Novel approaches to treating the asymptomatic hormone-refractory prostate cancer patient.
For >50 years, the standard treatment for advanced prostate cancer has been hormonal therapy. However, all such treated patients eventually develop disease refractory to androgen suppression as manifested by increasing prostate-specific antigen (PSA) levels, progressive disease on radiographic imaging, and ultimately, symptomatic deterioration. Historical perceptions that treatment of hormone-refractory prostate cancer was a largely futile venture have faded over the past decade with the advances in new therapeutic strategies. With the use of PSA values to follow the progress of patients after definitive therapy, physicians are seeing more patients who have failed hormonal therapy yet have no symptoms from their disease. There are standard therapies available for patients who require palliation for symptoms, but there is no consensus on treatment for asymptomatic patients. To date, there has been no definitive increase in survival with any therapy in this group of patients. In addition, several novel drugs have advanced through preclinical testing into early clinical trials. It is these drugs--alone or in combination--that are designed to target strategic tumor pathways in these patients. This article will review a selection of agents that may be potentially useful in this population.
Gulley
James
J
Laboratory of Tumor Immunology and Biology, and the Genitourinary Clinical Research Section, Medical Oncology Clinical Research Unit, National Cancer Institute, Bethesda, Maryland 20892, USA. gulleyj@mail.nih.gov
Dahut
William L
WL
D000230:Adenocarcinoma / Q000188:drug therapy / Q000628:therapy*; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D019496:Cancer Vaccines / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D017326:Clinical Trials, Phase III as Topic; D003131:Combined Modality Therapy; D000077143:Docetaxel; D004961:Estramustine / Q000008:administration & dosage; D005544:Forecasting; D015316:Genetic Therapy; D006801:Humans; D016233:Immunotherapy, Active; D008297:Male; D016376:Oligonucleotides, Antisense / Q000627:therapeutic use; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000628:therapy*; D043823:Taxoids / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D018931:Antineoplastic Agents, Hormonal; D000972:Antineoplastic Agents, Phytogenic; D019496:Cancer Vaccines; D016376:Oligonucleotides, Antisense; D043823:Taxoids; D000077143:Docetaxel; D004961:Estramustine