Secondary Hormonal Therapy for Advanced Prostate Cancer

Abstract

Secondary hormonal therapy serves as an excellent therapeutic option in patients with AIPC in whom primary hormonal therapy has failed. Practicing urologists should familiarize themselves with these oral medications, their indications and their potential side effects.

Docetaxel as a vital option for corticosteroid-refractory prostate cancer

“…Corticosteroids are also shown to retard prostate cancer growth in a direct manner by interfering with several growth factors [12,13]. Clinical efficacy of corticosteroids as a second-line therapy has been reported in observational and prospective studies since late 1980s [5][6][7][8][9][10]. However, in general, the effects of hydrocortisone are limited as a single agent; the median duration of response is approximately 4 months [6].…”

“…In Japan, a common practice for CRPC prior to the governmental approval of TAX was corticosteroid therapy by dexamethasone (DEX) or prednisone [5][6][7][8][9][10]. Immediately after the approval as of August 2008, TAX was initially used for CRCP that had already acquired resistance to corticosteroid [11].…”

Efficacy of treatment with a GnRH antagonist in prostate cancer patients previously treated with a GnRH agonist

“…Over the last decade, several new drugs for CRPC have been approved, but some traditional secondary hormonal manipulations such as antiandrogen addition or withdrawal, corticosteroids and estrogenic compounds are still used before considering chemotherapy [2]. Since the emergence of GnRH antagonists, switching from a GnRH agonist to a GnRH antagonist has been tried for patients resistant to GnRH agonists [3].…”

Second-Line Antiandrogen Therapy in Japanese Men with Advanced Prostate Cancer Relapsed after Primary Combined Androgen Blockade: Who Will Benefit from Second-Line Hormonal Therapy?

“…However, the role of second-line AA as salvage treatment for patients who relapse after first-line therapy is unclear because of a range of reported response rates [16]. This lack of definitive efficacy of subsequent hormonal therapy results partly from the heterogeneous clinical characteristics of patients, which implies that it may be useful to isolate the beneficiaries from second-line hormonal therapy.…”