Androgen receptor-blocking agents: potential role in pancreatic cancer

The growth of pancreatic adenocarcinoma may be under the control of the sex steroid hormone testosterone, besides other unknown stimuli. This premise was based on the discovery of androgen receptors, together with the enzymes aromatase and 5alpha-reductase, which use testosterone as a substrate, in malignant tissue. The additional support of low circulating serum testosterone and its stimulatory role in an animal model using human tumour xenografts further enhance this suggestion. Confirmatory evidence has now come from a double-blind, placebo-controlled trial in patients with pancreatic cancer in which flutamide, the pure androgen receptor blocker, doubled survival duration over control patients. Flutamide was administered in a dosage of 250mg 3 times daily. Support for this finding has recently been presented at a meeting of the Pancreatic Society of Great Britain. It is now important for further confirmatory studies to be carried out and to use flutamide in combination with other current adjuvant therapies in patients with pancreatic cancer.