title: Somatostatin analogues and estrogens in the treatment of androgen ablation refractory prostate adenocarcinoma.
abstract: OBJECTIVE
  Prostate cancer progression to androgen ablation refractory stage D3 corresponds to cancer cell escape from androgen withdrawal induced apoptosis. Of note, salvage chemotherapy can extend the median survival of approximately 10 months in patients with stage D3. Therefore, novel therapeutic strategies that target the molecular basis of androgen resistance are required.
  
  
  METHODS
  The MEDLINE and Current Content databases were used to find studies of the use of estrogens and somatostatin analogues for D3 prostate adenocarcinoma. We also analyzed the rationale and clinical results of our combination therapy using lanreotide and ethinylestradiol.
  
  
  RESULTS
  Negative experiences have been reported with somatostatin analogues as monotherapy. On the other hand, the median progression-free survival reported in our experience using lanreotide acetate plus ethinylestradiol clearly surpassed the 10-month survival historically described in stage D3 cases.
  
  
  CONCLUSIONS
  The use of somatostatin analogues in combination therapy for D3 prostate cancer sustains the novel concept in cancer treatment in which therapies may target not only cancer cells, but also the microenvironment in combination, which can confer protection from apoptosis.
authors.affiliation: Department of Urology, University La Sapienza, Rome, Italy. sciarrajr@hotmail.com
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sciarra
authors.forename: Cesare
authors.initials: C
authors.lastname: Bosman
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Monti
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Gentile
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Autran Gomez
authors.forename: Mauro
authors.initials: M
authors.lastname: Ciccariello
authors.forename: Antonio
authors.initials: A
authors.lastname: Pastore
authors.forename: Gianfilippo
authors.initials: G
authors.lastname: Salvatori
authors.forename: Francesca
authors.initials: F
authors.lastname: Fattore
authors.forename: Franco
authors.initials: F
authors.lastname: Di Silverio
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy*; D000728:Androgens / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D004997:Ethinyl Estradiol / Q000008:administration & dosage; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D013004:Somatostatin / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D000728:Androgens; D004997:Ethinyl Estradiol; D013004:Somatostatin