title: Assessment of hormone refractory prostate cancer.
abstract: OBJECTIVE
  To define guidelines for the assessment of treatment in patients with hormone-refractory prostate cancer (HRPC).
  
  
  METHODS
  In the light of modern research, and taking new treatment options into account, the Committee essays to specify different categories of patients entering clinical trials, and to define response criteria and those endpoints that are relevant in phase III studies and in short-term follow-up.
  
  
  RESULTS
  HRPC comprises a range of disease states with varying responsiveness to therapy and length of survival. Patients with progression as evaluated by increasing prostate-specific antigen (PSA) values alone have a more favorable prognosis than those presenting with increasing tumor spread. In the assessment of these patients, the modes of previous therapy and the kind of tumor progression must be taken into account. The benefit of treatment of HRPC is often modest. While duration of survival remains the main and ultimate endpoint, the means of measuring short-term responsiveness to therapy are limited. A minority of patients have measurable tumor lesions. Decrease of PSA or other biochemical tumor markers may indicate depression of the tumor activity, but is not always associated with prolongation of survival. A variety of new treatments in HRPC are being investigated. They affect measurable tumor parameters in different ways.
  
  
  CONCLUSIONS
  When a new agent is to be tested, it is important to measure all possible parameters before deciding which particular ones are appropriate for future investigations of this agent. In symptomatic patients, evaluation of subjective parameters, for example, relief of pain or improvement of performance status, is often the most reliable measure of treatment effect. However, these parameters should be clearly defined.
authors.affiliation: Department of Urology, Academic Hospital, Free University, Amsterdam, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: Newling
authors.forename: S D
authors.initials: SD
authors.lastname: Fosså
authors.forename: L
authors.initials: L
authors.lastname: Andersson
authors.forename: P A
authors.initials: PA
authors.lastname: Abrahamsson
authors.forename: Y
authors.initials: Y
authors.lastname: Aso
authors.forename: M A
authors.initials: MA
authors.lastname: Eisenberger
authors.forename: S
authors.initials: S
authors.lastname: Khoury
authors.forename: J S
authors.initials: JS
authors.lastname: Kozlowski
authors.forename: K
authors.initials: K
authors.lastname: Kelly
authors.forename: H
authors.initials: H
authors.lastname: Scher
authors.forename: B
authors.initials: B
authors.lastname: Hartley-Asp
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000556:secondary; D006801:Humans; D008297:Male; D010166:Palliative Care; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D015996:Survival Rate; D017211:Treatment Failure
chemical_list: D018931:Antineoplastic Agents, Hormonal