Pub Date : 1999-07-01DOI: 10.1046/J.1525-1411.1999.14003.X
Matthew R. Smith, P. Kantoff, W. Oh, Grace A. Elson, J. Manola, M. McMullin, J. Jacobsen, A. Brufsky, D. Kaufman
Objectives: Estrogen receptors are expressed in healthy and malignant prostate epithelium. Previous studies of the antiestrogen tamoxifen (20–100 mg po qd) for recurrent or metastatic prostate cancer (CaP) reported response rates of 0–23%. These studies may have underestimated the activity of antiestrogens, however, because of their reliance on insensitive clinical and radiographic response criteria. In addition, treatment-related increases in androgen levels among men who initiated treatment with noncastrate testosterone levels may have confounded the results. The aims are to evaluate the activity of the antiestrogen toremifene, a triphenylethylene derivative antiestrogen related chemically and pharmacologically to tamoxifen, in men with androgen-independent CaP using prostate specific antigen (PSA) response criteria and to determine the effect of toremifene treatment on serum testosterone levels in castrated men. Materials and Methods: Fifteen men (median age 71 years; median PSA 58.5 ng/ml) with castrate testosterone levels, no disease-related symptoms, and rising PSA after androgen deprivation and antiandrogen withdrawal were treated with toremifene, 60 mg po qd, until it was determined that the patient was not responding to treatment. Nonresponse to treatment was defined as symptomatic disease progression or a PSA level 150% study nadir on two determinations at least 4 weeks apart. Response was defined as >50% PSA decrease on two determinations at least 4 weeks apart. Results: Twelve men were evaluable for response. Median time to determination of nonresponse to treatment was 16 weeks (range 8 to 19 weeks). There were no responses to treatment (response rate 0%; 95% confidence interval 0–22%). Treatment did not significantly change serum testosterone levels. Conclusions: These results indicate that toremifene is inactive for the treatment of androgen-independent CaP and suggest that antiestrogens should not be used routinely as secondary hormonal therapy. The treatment of castrated men with toremifene does not significantly change serum testosterone levels.
{"title":"Phase II Trial of the Antiestrogen Toremifene for Androgen‐Independent Prostate Cancer","authors":"Matthew R. Smith, P. Kantoff, W. Oh, Grace A. Elson, J. Manola, M. McMullin, J. Jacobsen, A. Brufsky, D. Kaufman","doi":"10.1046/J.1525-1411.1999.14003.X","DOIUrl":"https://doi.org/10.1046/J.1525-1411.1999.14003.X","url":null,"abstract":"Objectives: Estrogen receptors are expressed in healthy and malignant prostate epithelium. Previous studies of the antiestrogen tamoxifen (20–100 mg po qd) for recurrent or metastatic prostate cancer (CaP) reported response rates of 0–23%. These studies may have underestimated the activity of antiestrogens, however, because of their reliance on insensitive clinical and radiographic response criteria. In addition, treatment-related increases in androgen levels among men who initiated treatment with noncastrate testosterone levels may have confounded the results. The aims are to evaluate the activity of the antiestrogen toremifene, a triphenylethylene derivative antiestrogen related chemically and pharmacologically to tamoxifen, in men with androgen-independent CaP using prostate specific antigen (PSA) response criteria and to determine the effect of toremifene treatment on serum testosterone levels in castrated men. \u0000 \u0000 \u0000 \u0000Materials and Methods: Fifteen men (median age 71 years; median PSA 58.5 ng/ml) with castrate testosterone levels, no disease-related symptoms, and rising PSA after androgen deprivation and antiandrogen withdrawal were treated with toremifene, 60 mg po qd, until it was determined that the patient was not responding to treatment. Nonresponse to treatment was defined as symptomatic disease progression or a PSA level 150% study nadir on two determinations at least 4 weeks apart. Response was defined as >50% PSA decrease on two determinations at least 4 weeks apart. \u0000 \u0000 \u0000 \u0000Results: Twelve men were evaluable for response. Median time to determination of nonresponse to treatment was 16 weeks (range 8 to 19 weeks). There were no responses to treatment (response rate 0%; 95% confidence interval 0–22%). Treatment did not significantly change serum testosterone levels. \u0000 \u0000 \u0000 \u0000Conclusions: These results indicate that toremifene is inactive for the treatment of androgen-independent CaP and suggest that antiestrogens should not be used routinely as secondary hormonal therapy. The treatment of castrated men with toremifene does not significantly change serum testosterone levels.","PeriodicalId":22947,"journal":{"name":"The open prostate cancer journal","volume":"121 1","pages":"185-189"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86162057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-07-01DOI: 10.1046/J.1525-1411.1999.14004.X
