Clinical relevance of plasma testosterone and prolactin changes in advanced cancer of prostate treated with diethylstilbestrol or estramustine phosphate

Morales, Álvaro; Nickel, J. Curtis

doi:10.1016/0090-4295(85)90158-x

Cited by 18 publications

(7 citation statements)

References 21 publications

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“…This is in accordance with most previous reports in this field [1,3,4,7,10]. Adlercreutz et al [1] found a significant asso ciation between a low pretreatment testosterone/PRL ratio and a poor prognosis.…”

Section: Discussionsupporting

confidence: 82%

“…Similar results have recently been reported by Bishop et al [4] during CAP treatment with diethylstilbestrol or estramustin phosphate. These results are at variance with those of Mee et al [9] and Morales and Nickel [10], who reported significant asso ciations between high PRL level during endocrine treat ment and a poor prognosis. However, in the study of Mee et al [9] the patients were not randomized, results from several forms of mixed treatment with or without hyperprolactinemia-inducing drugs were combined, and even untreated patients were included.…”

Section: Discussioncontrasting

confidence: 57%

“…The elevated PRL levels observed in nonresponders by Mee et al [9] may therefore not be related to CAP per se. Morales and Nickel [10] used diethylstilbetrol and estramustin phos phate in a randomized double-blind study and reported higher PRL values during treatment in nonresponders. However, both drugs are well-known inducers of hyper prolactinemia, but they possess different specific activity in this respect [4,8], The distribution of the two types of treatment in the responder and nonrespondcr groups was not specified.…”

Section: Discussionmentioning

confidence: 99%

“…Elevated serum levels of prolactin (PRL) during treat ment with estrogens or by orchidectomy [9,10] have been suggested to indicate a poor prognosis in patients with cancer of the prostate (CAP). However, other workers have failed to demonstrate any association between PRL levels and prognosis in CAP treatment [1,3,4,7].…”

Section: Introductionmentioning

confidence: 99%

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Serum Prolactin Assays Have No Prognostic Value in Treatment of Prostatic Cancer by Orchidectomy or Estrogens

Stege¹,

Carlström

Eriksson³

et al. 1987

Urol Int

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Eighty patients (54–75 years) with cytologically and/or histologically confirmed cancer of the prostate (CAP) were randomly allocated to either orchidectomy (ORX, n = 41) or combined intramuscular and oral estrogen treatment (ESTR, n = 39). Serum levels of prolactin (PRL) were determined prior to treatment and 6, 12 and 24 months after initiation of the treatment. In the ORX group, 32 patients responded to the treatment and 9 did not. In the ESTR group, 27 patients responded and 12 did not. Serum PRL levels were significantly increased by ESTR treatment in responders as well as in nonresponders, but were not affected by ORX. There were no differences in PRL values between responders and nonresponders at any time in any of the two treatment groups. It is concluded that serum PRL assays have no prognostic value in the employed endocrine treatment of CAP.

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Section: Discussionsupporting

confidence: 82%

Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Serum Prolactin Assays Have No Prognostic Value in Treatment of Prostatic Cancer by Orchidectomy or Estrogens

Stege¹,

Carlström

Eriksson³

et al. 1987

Urol Int

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“…The general finding is that low-to-moderate levels of Prl potentiate the trophic effects of testosterone on prostatic growth but that, beyond optimal levels, the lactogen becomes an inhibitor of both normal and neoplastic growth. These relationships have clinical significance since there is an inverse relationship between survival and serum prolactin levels in prostatic cancer patients [ 1,2], and stabilization or remission of the disease has been found to follow prolactin depletion [3,4].…”

Section: Introductionmentioning

confidence: 97%

Prolactin effect on the permeability of human benign hyperplastic prostate to testosterone

Farnsworth¹

1988

The Prostate

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While it has been known for over 30 years that prolactin (Prl) synergizes with androgen in the support and stimulation of prostatic growth and metabolism, the evidence that this is accomplished through increasing access of the steroid to the cellular machinery of the gland has arisen only since about 1970. There is widespread uncertainty as to how the Prl effect takes place: by 1) increasing the free steroid concentration in the blood; 2) facilitating the uptake of protein-bound androgen; 3) increasing, by metabolism or receptor-binding, the concentration gradient that can support passive diffusion of the steroid across the plasma membrane; or 4) modification of the fluidity of the membrane itself to increase the solubility of the steroid in the lipoprotein and, thus, the ease of penetration of the cell. The present study attempted to learn if Prl is an effective stimulus of androgen uptake when the first three options are not operative. Using an equilibrium exchange procedure to track the uptake of [17 alpha-3H]-testosterone ([17 alpha-3H]-T) into minced benign hyperplastic human prostate tissue and the irreversible metabolism of the entering steroid to [17 alpha-3H]-dihydrotestosterone [17 alpha-3H]-DHT, it was found that the rate of production of the 5 alpha-reduced metabolite, during a 1-hr incubation in vitro, was directly proportional to the concentration of ovine Prl over the dose range of 0-160 ng/ml. The clinical significance of Prl mediation of steroid uptake is discussed, and suggestions are made as to how the Prl might alter the permeability of the plasma membrane.

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The role of increased prolactin levels under gnrh analogue treatment in advanced prostatic carcinoma

Matzkin¹,

Kaver²,

Lewyshon³

et al. 1988

Cancer

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The role of prolactin in the progress of prostatic carcinoma still is obscure. It is known to modulate testosterone metabolism and may have a prognostic value in determining disease progression. Prolonged treatment with a GnRH analogue has been introduced recently as a therapeutic alternative to surgical castration in advanced prostatic carcinoma. It has been reported that prolactin levels remain unchanged or even decrease in GnRH analogue treatment. By contrast, in this series of 15 prostatic carcinoma patients treated with GnRH analogue, a significant rise was demonstrated in clinical responders as well as nonresponders. In the latter group, prolactin rise was more pronounced. These results suggest that frequent prolactin determinations might be of prognostic value in determining early disease progression under GnRH analogue treatment.

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Clinical relevance of plasma testosterone and prolactin changes in advanced cancer of prostate treated with diethylstilbestrol or estramustine phosphate

Cited by 18 publications

References 21 publications

Serum Prolactin Assays Have No Prognostic Value in Treatment of Prostatic Cancer by Orchidectomy or Estrogens

Serum Prolactin Assays Have No Prognostic Value in Treatment of Prostatic Cancer by Orchidectomy or Estrogens

Prolactin effect on the permeability of human benign hyperplastic prostate to testosterone

The role of increased prolactin levels under gnrh analogue treatment in advanced prostatic carcinoma

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