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 .
Development of a Second-Generation Antiandrogen for Treatment of Advanced Prostate Cancer
A Second Act for Anti and rogens  Men with advanced prostate cancer are often treated with anti and rogens ; drugs that inhibit the activity of male hormones , such as testosterone , that help drive tumor growth . Many of these drugs act by functionally disrupting the and rogen receptor ( AR ) , a transcriptional regulator of cell proliferation , but tumors eventually become resistant to the drugs by expressing higher levels of the AR . Tran et al. ( p. 787 , published online 9 April ) have developed a “ second-generation ” anti and rogen , a thiohydantoin called MDV3100 , which binds the AR with high affinity . MDV3100 retains its anticancer activity in cell culture and in mouse models even when AR levels are elevated . The drug appears to act both by inhibiting translocation of the AR into the nucleus and by reducing its transcriptional activity . MDV3100 is being tested in patients with advanced prostate cancer , the first group of which have shown a decline in blood levels of a marker of cancer growth , prostate-specific antigen . A drug that binds to the and rogen receptor acts by disrupting its activity in the cell nucleus . Metastatic prostate cancer is treated with drugs that antagonize and rogen action , but most patients progress to a more aggressive form of the disease called castration-resistant prostate cancer , driven by elevated expression of the and rogen receptor . Here we characterize the diarylthiohydantoins RD162 and MDV3100 , two compounds optimized from a screen for nonsteroidal anti and rogens that retain activity in the setting of increased and rogen receptor expression . Both compounds bind to the and rogen receptor with greater relative affinity than the clinical ly used anti and rogen bicalutamide , reduce the efficiency of its nuclear translocation , and impair both DNA binding to and rogen response elements and recruitment of coactivators .  RD162 and MDV3100 are orally available and induce tumor regression in mouse models of castration-resistant human prostate cancer . Of the first 30 patients treated with MDV3100 in a Phase I/II clinical trial , 13 of 30 ( 43 % ) showed sustained declines ( by > 50 % ) in serum concentrations of prostate-specific antigen , a biomarker of prostate cancer . These compounds thus appear to be promising c and i date s for treatment 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 .