[Progress in oral anti-cancer drug therapy for urological cancer]

We describe the progress in oral anti-cancer drug therapy for urological cancer. Pure antiandrogen (e.g., flutamide) is widely used as a means of maximal androgen blockade (MAB) in the treatment of prostate cancer. However, all series reported in the past several years did not show positive effects on prolongation of the patient's survival. Evaluations by meta-analysis are in progress. As the mechanism of antiandrogen withdrawal syndrome has been recognized, it was widely accepted that antiandrogen should be discontinued when disease progression or PSA elevation becomes evident. Estramustine was recently clarified as an effective therapeutic agent in the treatment of hormone refractory prostate cancer in combination with oral etoposide. Oral etoposide therapy has been tried as a maintenance or a palliative chemotherapy for non-curative or high-risk germ cell tumor. UFT (a compound of tegafur and uracil) is said to be effective for bladder cancer. It has been also suggested that UFT was partly effective as a means of first-line endocrine chemotherapy for advanced prostate cancer and was a promising agent in the treatment of advanced renal cell carcinoma in combination with Interferon-alpha. Usually the age of the patient with urological malignancy, excluding testicular cancer, is high and complicated. For such patients, an aggressive intravenous chemotherapy can not always be used. Therefore, a less aggressive, less toxic chemotherapy with oral drug is often planned to maintain QOL.