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Combinations of Hormonal Therapy and Chemotherapy

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Book cover Bone Metastases from Prostate Cancer

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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.

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Author information

Authors and Affiliations

  1. Department of Medical Oncology, Cliniche Humanitas Gavazzeni, Bergamo, Italy

    Giovanni Luca Ceresoli, Maria Bonomi & Maria Grazia Sauta

  2. Academic Unit of Medical Oncology, IRCCS AOU San Martino-IST (San Martino University Hospital and National Cancer Research Institute), Genoa, Italy

    Elisa Zanardi & Francesco Boccardo

Authors
  1. Giovanni Luca Ceresoli
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  2. Maria Bonomi
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  3. Maria Grazia Sauta
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  4. Elisa Zanardi
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  5. Francesco Boccardo
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Correspondence to Giovanni Luca Ceresoli .

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Editors and Affiliations

  1. University of Verona, Director of Metabolic Bone Diseases and Osteoncology Unit, Internal Medicine Department of Medicine, Verona, Italy

    Francesco Bertoldo

  2. IRCCS AOU San Martino-IST National Cancer Research Institute, Department of Internal Medicine and Medical specialties (DIMI), School of Medical and Pharmacological Sciences, University of Genoa, Academic Unit of Medical Oncology, Department of Oncology (DIPOE), Genoa, Italy

    Francesco Boccardo

  3. Humanitas Gavazzeni Clinic, Clical Scientific Director Department of Nuclear Medicine, Bergamo, Italy

    Emilio Bombardieri

  4. Veneto Institute of Oncology IOV - IRCCS, Nuclear Medicine and Molecular imaging Unit, Padova, Italy

    Laura Evangelista

  5. Radiation Oncology 1 and Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Oncology and Hemato-oncology, Università di Milano, Milan, Italy

    Riccardo Valdagni

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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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  • Online ISBN: 978-3-319-42327-2

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