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 .
Casodex 10-200 mg daily, used as monotherapy for the treatment of patients with advanced prostate cancer. An overview of the efficacy, tolerability and pharmacokinetics from three phase II dose-ranging studies. Casodex Study Group.
OBJECTIVES To evaluate the efficacy , tolerability , endocrinological effects and the pharmacokinetics of Casodex , when given as monotherapy during daily dosing of 10 - 200 mg to patients with advanced prostate cancer . METHODS A total of 390 patients with advanced prostate cancer were treated for a minimum of 12 weeks with a daily monotherapy dose of Casodex . The doses ranged from 10 to 200 mg . Objective assessment s of efficacy included : review of measurable metastases , prostate dimension , prostatic acid phosphatase and prostate-specific antigen ( PSA ) levels . Subjective assessment s of efficacy included review of urological symptoms , performance status , bone scan and analgesic requirement . Pharmacokinetic sample s were taken at various time points up to 3 months , and assayed using an achiral HPLC method . RESULTS Clear objective responses were observed , particularly at doses of 50 mg and above . Specifically , the median percentage decrease in PSA at 50 mg was 90.0 % , and at 100 and 200 mg it was 93.4 and 94.8 % , respectively . Up to 53 % of symptomatic patients demonstrated a subjective response at 3 months . Casodex was well tolerated at all doses with no effect on haematological or cardiovascular parameters and no effect on renal function . The expected pharmacological effects of potent anti and rogen therapy , such as breast tenderness ( 58 % ) , gynaecomastia ( 48 % ) , and hot flushes ( 17 % ) , were reported , but these incidences reflected the direct eliciting of these events . The intrinsic efficacy of Casodex was demonstrated despite increases of 60 % in testosterone levels . However , this increase reached a plateau after 4 - 12 weeks of therapy , but the majority of values remained within the normal range . Casodex has a half-life of approximately 1 week , enabling once-daily dosing with no effect of age or renal impairment on its pharmacokinetics . CONCLUSION Casodex has a favourable side effect profile compared with the known safety profiles of other anti and rogens and has demonstrated intrinsic efficacy . Casodex warrants further investigation as a monotherapy for the management of advanced 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 .