Trends in primary androgen depletion therapy for patients with localized and locally advanced prostate cancer: Japanese perspective

Akaza, Hideyuki

doi:10.1111/j.1349-7006.2006.00180.x

Cited by 29 publications

(31 citation statements)

References 34 publications

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“…Several other publications have commented on this trend and noted that the potential benefits of hormone therapy may be underutilized in early stage disease [30,31] .…”

Section: Trends In the Use Of Hormonal Therapy For Localized And Locamentioning

confidence: 99%

Future Prospects for Luteinizing Hormone-Releasing Hormone Analogues in Prostate Cancer Treatment

Akaza

2010

Pharmacology

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Luteinizing hormone-releasing hormone (LHRH) analogues play a pivotal role in hormonal therapy regimens for the treatment of prostate cancer. Hormonal therapy has traditionally been used as a palliative treatment for patients with advanced disease, and international treatment guidelines do not recommend its use as a first-line therapy at earlier disease stages. However, there appears to be a gap between international guideline recommendations and actual clinical practice regarding the use of primary androgen deprivation therapy (PADT) for prostate cancer therapy. Despite limited evidence to date for the impact on clinical outcomes, the use of PADT in patients with localized or locally advanced prostate cancer has increased in many countries, most notably Japan. Clinical evidence is now accumulating to confirm the valuable role of PADT, both as monotherapy but particularly when used as part of a maximal androgen blockade regimen, on the long-term control of both localized and locally advanced disease, and importantly on survival outcomes in these patients.

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“…Several other publications have commented on this trend and noted that the potential benefits of hormone therapy may be underutilized in early stage disease [30,31] .…”

Section: Trends In the Use Of Hormonal Therapy For Localized And Locamentioning

confidence: 99%

Future Prospects for Luteinizing Hormone-Releasing Hormone Analogues in Prostate Cancer Treatment

Akaza

2010

Pharmacology

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“…This trend is also on the rise in clinical practice in the USA (Akaza 2006). More evidence has been accumulating that progression of prostate cancer was retarded by primary hormone therapy in men with localized or locally advanced prostate cancer .…”

Section: Androgen Deprivation As Monotheraphy For Localized Prostate mentioning

confidence: 97%

Leuprorelin depot injection: patient considerations in the management of prostatic cancer

Crawford¹

2008

TCRM

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Hormone therapy is well established for treating patients with prostate cancer and remains the mainstay of the treatment of metastatic and locally advanced disease, this article reviews the rationale for its use, its different forms, and complications and controversies still surrounding some of its modalities. Availability of long-acting synthetic luteinizing hormonereleasing hormone (LHRH) agonists revolutionized the hormonal treatment of prostate cancer, and helped to avoid the emotional and psychological effects related to surgical castration. The depot formula has gained wide acceptance from both patients and physicians. This review emphasizes the newer, long-acting formula, leuprorelin (leuprolide acetate), especially the 6-month formula, its advantage over over shorter-acting depot products, and its potential to become a standard of care for patients eligible for androgen deprivation therapy.

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“…The following is an example: 'prostate cancer is a disease that initially responds but later becomes resistant to androgen blockade' . As discussed in more detail later, this statement essentially comes from metastatic disease but is not appropriate for localized disease of which cure can be obtained with CAB (Labrie et al 2002, Akaza 2006, Akaza et al 2006a. Similarly, it cannot be said 'All patients ultimately progress to metastatic CRPC' ).…”

Section: Distinction Must Be Made Between Localized and Metastatic DImentioning

confidence: 99%

“…Similarly, it cannot be said 'All patients ultimately progress to metastatic CRPC' ). This sentence is correct for patients first treated by castration at the metastatic stage, but it does not apply for CAB treatment at the localized stage of which cure is a possibility and progression is an exception (Labrie et al 2002, 2006a, Homma et al 2004, Akaza 2006, Ueno et al 2006). …”

Section: Distinction Must Be Made Between Localized and Metastatic DImentioning

confidence: 99%

“…While CAB, as mentioned above, has many advantages on quality of life (including rapid response, decrease in pain, and survival) (Crawford et al 1989, Caubet et al 1997, Denis et al 1998, Bennett et al 1999, Prostate Cancer Triallists' Collaborative Group 2000, the costs are higher than other treatment options and some data suggest the possibility of negative cardiovascular effects (Levine et al 2010) which need to be further investigated and balanced with the benefits mentioned earlier (Labrie et al 2002, 2006a, b, Egawa et al 2004, Homma et al 2004, Akaza 2006, Ueno et al 2006, Namiki et al 2008.…”

Section: Treatment Of Metastatic Diseasementioning

confidence: 99%

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GnRH agonists and the rapidly increasing use of combined androgen blockade in prostate cancer

Labrie¹

2014

Endocrine-Related Cancer

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The discovery of medical castration with GnRH agonists in 1979 rapidly replaced surgical castration and high doses of estrogens for the treatment of prostate cancer. Soon afterwards, it was discovered that androgens were made locally in the prostate from the inactive precursor DHEA of adrenal origin, a mechanism called intracrinology. Taking into account these novel facts, combined androgen blockade (CAB) using a pure antiandrogen combined with castration in order to block the two sources of androgens was first published in 1982. CAB was the first treatment shown in randomized and placebo-controlled trials to prolong life in prostate cancer, even at the metastatic stage. Most importantly, the results recently obtained with the novel pure antiandrogen enzalutamide as well as with abiraterone, an inhibitor of 17a-hydroxylase in castration-resistant prostate cancer, has revitalized the CAB concept. The effects of CAB observed on survival of heavily pretreated patients further demonstrates the importance of the androgens made locally in the prostate and are a strong motivation to apply CAB to efficiently block all sources of androgens earlier at start of treatment and, even better, before metastasis occurs. The future of research in this field thus seems to be centered on the development of more potent blockers of androgens formation and action in order to obtain better results at the metastatic stage and, for the localized stage, reduce the duration of treatment required to achieve complete apoptosis and control of prostate cancer proliferation before it reaches the metastatic or noncurable stage.

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Trends in primary androgen depletion therapy for patients with localized and locally advanced prostate cancer: Japanese perspective

Cited by 29 publications

References 34 publications

Future Prospects for Luteinizing Hormone-Releasing Hormone Analogues in Prostate Cancer Treatment

Future Prospects for Luteinizing Hormone-Releasing Hormone Analogues in Prostate Cancer Treatment

Leuprorelin depot injection: patient considerations in the management of prostatic cancer

GnRH agonists and the rapidly increasing use of combined androgen blockade in prostate cancer

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