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Advanced prostatic carcinoma. Early versus late endocrine therapy
J M Kozlowski1, W J Ellis, J T Grayhack
1GU Oncology Program, Northwestern University Medical School, Chicago, Illinois.
The Urologic Clinics of North America
|February 1, 1991
Summary
Early androgen deprivation therapy may improve survival for younger men with advanced prostate cancer. Further research is needed for effective treatments against androgen-resistant prostate cancer cells.
Area of Science:
- Oncology
- Urology
Background:
- Androgen deprivation therapy (ADT) has been a cornerstone for advanced prostate cancer since 1941.
- Early studies on hormonal therapy yielded conflicting survival data, with later trials questioning its benefit.
Purpose of the Study:
- To review the current evidence supporting early androgen deprivation for advanced prostate cancer.
- To re-evaluate the risk-benefit analysis of initiating hormonal therapy promptly upon diagnosis.
Main Methods:
- Reanalysis of historical data, including the Veterans Administration Cooperative Urological Research Group (VACURG) studies.
- Review of recent experimental and clinical findings on early ADT.
Main Results:
- A reanalysis of VACURG data suggests a survival advantage for early ADT in younger patients with high-grade, stage D prostate cancer.
- Current evidence increasingly supports the benefits of early hormonal therapy initiation.
Conclusions:
- The risk-benefit profile favors early hormonal therapy for advanced prostate cancer.
- Novel strategies targeting androgen-resistant cells are crucial for long-term survival in metastatic prostate cancer, alongside early ADT.