequent biochemical relapse responded to the rechallenge with hormonal treatment. Results: The series of patients presented here demonstrates this phenomenon occurs after salvage brachytherapy with no exposure to chemotherapy. Recovery of sensitivity is demonstrated both to androgen deprivation and to androgen receptor antagonism. The recovery of hormone sensitivity was surprisingly durable, ranging from eight months to over twenty-one months. Conclusions: Hormone sensitivity may be recovered after salvage brachytherapy. Potential mechanisms underlying these observations are discussed and the likely central role of the activity of the androgen receptor highlighted. The relevance of these findings to the management of advanced prostate cancer is considered including thoughts on the practice of intermittent anti-androgen therapy.

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Section: Introductionsupporting

confidence: 77%

Recovery of hormone sensitivity after salvage brachytherapy for hormone refractory localized prostate cancer

Smith

Plowman

2010

Int. braz j urol.

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“…Four out of eight patients (50%) responded to rechallenge with DES and eight out of 12 patients (67%) who did not respond to DES before chemotherapy did so after chemotherapy. Similar experiences with reinduction of hormone sensitivity to DES after docetaxel and prednisolone have been reported by others [90].…”

Section: Diethylstilboestrol and Chemotherapysupporting

confidence: 69%

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

Turo¹,

Smolski²,

Esler³

et al. 2013

Scandinavian Journal of Urology

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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.

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“…12 More recently, rechallenge-like regimens used for retreatment include anthracyclines and taxanes in adjuvant or metastatic breast cancer, 150 platinum-based therapy in ovarian cancer, 13 tamoxifen in oestrogen receptor-positive breast cancer, 168 and diethylstilbesterone or maximum androgen blockade in androgen-independent prostate cancer. 28,169,170 Specific experiences with chemotherapy rechallenge have changed definitions of drug resistance to exclude relapses that occur after a prolonged period off therapy. 13–15 …”

Section: Figurementioning

confidence: 99%

Drug rechallenge and treatment beyond progression—implications for drug resistance

et al. 2013

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The established dogma in oncology for managing recurrent or refractory disease dictates that therapy is changed at disease progression, because the cancer is assumed to have become drug-resistant. Drug resistance, whether pre-existing or acquired, is largely thought to be a stable and heritable process; thus, reuse of therapeutic agents that have failed is generally contraindicated. Over the past few decades, clinical evidence has suggested a role for unstable, non-heritable mechanisms of acquired drug resistance pertaining to chemotherapy and targeted agents. There are many examples of circumstances where patients respond to reintroduction of the same therapy (drug rechallenge) after a drug holiday following disease relapse or progression during therapy. Additional, albeit limited, evidence suggests that, in certain circumstances, continuing a therapy beyond disease progression can also have antitumour activity. In this Review, we describe the anticancer agents used in these treatment strategies and discuss the potential mechanisms explaining the apparent tumour re-sensitization with reintroduced or continued therapy. The extensive number of malignancies and drugs that challenge the custom of permanently switching to different drugs at each line of therapy warrants a more in-depth examination of the definitions of disease progression and drug resistance and the resulting implications for patient care.

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Re-induction of hormone sensitivity to diethylstilboestrol in androgen refractory prostate cancer patients following chemotherapy

Cited by 10 publications

References 4 publications

Recovery of hormone sensitivity after salvage brachytherapy for hormone refractory localized prostate cancer

Recovery of hormone sensitivity after salvage brachytherapy for hormone refractory localized prostate cancer

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

Drug rechallenge and treatment beyond progression—implications for drug resistance

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