S. Jackman, L. Kavoussi
{"title":"The Role of Laparoscopy in Prostate Cancer Staging","authors":"S. Jackman, L. Kavoussi","doi":"10.1046/J.1525-1411.1999.14004.X","DOIUrl":"https://doi.org/10.1046/J.1525-1411.1999.14004.X","url":null,"abstract":"","PeriodicalId":22947,"journal":{"name":"The open prostate cancer journal","volume":"27 1","pages":"166-173"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90773140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-07-01DOI: 10.1046/J.1525-1411.1999.14009.X
D. Lamm, D. Riggs, David A. Donley, Justin White, R. Yeater, R. Bryner
Objectives: Bacillus Calmette-Guerin (BCG) is the treatment of choice for carcinoma in situ of the bladder, but its application to other cancers is very limited. The current study evaluates the effect of intralesional BCG in the PA3 rat prostate cancer model. Materials and Methods: One hundred five rats were randomized to four groups. Each group received 1 × 106 PA3 cells subcutaneously on experiment Day 0. On experimental Day 7, the groups received the first of six weekly treatments. Treatments consisted of saline solution, BCG 1 × 104 colony-forming units (cfu), BCG 1 × 105 cfu, and BCG 1 × 106 cfu. All animals were monitored for tumor growth throughout the duration of the experiment. Results: Animals receiving treatments with BCG 1 × 106 cfu exhibited the greatest reduction in tumor volume ([mean ± SD] 4130.0 ± 1738.3 mm3; p = 0.0738), followed by those receiving BCG 1 × 104 cfu (4527.6 ± 1932.7 mm3; p = 0.1093) and BCG 1 × 105 cfu (4838.2 ± 1889.9 mm3; p = 0.5218), compared to those receiving the saline solution control (5445.0 ± 3119.5 mm3). Animal survival on Day 60 after transplantation was significantly increased in the group receiving BCG 1 × 106 cfu (19 [73.1%] of 26 animals; p = 0.0326) when compared to those receiving the saline solution control (12 [44%] of 27 animals). Treatment with BCG 1 × 105 cfu (11 [42.3%] of 26 animals survived; p = 0.5479) and BCG 1 × 104 cfu (13 [50%] of 26 animals survived; p = 0.4484) also reduced survival compared to the saline solution control, but not to the level of significance. Conclusions: The consistent reduction in tumor growth and animal mortality in animals receiving intralesional BCG demonstrates antitumor activity in this aggressive model of prostate cancer. The greatest efficacy was seen with the highest dose of BCG, suggesting that higher doses may be optimal in this model. BCG immunotherapy of prostate cancer warrants clinical evaluation.
{"title":"Bacillus Calmette‐Guerin Immunotherapy Significantly Prolongs Survival of Animals with Prostate Cancer","authors":"D. Lamm, D. Riggs, David A. Donley, Justin White, R. Yeater, R. Bryner","doi":"10.1046/J.1525-1411.1999.14009.X","DOIUrl":"https://doi.org/10.1046/J.1525-1411.1999.14009.X","url":null,"abstract":"Objectives: Bacillus Calmette-Guerin (BCG) is the treatment of choice for carcinoma in situ of the bladder, but its application to other cancers is very limited. The current study evaluates the effect of intralesional BCG in the PA3 rat prostate cancer model. \u0000 \u0000 \u0000 \u0000Materials and Methods: One hundred five rats were randomized to four groups. Each group received 1 × 106 PA3 cells subcutaneously on experiment Day 0. On experimental Day 7, the groups received the first of six weekly treatments. Treatments consisted of saline solution, BCG 1 × 104 colony-forming units (cfu), BCG 1 × 105 cfu, and BCG 1 × 106 cfu. All animals were monitored for tumor growth throughout the duration of the experiment. \u0000 \u0000 \u0000 \u0000Results: Animals receiving treatments with BCG 1 × 106 cfu exhibited the greatest reduction in tumor volume ([mean ± SD] 4130.0 ± 1738.3 mm3; p = 0.0738), followed by those receiving BCG 1 × 104 cfu (4527.6 ± 1932.7 mm3; p = 0.1093) and BCG 1 × 105 cfu (4838.2 ± 1889.9 mm3; p = 0.5218), compared to those receiving the saline solution control (5445.0 ± 3119.5 mm3). Animal survival on Day 60 after transplantation was significantly increased in the group receiving BCG 1 × 106 cfu (19 [73.1%] of 26 animals; p = 0.0326) when compared to those receiving the saline solution control (12 [44%] of 27 animals). Treatment with BCG 1 × 105 cfu (11 [42.3%] of 26 animals survived; p = 0.5479) and BCG 1 × 104 cfu (13 [50%] of 26 animals survived; p = 0.4484) also reduced survival compared to the saline solution control, but not to the level of significance. \u0000 \u0000 \u0000 \u0000Conclusions: The consistent reduction in tumor growth and animal mortality in animals receiving intralesional BCG demonstrates antitumor activity in this aggressive model of prostate cancer. The greatest efficacy was seen with the highest dose of BCG, suggesting that higher doses may be optimal in this model. BCG immunotherapy of prostate cancer warrants clinical evaluation.","PeriodicalId":22947,"journal":{"name":"The open prostate cancer journal","volume":"112 1","pages":"190-194"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79681663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-07-01DOI: 10.1046/J.1525-1411.1999.14005.X
