Intermittent versus continuous hormone deprivation in metastatic prostate cancer: preliminary data from an ongoing European study

Mottet, N.; Costa, P.; Navratil, H

doi:10.1038/sj.pcan.4500317

Cited by 6 publications

(5 citation statements)

References 3 publications

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“…Intermittent treatment was stopped when PSA levels decreased below 4 ng/ml and signs of clinical progression disappeared, and restarted when there was evidence of progression or PSA levels rose above 10 ng/ml. Preliminary results from this study showed that intermittent therapy was acceptable to most patients, and that intermittent therapy was not associated with the early development of hormone independence 32 . There was no significant difference in the incidence of progression between patients receiving intermittent therapy and those receiving continuous therapy.…”

Section: Hormonal Therapy Alonementioning

confidence: 72%

“…Preliminary results from this study showed that intermittent therapy was acceptable to most patients, and that intermittent therapy was not associated with the early development of hormone independence. 32 There was no significant difference in the incidence of progression between patients receiving intermittent therapy and those receiving continuous therapy.…”

Section: Intermittent Androgen Deprivationmentioning

confidence: 88%

“…In a European multicentre study, men with metastatic prostate cancer and serum PSA concentrations of 20 ng/ml or above were treated with leuprorelin and flutamide for six months, after which those patients with no progression and PSA levels below 4 ng/ml were randomised to intermittent or continuous treatment 32 . Intermittent treatment was stopped when PSA levels decreased below 4 ng/ml and signs of clinical progression disappeared, and restarted when there was evidence of progression or PSA levels rose above 10 ng/ml.…”

Section: Hormonal Therapy Alonementioning

confidence: 99%

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Management of Locally Advanced Prostate Cancer: A European Consensus

Boccon-Gibod

Bertaccini

Bono

et al. 2003

Int J Clinical Practice

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SUMMARYThis report summarises the findings of a European Consensus Group review of current standards of care in locally advanced prostate cancer defined as (a) untreated cancer extending clinically beyond the prostatic capsule in patients with no evidence of lymph node invasion or distant metastases, and (b) residual disease remaining after local treatment with positive surgical margins, seminal vesicle invasion, persistent prostate‐specific antigen (PSA) and/or secondary PSA relapse. There was no overall consensus as to the standard of care in clinically apparent locally advanced prostate cancer. It was agreed, however, that hormonal therapy (e.g. with a gonadotrophin releasing hormone analogue [GnRHa]) represents a valid treatment in these patients. Treatment practices and regimens vary considerably between European countries, but GnRHa is widely used, either alone or in combination with antiandrogens. Hormonal therapy alone is a valid option, though the optimal modality, timing and duration of treatment remain to be defined. Adjuvant therapy with a GnRHa has been shown to improve survival in patients undergoing external beam radiotherapy. It is a viable option after prostatectomy in patients with persistent or secondary relapsing PSA. It was determined that optimal treatment will be different according to PSA, clinical staging and Gleason score, and the treatment of locally advanced disease should be individually tailored after discussion between physician and patient. In many instances, patients prefer and expect some form of treatment in preference to watchful waiting. Treatment nomograms such as the Kattan nomograms provide precise, comprehensive and invaluable tools for everyday use and may be used to predict outcomes and guide treatment decisions.

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Section: Hormonal Therapy Alonementioning

confidence: 72%

Section: Intermittent Androgen Deprivationmentioning

confidence: 88%

Section: Hormonal Therapy Alonementioning

confidence: 99%

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Management of Locally Advanced Prostate Cancer: A European Consensus

Boccon-Gibod

Bertaccini

Bono

et al. 2003

Int J Clinical Practice

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“…Progression to a hormone‐refractory state appears due to the fact that apoptosis induced by androgen ablation is not able to eradicate all malignant cells, the remaining cells losing their apoptotic potential [30]. The emergence of androgen‐independent prostate cancer cells may arise from the selection of pre‐existing clones of androgen‐independent cells resistant to apoptosis generated randomly by genetic instability of tumours (clonal selection hypothesis) or from the upregulation of androgen‐repressed adaptive mechanisms and growth factors (adaptation hypothesis) [31].…”

Section: Intermittent Adtmentioning

confidence: 99%

Landmarks in hormonal therapy for prostate cancer

Hammerer

Madersbacher

2012

BJU International

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• It is >70 years since the responsiveness of symptomatic metastatic prostate cancer to androgen deprivation was first demonstrated. • Since those pivotal studies, progress in hormonal therapy of prostate cancer has been marked by several important developments and the availability of various androgen-suppressing agents. • Treatment guidelines have continued to evolve with clinical and therapeutic progress, but androgen-deprivation therapy (ADT) remains the standard of care for non-localised prostate cancer. • Because of the long-term experience (>20 years) and wealth of evidence from the large number of clinical trials, the luteinizing hormone-releasing hormone (LHRH) agonists are currently the main forms of ADT. • Treatment strategies should be adapted to the individual patient in terms of timing, duration and choice of agent. • Prostate cancer remains the most common type of cancer in men and the development of castration-resistant disease seems inevitable, which together drive the clear and continuing need for new, effective agents for ADT to be used alongside the LHRH agonists.

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“…However, phase II studies should be regarded mainly as a demonstration of the feasibility of the approach. Several phase III studies are currently comparing tumour progression, safety and quality of life with intermittent or continuous MAB in patients with metastatic prostate cancer 58,68 …”

Section: Pharmacokineticsmentioning

confidence: 99%

Leuprorelin Acetate in Prostate Cancer: A European Update

Persad

2002

Int J Clinical Practice

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SUMMARYThis review provides an update on leuprorelin acetate, the world's most widely prescribed depot luteinising hormone‐releasing hormone analogue. Leuprorelin acetate has been in clinical use in the palliative treatment of prostate cancer for more than 20 years, but advances continue to be made in terms of convenience and flexibility of administration, and in the incorporation of leuprorelin acetate into novel treatment regimens. The drug is administered in the form of a depot injection containing leuprorelin acetate microspheres, and is at least as effective in suppressing testosterone secretion as orchiectomy. In patients with prostate cancer, serum testosterone levels are reduced to castrate levels (≤50 ng/dl) within 2–3 weeks of the first one‐month depot injection of 3.75 mg or three‐month depot injection of 11.25 mg. Both the one‐month and three‐month formulations are effective in delaying tumour progression and alleviating symptoms of locally advanced and metastatic prostate cancer. Tolerability is generally good, with side‐effects reflecting effective testosterone suppression. Recent studies have investigated the place of leuprorelin acetate as part of continuous or intermittent maximal androgen blockade (MAB) and in neoadjuvant therapy (i.e. to reduce the size of the prostate and downsize the tumour before radiotherapy). Additional formulations and presentations are in development, including a six‐month injection, with the aim of adding to the clinical flexibility and patient acceptability of this important palliative treatment for prostate cancer.

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Intermittent versus continuous hormone deprivation in metastatic prostate cancer: preliminary data from an ongoing European study

Cited by 6 publications

References 3 publications

Management of Locally Advanced Prostate Cancer: A European Consensus

Management of Locally Advanced Prostate Cancer: A European Consensus

Landmarks in hormonal therapy for prostate cancer

Leuprorelin Acetate in Prostate Cancer: A European Update

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