Role of secondary hormonal therapy in the management of recurrent prostate cancer.
Androgen ablation remains the cornerstone of the systemic management of prostate cancer. After initial androgen deprivation, clinical outcomes vary considerably. For the patient with progressive disease after androgen deprivation, multiple therapeutic options are available and include antiandrogen withdrawal, chemotherapy, and secondary hormonal agents. Multiple secondary hormonal agents have clinical activity and the sequential use of these agents may lead to prolonged periods of clinical response. In addition to the use of oral antiandrogens, active secondary hormonal therapies include adrenolytic agents such as ketoconazole and aminoglutethimide, corticosteroids and estrogenic compounds. This article reviews the clinical trial data for these various agents and discusses their role in the management of patients with advanced prostate cancer.
Ryan
Charles J
CJ
Urologic Oncology Program, University of California San Francisco Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California 94143, USA. ryanc@medicine.ucsf.edu
Small
Eric J
EJ
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000311:Adrenal Glands / Q000187:drug effects; D000726:Androgen Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D000728:Androgens; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic / Q000379:methods; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004967:Estrogens / Q000627:therapeutic use; D005544:Forecasting; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000037:antagonists & inhibitors; D006801:Humans; D008297:Male; D009363:Neoplasm Proteins / Q000097:blood; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D009919:Orchiectomy; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D016879:Salvage Therapy; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000726:Androgen Antagonists; D000728:Androgens; D018931:Antineoplastic Agents, Hormonal; D004967:Estrogens; D009363:Neoplasm Proteins; D007987:Gonadotropin-Releasing Hormone; D017430:Prostate-Specific Antigen