Complete and rogen blockade has a small survival benefit of about 5 % .
Intermittent and rogen deprivation ( IAD ) results in equivalent oncologic efficacy when compared with continuous and rogen-deprivation therapy ( ADT ) in well-selected population s. In locally advanced and metastatic PCa , early ADT does not result in a significant survival advantage when compared with delayed ADT .
Zoledronic acid and denusomab can be used in men with CRPC and osseous metastases to prevent skeletal-related complications .
OBJECTIVES Our aim is to present a summary of the 2010 version of the European Association of Urology ( EAU ) guidelines on the treatment of advanced , relapsing , and castration-resistant prostate cancer ( CRPC ) .
The guidelines were up date d , and the levels of evidence ( LEs ) and /or grade s of recommendation ( GR ) were added to the text based on a systematic review of the literature , which included a search of online data bases and bibliographic review s. RESULTS Luteinising hormone-releasing hormone ( LHRH ) agonists are the st and ard of care in metastatic prostate cancer ( PCa ) .
Although LHRH antagonists decrease testosterone without any testosterone surge , their clinical benefit remains to be determined .
Treatment of castration-resistant prostate cancer ( CRPC ) includes second-line hormonal therapy , novel agents , and chemotherapy with docetaxel at 75 mg/m(2 ) every 3 wk .
Lower baseline prostate-specific antigen is associated with a greater overall survival benefit from sipuleucel-T in the Immunotherapy for Prostate Adenocarcinoma Treatment (IMPACT) trial.
OBJECTIVE To explore the prognostic and predictive value of baseline variables in 512 patients with metastatic castration-resistant prostate cancer from the phase III Immunotherapy for Prostate Adenocarcinoma Treatment ( IMPACT ) trial who were r and omized to receive sipuleucel-T or control .  METHODS The most powerful of these prognostic factors , baseline prostate-specific antigen ( PSA ) , was subdivided into quartiles to evaluate treatment effect patterns . Cox regression analyses were used to assess predictors of overall survival ( OS )  and sipuleucel-T treatment effect within PSA quartiles . Median OS was estimated by the Kaplan-Meier method . RESULTS PSA was the strongest baseline prognostic factor ( P < .0001 ) . Furthermore , the sipuleucel-T  treatment effect appeared greater with decreasing baseline PSA . The OS hazard ratio for patients in the lowest baseline PSA quartile ( ≤22.1 ng/mL ) was 0.51 ( 95 % confidence interval , 0.31 - 0.85 ) compared with 0.84 ( 95 % confidence interval , 0.55 - 1.29 ) for patients in the highest PSA quartile ( > 134 ng/mL ) . Estimated improvement in median survival varied from 13.0 months in the lowest baseline PSA quartile to 2.8 months in the highest quartile . Estimated 3-year survival in the lowest PSA quartile was 62.6 % for sipuleucel-T patients and 41.6 % for control patients , representing a 50 % relative increase . CONCLUSION The greatest magnitude of benefit with sipuleucel-T treatment in this exploratory analysis was observed among patients with better baseline prognostic factors , particularly those with lower baseline PSA values . These findings suggest that patients with less advanced disease may benefit the most from sipuleucel-T treatment and provide a rationale for immunotherapy as an early treatment strategy in sequencing algorithms for metastatic castration-resistant prostate cancer
Complete and rogen blockade has a small survival benefit of about 5 % .
Intermittent and rogen deprivation ( IAD ) results in equivalent oncologic efficacy when compared with continuous and rogen-deprivation therapy ( ADT ) in well-selected population s. In locally advanced and metastatic PCa , early ADT does not result in a significant survival advantage when compared with delayed ADT .
Zoledronic acid and denusomab can be used in men with CRPC and osseous metastases to prevent skeletal-related complications .
OBJECTIVES Our aim is to present a summary of the 2010 version of the European Association of Urology ( EAU ) guidelines on the treatment of advanced , relapsing , and castration-resistant prostate cancer ( CRPC ) .
The guidelines were up date d , and the levels of evidence ( LEs ) and /or grade s of recommendation ( GR ) were added to the text based on a systematic review of the literature , which included a search of online data bases and bibliographic review s. RESULTS Luteinising hormone-releasing hormone ( LHRH ) agonists are the st and ard of care in metastatic prostate cancer ( PCa ) .
Although LHRH antagonists decrease testosterone without any testosterone surge , their clinical benefit remains to be determined .
Treatment of castration-resistant prostate cancer ( CRPC ) includes second-line hormonal therapy , novel agents , and chemotherapy with docetaxel at 75 mg/m(2 ) every 3 wk .