W. Dale, O. Sartor, T. Davis, C. Bennett
Objectives: Prostate cancer accounted for more than 180,000 new cases and almost 40,000 deaths in the United States in 1998. Higher rates of mortality have been noted among racial minorities and lower socioeconomic status groups, primarily because of advanced stage of cancer at presentation. Understanding barriers toward early detection of prostate cancer may help diminish these variations. Materials and Methods: Thirty-two focus group sessions with individuals of lower socioeconomic status addressed attitudes toward physical examinations, prostate cancer, and sources of health-care information. Barriers to early detection were identified, based on transcripts that were analyzed using the Health Belief Model. Results: Most men of lower socioeconomic status viewed physical examinations negatively, with barriers including time, monetary costs, negative impressions of the prostate examination, and lack of belief in early detection. Among the minority of men who had had prostate examinations, they typically did so as part of examinations for chronic medical conditions or because of employer requirements for routine check-ups. The rectal examination was viewed very negatively because of concerns of physical pain, social embarrassment, and uncertain value. Fear and fatalism regarding prostate cancer were expressed by the majority of attendees. With respect to sources of health information, men typically received health-care information from the media, with television being the most common source. No significant differences in barriers to early detection efforts were observed between focus groups composed of white versus African American poor men. Conclusions: The Health Belief Model provides a framework for evaluating the perceptions of men of lower socioeconomic status toward the early detection of prostate cancer. Negative perceptions regarding physical examinations and skepticism about the value of early detection were major barriers to the early detection of prostate cancer. Targeted strategies directed at each of these barriers are needed to improve the rates of early detection in men of lower socioeconomic status.
{"title":"Understanding Barriers to the Early Detection of Prostate Cancer Among Men of Lower Socioeconomic Status","authors":"W. Dale, O. Sartor, T. Davis, C. Bennett","doi":"10.1046/J.1525-1411.1999.14005.X","DOIUrl":"https://doi.org/10.1046/J.1525-1411.1999.14005.X","url":null,"abstract":"Objectives: Prostate cancer accounted for more than 180,000 new cases and almost 40,000 deaths in the United States in 1998. Higher rates of mortality have been noted among racial minorities and lower socioeconomic status groups, primarily because of advanced stage of cancer at presentation. Understanding barriers toward early detection of prostate cancer may help diminish these variations. \u0000 \u0000 \u0000 \u0000Materials and Methods: Thirty-two focus group sessions with individuals of lower socioeconomic status addressed attitudes toward physical examinations, prostate cancer, and sources of health-care information. Barriers to early detection were identified, based on transcripts that were analyzed using the Health Belief Model. \u0000 \u0000 \u0000 \u0000Results: Most men of lower socioeconomic status viewed physical examinations negatively, with barriers including time, monetary costs, negative impressions of the prostate examination, and lack of belief in early detection. Among the minority of men who had had prostate examinations, they typically did so as part of examinations for chronic medical conditions or because of employer requirements for routine check-ups. The rectal examination was viewed very negatively because of concerns of physical pain, social embarrassment, and uncertain value. Fear and fatalism regarding prostate cancer were expressed by the majority of attendees. With respect to sources of health information, men typically received health-care information from the media, with television being the most common source. No significant differences in barriers to early detection efforts were