Volume 5, Supplement 2SupplementRationale for the Radiation Therapy Oncology Group Study RTOG P-0014Kenneth J PientaHoward M SandlerProstate cancerChemotherapyAndrogen ablationClinical trialsHormone-refractory disease
Volume 5, Supplement 3SupplementRationale for the Radiation Therapy Oncology Group Study RTOG P-0014Kenneth J PientaHoward M SandlerProstate cancerChemotherapyAndrogen ablationClinical trialsHormone-refractory disease
Volume 8, Supplement 2Review ArticlesThe Treatment of Hormone-Refractory Prostate Cancer: Docetaxel and Beyond16th International Prostate Cancer UpdateDaniel P PetrylakTwo randomized clinical trials demonstrated a survival benefit of 20% to 24% with docetaxel-based therapy when compared with survival with mitoxantrone and prednisone after failure of androgen ablation therapy. These studies supported the approval of docetaxel-based therapy for the treatment of metastatic hormone-refractory prostate cancer by the US Food and Drug Administration in May 2005. Clinical trials in hormone-refractory prostate cancer are now focused on building on the survival improvement seen with docetaxel-based therapy. This article presents a summary of some of the more promising treatments and regimens for advanced prostate cancer. [Rev Urol. 2006;8(suppl 2):S48-S55]Prostate cancerProstate-specific antigenAndrogen ablationDocetaxelEstramustineEndothelin receptor antagonist
Volume 8, Supplement 2Review ArticlesHormonal Therapy for Prostate Cancer16th International Prostate Cancer UpdateMichael K BrawerUpdates on hormonal therapy in the treatment of prostate cancer are presented. The most common therapy is to reduce testosterone to castrate levels. A dosage of 1 mg diethylstilbestrol daily prolonged survival in patients with advanced prostate cancer. The leuteinizing hormone–releasing hormone agonists have essentially replaced surgical orchiectomy in the vast majority of clinical settings; however, a major problem with the leuteinizing hormone– releasing hormone agonists has been the surge and flare of testosterone levels. If hormonal therapy is initiated early, the risk of major complications is significantly decreased. Combined androgen blockade is better than monotherapy, although there is only a small clinical benefit. When androgen deprivation is used for a short time and the normal androgen milieu is re-established, the side effects and toxicity of androgen deprivation are decreased. The major complications of androgen deprivation include hot flushes, reduction of bone mineral density, osteoporosis, and anemia. Intermittent androgen blockade might have the same benefits of total androgen suppression with fewer side effects, increased duration of androgen dependence, and less cost. The 10 steps to take when advising patients about initiation of androgen deprivation therapy are reviewed. [Rev Urol. 2006;8(suppl 2):S35-S47]Prostate cancerHormonal therapyAndrogen ablationDiethylstilbestrol
Volume 11, Number 2Review ArticlesEffective Testosterone Suppression for Prostate Cancer: Is There a Best Castration Therapy?Management UpdateLeonard G GomellaAchieving and maintaining effective suppression of serum testosterone levels in men treated with androgen ablation is one of the essential strategies in the management of prostate cancer. Historically, a serum testosterone below 50 ng/dL was considered to be the castrate level. Current data suggest that the new target for either surgical or chemical castration is a serum testosterone level of lower than 20 ng/dL in an attempt to maximize therapeutic outcomes. Testosterone breakthrough and the acute-on-chronic effects of administration of a luteinizing hormone-releasing hormone analogue may cause testosterone levels to periodically rise, sometimes to noncastrate levels. The goal of androgen ablation is to identify those agents that will most consistently achieve and maintain the lowest testosterone levels possible.[Rev Urol. 2009;11(2):52-60]Prostate cancerAndrogen ablationLHRH analoguesLHRH antagonists