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EORTC prostate cancer trials: what have we learnt?

Theo M de Reijke1, Laurence Collette

  • 1Department of Urology, Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands. t.m.dereyke@amc.uva.nl

Critical Reviews in Oncology/Hematology
|August 23, 2002
PubMed
Summary

The European Organization for Research and Treatment of Cancer-GU Group advances prostate cancer treatment through clinical trials. Quality of life and PSA response are key endpoints, guiding improved therapeutic strategies.

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Area of Science:

  • Oncology
  • Urology
  • Clinical Trials

Background:

  • The European Organization for Research and Treatment of Cancer-GU (EORTC-GU) Group conducts international trials to improve cancer treatment.
  • Early EORTC-GU studies in prostate cancer focused on chemotherapy, identifying Mitomycin C as active.

Purpose of the Study:

  • To evaluate treatment strategies for advanced prostate cancer, including chemotherapy, androgen blockade, and combined therapies.
  • To establish Quality of Life (QoL) and Prostate-Specific Antigen (PSA) response as crucial endpoints for clinical trials.

Main Methods:

  • Conducted Phase II and III multicenter, multinational trials for prostate cancer.
  • Assessed treatment efficacy using endpoints such as tumor response, QoL, and PSA levels.
  • Investigated maximal androgen blockade (MAB), anti-androgen monotherapy, and hormonal therapy combined with radiation.

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Main Results:

  • Mitomycin C showed activity in advanced prostate cancer. QoL and PSA response are vital endpoints.
  • Maximal androgen blockade yielded conflicting results, potentially due to patient heterogeneity.
  • Anti-androgen monotherapy was feasible for good-prognosis patients; steroidal agents had more side effects.
  • Hormono-chemotherapy did not improve survival or QoL in poor-prognosis patients.
  • Combined radiation and 3-year hormonal therapy improved survival in locally advanced disease.

Conclusions:

  • QoL and PSA response are critical endpoints for evaluating prostate cancer treatments.
  • Combined modality treatments, such as radiation with hormonal therapy, show promise.
  • Ongoing trials investigate intermittent versus continuous hormonal therapy and novel treatment regimens.