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Combinations of Hormonal Therapy and Chemotherapy

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Abstract

Prostate cancer (PC) is a heterogeneous disease, with a complex natural history, whose growth is driven by androgens and androgen receptors. In most cases, patients have localized disease at presentation, which may be successfully treated with radical prostatectomy and external beam radiation. However, many patients subsequently develop metastatic disease. De novo metastases can also occur in a minority of cases.Androgen deprivation therapy (ADT) is the standard treatment of metastatic hormone-naïve (or castration-sensitive) prostatic cancer (CSPC). ADT usually determines a profound PSA decline and a radiological and clinical benefit in most patients. However, essentially all patients experience progression to castration-resistant prostate cancer (CRPC) despite persisting low testosterone levels in around 1–2 years, and overall prognosis remains disappointing, although subsequent active treatments are available. Early targeting of cells that survive hormonal therapy may potentially prevent the development of CRPC. The aim of these therapeutic strategies is the elimination of resistant cells at the time the tumor is apparently “androgen sensitive”. The large randomized studies analyzed in this chapter, addressing the early use of docetaxel in combination with ADT in men with metastatic CSPC, have shown evidence that at least a subset of patients with metastatic CSPC may benefit from the combination of ADT with docetaxel as initial therapy.

Keywords

  • Prostate Cancer
  • Androgen Receptor
  • Zoledronic Acid
  • Metastatic Prostate Cancer
  • Abiraterone Acetate

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Fig. 12.1

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Correspondence to Giovanni Luca Ceresoli .

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Ceresoli, G.L., Bonomi, M., Sauta, M.G., Zanardi, E., Boccardo, F. (2017). Combinations of Hormonal Therapy and Chemotherapy. In: Bertoldo, F., Boccardo, F., Bombardieri, E., Evangelista, L., Valdagni, R. (eds) Bone Metastases from Prostate Cancer . Springer, Cham. https://doi.org/10.1007/978-3-319-42327-2_12

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  • DOI: https://doi.org/10.1007/978-3-319-42327-2_12

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