Treatment advances of hormone-resistant prostate cancer

Apr 12
08:57

2012

David Yvon

David Yvon

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From the 1940s, endocrine therapy has become first-line treatment for advanced metastatic prostate cancer. However, previous research has found that almost all patients with the start of endocrine therapy sensitivity of prostate cancer ultimately develop into hormone resistance.

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That means it is no response to endocrine treatment or the treatment promoting disease progression. They all result in deterioration of the irreversible clinical plant extracts progress and ultimately lead to death. Before the 1990s,Treatment advances of hormone-resistant prostate cancer Articles the treatment of hormone-refractory prostate cancer is lacking of surgery. With the new treatment options are emerging, people are no longer helpless.

In past, prostate cancer has been considered as a malignant tumor which is not sensitive to chemotherapy for a long time. Between 1988 to 1992, there have been 26 kinds of chemotherapy, single agent is used in the treatment of prostate cancer, the overall response rate was only 8.7%, median survival time of 10-12 months, efficacy disappointing; and chemotherapy of many toxic side effects of chemotherapy once suffered cold. The emergence of docetaxel chemotherapy for prostate cancer has opened up new prospects in 2004 Phase III clinical trials TAX327 and SWOG9916 to establish the preferred status of docetaxel chemotherapy in the treatment of HRPC.

Docetaxel and irinotecan mainly through the strengthening of tubulin polymerization and inhibiting microtubule depolymerization leads to the formation of stable non-functional microtubules. It can destroy tumor cells in mitosis, inhibit tumor growth and promote tumor apoptosis. On the other hand, metastatic prostate cancer regardless of the primary tumor or metastases are highly expressed in the anti-apoptotic gene, Bcl-2 phosphorylation can inhibit its anti-apoptotic effect, and Docetaxel is an efficient phosphorylation accelerator, so that it can inhibit the anti-apoptotic role of genes, induced apoptosis in prostate cancer. Clinical trials with docetaxel, there is no test more treatment differences between docetaxel combined with prednisone and docetaxel combined estradiol nitrogen mustard.

However, because the estradiol chlormethin has obvious side effects caused by venous thrombosis, it must be applied while using anticoagulant drugs such as aspirin. In contrast, combination with prednisone treatment did not increase too many side effects. Hematological toxicity and gastrointestinal side effects are relatively mild, most patients can safely withstand. Docetaxel combining with prednisone may be more easily accepted by patients. Docetaxel chemotherapy in the treatment of HRPC successful application, so that people began to explore the application prospects in the adjuvant or neoadjuvant treatment of earlier prostate cancer.

Targeted biological therapy is one of the hot spots in cancer treatment. As research continues, more and more receptor or ligand drugs and immune-related therapy are used in the treatment of tumors. Tyrosine kinase inhibitor, angiogenesis inhibitors, endothelin inhibitors, vaccine therapy and monoclonal antibodies in clinical trials have high security while many of them are for HRPC. Standard treatment of HRPC is the androgen stripping treatment, chemotherapy and application of bisphosphonates. Docetaxel chemotherapy is the only HRPC treatment today which can improve survival. Many exploring biological treatments will become promising alternative to chemotherapy treatment in future.Source:http://www.cospcn.com