Anti-androgens and other hormonal therapies for prostate cancer.
Many men who show evidence of a progression of prostate cancer by rising prostate-specific antigen (PSA) or other symptoms are treated with anti-androgens. Anti-androgen withdrawal represents the first line of treatment after failure of hormonal manipulation. Flutamide is an approved anti-androgen that has been incorporated in many of the combined androgen blockade studies. Bicalutamide is also a nonsteroidal anti-androgen that offers the advantages of reduced dosage amounts and reduction in side effects. Additionally, there are a variety of therapeutic agents that can suppress adrenal secretion of androgens. The most promising of these agents include aminoglutethamide, ketoconazole, and corticosteroids, with an expected response rate of 10% to 15%. Studies have shown that some patients may respond to an anti-estrogen such as tamoxifen. There are a variety of therapeutic treatment options available for patients with hormone refractory prostate cancer. However, quality-of-life issues are becoming increasingly important and should be incorporated into clinical trial endpoints.
Richie
J P
JP
Division of Urology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
D000726:Androgen Antagonists / Q000627:therapeutic use*; D000728:Androgens / Q000097:blood* / Q000378:metabolism; D000813:Anilides / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D005485:Flutamide / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009376:Neoplasms, Hormone-Dependent / Q000097:blood / Q000188:drug therapy*; D009570:Nitriles; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy*; D013629:Tamoxifen / Q000627:therapeutic use; D014105:Tosyl Compounds
D000726:Androgen Antagonists; D000728:Androgens; D000813:Anilides; D014408:Biomarkers, Tumor; D009570:Nitriles; D014105:Tosyl Compounds; D013629:Tamoxifen; D005485:Flutamide; C053541:bicalutamide; D017430:Prostate-Specific Antigen