This Article Full Text Full Text (PDF) eLetters: Submit a response to this article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article link to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints/Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Evens, A. M. Articles by Bitran, J. D. Search for Related Content PubMed PubMed Citation Articles by Evens, A. M. Articles by Bitran, J. D.

Intermittent Androgen Suppression as a Treatment for Prostate Cancer: A Review

Department of Medicine, Division of Hematology/Oncology, Lutheran General Hospital, and Lutheran General Hospital Cancer Care Center, Park Ridge, Illinois, USA

Correspondence: Jacob D. Bitran, M.D., Lutheran General Hospital Cancer Care Center, 1700 Luther Lane, Park Ridge, Illinois 60068, USA. Telephone: 847-723-2500; Fax: 847-318-2905; e-mail: jacob.bitran-md{at}advocatehealth.com

Prostate cancer continues as the most common malignancy in men in the United States, with a large number of patients presenting with advanced disease. The current treatment for metastatic prostate cancer, permanent androgen withdrawal, is palliative. Patients treated with permanent androgen withdrawal usually relapse and die secondary to prostate cancer's ability to progress to an androgen-independent state of growth. Based on preclinical studies and phase II trials, intermittent androgen suppression (IAS) appears to be a potential alternative to permanent androgen withdrawal.

IAS may be a feasible alternative for the treatment of metastatic prostate cancer. In this paper, preclinical studies that form the basis of IAS and the clinical studies to date concerning IAS are reviewed. Through the cycling of reversible androgen suppression, there appears to be recovery of apoptosis and subsequent slower progression to an androgen-independent state. The small clinical studies conducted to date show the feasibility of IAS, and, in a few studies, there appears to be a survival advantage over historic controls. A prospective randomized trial which is currently under way will test IAS as a treatment alternative in stage D₂ prostate cancer.

Key Words. Prostate cancer • Intermittent androgens • Treatment • Stage D prostate cancer • Androgen receptor • Androgen receptor upregulation