Cyproterone acetate in the therapy of prostate carcinoma

Prostatic carcinoma is one of the most commonly neoplasm in men, with the strongest incidence around the age of 70 years. In consideration of the high hormonodependence of prostatic neoplasm the reduction of testosterone levels represents the choice of treatment for the patients with metastatic disease, and has an application also in the treatment of patients with a more limited disease, but not elegible to local treatment with a curative aim. The circulating testosterone can be maintained to the lowest levels by the use of drugs that can obtain, with different mechanism of action, a "medical castration". Cyproterone acetate (CPA) is a steroideal antiandrogen which has affinity with progesteron and with glucocorticoidal receptors. It centrally inhibits the release of lutehinizing hormon blocking in this way the secretion of testosterone of testicular origin. Besides, it inhibits the action of the androgens of surrenalic and testicular origin to the cellular level through a competitive direct interaction with the cellular receptors. This review illustrates the main evidences of efficacy and safety of CPA in the treatment of prostatic carcinoma.