observed between focus groups composed of white versus African American poor men. \u0000 \u0000 \u0000 \u0000Conclusions: The Health Belief Model provides a framework for evaluating the perceptions of men of lower socioeconomic status toward the early detection of prostate cancer. Negative perceptions regarding physical examinations and skepticism about the value of early detection were major barriers to the early detection of prostate cancer. Targeted strategies directed at each of these barriers are needed to improve the rates of early detection in men of lower socioeconomic status.","PeriodicalId":22947,"journal":{"name":"The open prostate cancer journal","volume":"3 1","pages":"179-184"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75608504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-07-01DOI: 10.1046/J.1525-1411.1999.14010.X
B. Brockstein, D. Shepard, J. Kugler, P. Fishkin, R. Arrieta, M. Ratain, E. Vokes, N. Vogelzang
Hormone refractory prostate cancer (HRPC) will affect more than 40,000 men in the United States in 1999, and only a few drugs have activity in this disease. We studied trimethylcolchicinic acid (TMCA), an oral colchicine derivative, in a Phase II trial involving 18 chemotherapy-naive men with HRPC. TMCA, 5 mg/m2/day, was given orally for 4 or 5 days with cycles repeated every 3 weeks. No patients showed an objective response by clinical or prostate specific antigen criteria. Neutropenia and stomatitis were common on this schedule. One fatal episode of neutropenic fever occurred. Pharmacokinetics suggested drug accumulation on Days 4 and 5. The cumulative area under the curve (AUC) of concentration × time correlated with the log neutrophil nadir, the log platelet nadir, and the severity of stomatitis. We conclude that TMCA has no clinical effect on HRPC despite severe hematologic toxicity and stomatitis, and that its hematologic toxicity is related to the AUC.
{"title":"A Phase II Trial of Oral Trimethylcolchicinic Acid in Patients with Hormone Refractory Prostate Cancer","authors":"B. Brockstein, D. Shepard, J. Kugler, P. Fishkin, R. Arrieta, M. Ratain, E. Vokes, N. Vogelzang","doi":"10.1046/J.1525-1411.1999.14010.X","DOIUrl":"https://doi.org/10.1046/J.1525-1411.1999.14010.X","url":null,"abstract":"Hormone refractory prostate cancer (HRPC) will affect more than 40,000 men in the United States in 1999, and only a few drugs have activity in this disease. We studied trimethylcolchicinic acid (TMCA), an oral colchicine derivative, in a Phase II trial involving 18 chemotherapy-naive men with HRPC. TMCA, 5 mg/m2/day, was given orally for 4 or 5 days with cycles repeated every 3 weeks. No patients showed an objective response by clinical or prostate specific antigen criteria. Neutropenia and stomatitis were common on this schedule. One fatal episode of neutropenic fever occurred. Pharmacokinetics suggested drug accumulation on Days 4 and 5. The cumulative area under the curve (AUC) of concentration × time correlated with the log neutrophil nadir, the log platelet nadir, and the severity of stomatitis. We conclude that TMCA has no clinical effect on HRPC despite severe hematologic toxicity and stomatitis, and that its hematologic toxicity is related to the AUC.","PeriodicalId":22947,"journal":{"name":"The open prostate cancer journal","volume":"25 1","pages":"195-202"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87196588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-07-01DOI: 10.1046/J.1525-1411.1999.14002.X
Matthew R. Smith
{"title":"Androgen Deprivation and Osteoporosis","authors":"Matthew R. Smith","doi":"10.1046/J.1525-1411.1999.14002.X","DOIUrl":"https://doi.org/10.1046/J.1525-1411.1999.14002.X","url":null,"abstract":"","PeriodicalId":22947,"journal":{"name":"The open prostate cancer journal","volume":"16 1","pages":"161-165"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78648393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-07-01DOI: 10.1046/J.1525-1411.1999.14001.X
M. Hurwitz
{"title":"Hyperthermia for Prostate Cancer: A Review","authors":"M. Hurwitz","doi":"10.1046/J.1525-1411.1999.14001.X","DOIUrl":"https://doi.org/10.1046/J.1525-1411.1999.14001.X","url":null,"abstract":"","PeriodicalId":22947,"journal":{"name":"The open prostate cancer journal","volume":"1 1","pages":"174-178"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86571268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-05-01DOI: 10.1046/J.1525-1411.1999.09921.X
S. Denmeade
{"title":"Apoptotic Pathways in Normal Prostate and Prostate Cancers","authors":"S. Denmeade","doi":"10.1046/J.1525-1411.1999.09921.X","DOIUrl":"https://doi.org/10.1046/J.1525-1411.1999.09921.X","url":null,"abstract":"","PeriodicalId":22947,"journal":{"name":"The open prostate cancer journal","volume":"27 1","pages":"120-125"},"PeriodicalIF":0.0,"publicationDate":"1999-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91157365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-05-01DOI: 10.1046/J.1525-1411.1999.09922.X
