FRII-13 HISTORY OF ANDROGEN DEPRIVATION APPROACHES FOR PROSTATE CANCER (2014)

You have accessJournal of UrologyHistory of Urology II (Moderated Poster)1 Apr 2014FRII-13 HISTORY OF ANDROGEN DEPRIVATION APPROACHES FOR PROSTATE CANCER Jason Phillips, Vassilis Siomos, Nicholas Westfall, McCabe Kenny, Joshua Spendlove, Thomas Pshak, Robert Larke, Kyle Rove, and E. David Crawford Jason PhillipsJason Phillips More articles by this author , Vassilis SiomosVassilis Siomos More articles by this author , Nicholas WestfallNicholas Westfall More articles by this author , McCabe KennyMcCabe Kenny More articles by this author , Joshua SpendloveJoshua Spendlove More articles by this author , Thomas PshakThomas Pshak More articles by this author , Robert LarkeRobert Larke More articles by this author , Kyle RoveKyle Rove More articles by this author , and E. David CrawfordE. David Crawford More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1751AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives The therapeutic landscape for the management of advanced prostate cancer is rapidly evolving. In the last five years seven new treatments have been brought to market. Current controversy exists regarding the optimal therapy for patients with metastatic prostate cancer. A thorough understanding of the history and evolution of androgen deprivation therapy is essential for Urologists using these agents. Methods The literature was reviewed for seminal articles in androgen deprivation therapy for prostate cancer. Results In 1941, Charles Huggins discovered that eliminating testosterone through castration could delay advanced prostate cancer. Huggins along with W.W. Scott then performed bilateral adrenalectomy and hypophysectomy to eliminate adrenal androgen production. Larger studies were then undertaken to better assess systemic ADT on prostate cancer. The VA Cooperative Urologic Research Group found that treating patients with DES was as effective as orchiectomy; however, side effects limited its use. It wasn’t until 40 years later that the first tolerated medical systemic therapy, leuprolide acetate, was FDA approved for castrate resistant prostate cancer. This pivotal therapy was based on the Nobel Prize winning work of Andrew Schally, who discovered the structure of gonadotropin releasing hormone. From that time up until 2008, five notable therapies have been brought to market including flutamide, strontium, mitoxantrone, zolendronic acid and docetaxel. Of these, only one modern chemotherapy agent (docetaxel) demonstrates a clear survival benefit. However, in the last five years, seven new agents have been developed including degarelix, sipuleucel-T, denosumab, abiraterone, cabazitaxel, enzalutamide, and radium-223. The optimal timing and use in combination has yet to be discovered. Conclusions We are now in the golden age of drug development for metastatic prostate cancer. We challenge Urologists to learn about the history of these medications and how they have shaped the current treatment landscape. New studies are pushing the use of these therapies earlier in the treatment algorithm. Understanding the path to our current environment lends perspective for the evolution and future of androgen deprivation therapy for prostate cancer. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e631-e632 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Jason Phillips More articles by this author Vassilis Siomos More articles by this author Nicholas Westfall More articles by this author McCabe Kenny More articles by this author Joshua Spendlove More articles by this author Thomas Pshak More articles by this author Robert Larke More articles by this author Kyle Rove More articles by this author E. David Crawford More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...