Pharmacotherapy of hormone refractory prostate cancer: new developments and challenges.
Hormone refractory prostate cancer (HRPC) remains a challenge in the management of prostate cancer patients. With the widespread use of PSA (prostate specific antigen), recurrent disease after local treatment for localised prostate cancer is usually diagnosed long before evidence of metastatic disease. In many cases, hormonal manipulations are started at the time of biochemical relapse and therefore, patients become 'hormone refractory' earlier in the course of their disease, frequently with a good performance status, often with no evidence of metastatic disease, and they still face a considerably long life expectancy. Despite these changes, the need for more options in the treatment of HRPC is obvious. The pharmacological treatments that are in use and those that are under investigation for this group of patients will be discussed and include: cytotoxic agents including the microtubule inhibitors, alone and in combination with other conventional or experimental therapies such as calcitriol or thalidomide; treatment with epothilone analogues; endothelin receptor antagonists; palliative therapy with bisphosphonates, bone-targeted radiopharmaceuticals and other developing treatments such as vaccines, gene therapies and monoclonal antibodies.
Rosenbaum
Eli
E
Division of Medical Oncology, Room 1M-89, Cancer Research Building, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 1650 Orleans Street Baltimore, Maryland 21231, MD 410-502-9746, USA.
Carducci
Michael A
MA
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols; D001859:Bone Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary; D002117:Calcitriol / Q000008:administration & dosage / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004164:Diphosphonates / Q000008:administration & dosage / Q000627:therapeutic use; D065128:Endothelin Receptor Antagonists; D034261:Epothilones / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008666:Metalloendopeptidases / Q000037:antagonists & inhibitors; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D013792:Thalidomide / Q000008:administration & dosage / Q000627:therapeutic use; D014807:Vitamin D / Q000008:administration & dosage / Q000627:therapeutic use
D000970:Antineoplastic Agents; D004164:Diphosphonates; D065128:Endothelin Receptor Antagonists; D034261:Epothilones; D014807:Vitamin D; D013792:Thalidomide; D008666:Metalloendopeptidases; D002117:Calcitriol