J. Nelson, M. Carducci
{"title":"The Role of the Endothelin Axis in Prostate Cancer","authors":"J. Nelson, M. Carducci","doi":"10.1046/J.1525-1411.1999.09922.X","DOIUrl":"https://doi.org/10.1046/J.1525-1411.1999.09922.X","url":null,"abstract":"","PeriodicalId":22947,"journal":{"name":"The open prostate cancer journal","volume":"180 1","pages":"126-130"},"PeriodicalIF":0.0,"publicationDate":"1999-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83012159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-05-01DOI: 10.1046/J.1525-1411.1999.09927.X
G. Hruby, H. Gurney, S. Turner, M. Berry, P. Harnett, V. Gebski
Background: To determine the feasibility of long-term use of intermittent hormone therapy (IHT) in patients with advanced prostate cancer.Methods: Sixteen hormone-naive patients were commenced on IHT and prospectively reviewed. IHT consisted of goserelin acetate alone (two patients) or combined with an antiandrogen. When the serum prostate specific antigen (PSA) level had fallen to 10 ng/ml, the same treatment was recommenced, constituting one complete cycle comprising both “on-treatment” and “off-treatment” phases. This was repeated until hormone independence (HI) occurred.Results: The median length follow-up was 49.9 months. Considering all patients, a mean of 41% of the total time was spent off hormone treatment, ranging from a median of 4.0 to 7.1 months for each cycle. Fifteen patients finished at least one complete cycle of IHT, and 7 patients completed two or more cycles. Nine patients became HI after a mean time period of 19.5 months. Six men remain on IHT; three are currently in their fourth or fifth cycle of treatment. For patients completing Cycles 1, 2, 3, 4, and 5, the median percentage time spent off treatment during each cycle was 41%, 54%, 58%, 53%, and 58%, respectively.Conclusions: Based on this pilot study, IHT would seem to allow considerable time off therapy without obviously affecting the time to HI. If the current randomized trials of IHT against continuous therapy demonstrate equivalent relapse-free survival, then quality of life and fiscal end points will be paramount in determining treatment options. An Australian intergroup study to examine these end points has already begun.
{"title":"Long‐Term Follow‐Up of Patients Treated with Intermittent Hormone Therapy for Advanced Prostate Cancer","authors":"G. Hruby, H. Gurney, S. Turner, M. Berry, P. Harnett, V. Gebski","doi":"10.1046/J.1525-1411.1999.09927.X","DOIUrl":"https://doi.org/10.1046/J.1525-1411.1999.09927.X","url":null,"abstract":"Background: To determine the feasibility of long-term use of intermittent hormone therapy (IHT) in patients with advanced prostate cancer.Methods: Sixteen hormone-naive patients were commenced on IHT and prospectively reviewed. IHT consisted of goserelin acetate alone (two patients) or combined with an antiandrogen. When the serum prostate specific antigen (PSA) level had fallen to 10 ng/ml, the same treatment was recommenced, constituting one complete cycle comprising both “on-treatment” and “off-treatment” phases. This was repeated until hormone independence (HI) occurred.Results: The median length follow-up was 49.9 months. Considering all patients, a mean of 41% of the total time was spent off hormone treatment, ranging from a median of 4.0 to 7.1 months for each cycle. Fifteen patients finished at least one complete cycle of IHT, and 7 patients completed two or more cycles. Nine patients became HI after a mean time period of 19.5 months. Six men remain on IHT; three are currently in their fourth or fifth cycle of treatment. For patients completing Cycles 1, 2, 3, 4, and 5, the median percentage time spent off treatment during each cycle was 41%, 54%, 58%, 53%, and 58%, respectively.Conclusions: Based on this pilot study, IHT would seem to allow considerable time off therapy without obviously affecting the time to HI. If the current randomized trials of IHT against continuous therapy demonstrate equivalent relapse-free survival, then quality of life and fiscal end points will be paramount in determining treatment options. An Australian intergroup study to examine these end points has already begun.","PeriodicalId":22947,"journal":{"name":"The open prostate cancer journal","volume":"15 1","pages":"138-143"},"PeriodicalIF":0.0,"publicationDate":"1999-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72837048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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