Somatostatin analogues and estrogens in the treatment of androgen ablation refractory prostate adenocarcinoma.
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.
Sciarra
Alessandro
A
Department of Urology, University La Sapienza, Rome, Italy. sciarrajr@hotmail.com
Bosman
Cesare
C
Monti
Giuseppe
G
Gentile
Vincenzo
V
Autran Gomez
Ana Maria
AM
Ciccariello
Mauro
M
Pastore
Antonio
A
Salvatori
Gianfilippo
G
Fattore
Francesca
F
Di Silverio
Franco
F
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*
D000728:Androgens; D004997:Ethinyl Estradiol; D013004:Somatostatin