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Treatment of Hormone-Resistant Prostate Cancer

Columbia Presbyterian Medical Center, Atchley Pavillion, Room 736, 161 Fort Washington Avenue, New York, NY 10032-3713

Despite a rapid and often dramatic response to total androgen ablation, nearly all patients with metastatic prostate cancer will relapse. The median time to progression is 18 to 24 months, and the median survival after progression is six months. Approaches to the treatment of hormone refractory diseases include second hormonal manipulations, systemic chemotherapy, and palliation of bone pain with isotopes of external beam irradiation. Clinical trials of systemic chemotherapy for hormone-resistant prostate cancer have been disappointing; a recent review of 22 clinical trials demonstrated a complete and partial response rate of 8.7%. Clearly, there is a need to identify new active agents and drug targets which improve bone pain, quality of life and, ultimately, prolong survival.

Recent trials have identified active drugs and combinations such as suramin, estramustine + vinblastine, estramustine + etoposide, estramustine + Taxol. Another agent which has demonstrated both preclinical and clinical activity is liarozole, an inhibitor of retinoic acid hydroxylation. In a randomized study which evaluated three different doses (75, 150 and 300 mg p.o. b.i.d.) in 135 men with hormone-resistant prostate cancer, PSA declines of >50% were observed in 7%, 20%, and 24% of patients treated. Toxicities were dose-dependent, and included nausea, fatigue, dry mouth, pruritus, and skin rash. Clinical trials are currently evaluating the combination of liarozole + interferon, and liarozole + prednisone.

This Article 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 Services E-mail this article link to a friend Similar articles in this journal 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 Petrylak, D. P. Search for Related Content PubMed Articles by Petrylak, D. P.