Early effects of pharmacological androgen deprivation in human prostate cancer.
OBJECTIVE
To assess the early histological effects of pharmacological androgen deprivation (AD), which have been assessed only over longer periods, as surgical castration leads rapidly to diminished cell proliferation and enhanced cell death within the prostate.


METHODS
With Institutional Review Board approval, 35 patients were randomly assigned (seven in each group) to receive 0, 7, 14, 21 and 28 days of AD (flutamide, 250 mg orally three times/day, and one injection with leuprolide acetate 7.5 mg) before radical prostatectomy. The surgical specimens were assessed by conventional histology and immunohistochemistry, while macroarray analysis and quantitative real-time polymerase chain reaction (QRT-PCR) were used to examine gene expression.


RESULTS
There were morphological changes within the prostatic tissues as early as 7 days after initiating AD, similar to the response to castration. There was tumour cell vacuolization indicating cellular injury, glandular atrophy and mononuclear cell infiltration as prominent and progressive effects but, by contrast with castration studies, there were no changes in epithelial proliferation or apoptosis. Macroarray analysis, validated by QRT-PCR and immunohistochemistry, showed up-regulation of numerous and potentially counter-effective genes involved in the cell cycle and apoptosis.


CONCLUSIONS
Pharmacological AD induces significant involution within prostatic tissues over 7-28 days, but allows the persistence of some viable tumour cells capable of proliferation.
Mercader
Maria
M
Department of Urology, Mayo Clinic, Rochester, MN 55905, USA.
Sengupta
Shomik
S
Bodner
Barbara K
BK
Manecke
Ryan G
RG
Cosar
Ediz F
EF
Moser
Michael T
MT
Ballman
Karla V
KV
Wojcik
Eva M
EM
Kwon
Eugene D
ED
D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology*; D000368:Aged; D000726:Androgen Antagonists / Q000494:pharmacology*; D005485:Flutamide / Q000494:pharmacology*; D006801:Humans; D016729:Leuprolide / Q000494:pharmacology*; D008297:Male; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000473:pathology*
D000726:Androgen Antagonists; D005485:Flutamide; D017430:Prostate-Specific Antigen; D016729:Leuprolide