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Intermittent Versus Continuous ADT for Advanced Prostate Cancer

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Management of Advanced Prostate Cancer
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Abstract

Androgen deprivation therapy (ADT) is the main systemic treatment of metastatic prostate cancer. However, the indications for ADT have been expanded to locally advanced disease with development of medical castration. Reversible medical androgen deprivation has facilitated adjuvant ADT in men with high-risk features treated with radiation or surgery. Considering the toxic effects of androgen deprivation and deterioration in quality of life, permanent androgen deprivation in patients with symptom-free biochemical recurrence seems unsuitable.

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References

  1. Bruchovsky N, Rennie PS, Coldman AJ, Goldenberg SL, To M, Lawson D. Effects of androgen withdrawal on the stem cell composition of the Shionogi carcinoma. Cancer Res. 1990;50(8):2275–82.

    PubMed  CAS  Google Scholar 

  2. Abrahamsson PA. Potential benefits of intermittent androgen suppression therapy in the treatment of prostate cancer: a systematic review of the literature. Eur Urol. 2010;57(1):49–59.

    Article  CAS  PubMed  Google Scholar 

  3. Akakura K, Bruchovsky N, Goldenberg SL, Rennie PS, Buckley AR, Sullivan LD. Effects of intermittent androgen suppression on androgen-dependent tumors. Apoptosis and serum prostate-specific antigen. Cancer. 1993;71(9):2782–90.

    Article  CAS  PubMed  Google Scholar 

  4. de Leval J, Boca P, Yousef E, Nicolas H, Jeukenne M, Seidel L, et al. Intermittent versus continuous total androgen blockade in the treatment of patients with advanced hormone-naive prostate cancer: results of a prospective randomized multicenter trial. Clin Prostate Cancer. 2002;1(3):163–71.

    Article  PubMed  Google Scholar 

  5. Crook JM, O'Callaghan CJ, Duncan G, Dearnaley DP, Higano CS, Horwitz EM, et al. Intermittent androgen suppression for rising PSA level after radiotherapy. N Engl J Med. 2012;367(10):895–903.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Hussain M, Tangen CM, Berry DL, Higano CS, Crawford ED, Liu G, et al. Intermittent versus continuous androgen deprivation in prostate cancer. N Engl J Med. 2013;368(14):1314–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Hershman DL, Unger JM, Wright JD, Ramsey S, Till C, Tangen CM, et al. Adverse health events following intermittent and continuous androgen deprivation in patients with metastatic prostate cancer. JAMA Oncol. 2016;2(4):453–61.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Botrel TE, Clark O, dos Reis RB, Pompeo AC, Ferreira U, Sadi MV, et al. Intermittent versus continuous androgen deprivation for locally advanced, recurrent or metastatic prostate cancer: a systematic review and meta-analysis. BMC Urol. 2014;14:9.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Jin C, Fan Y, Meng Y, Shen C, Wang Y, Hu S, et al. A meta-analysis of cardiovascular events in intermittent androgen-deprivation therapy versus continuous androgen-deprivation therapy for prostate cancer patients. Prostate Cancer Prostatic Dis. 2016;19(4):333–9.

    Article  CAS  PubMed  Google Scholar 

  10. Wolff JM, Abrahamsson PA, Irani J, da Silva FC. Is intermittent androgen-deprivation therapy beneficial for patients with advanced prostate cancer? BJU Int. 2014;114(4):476–83.

    Article  PubMed  Google Scholar 

  11. Hussain M, Tangen CM, Higano C, Schelhammer PF, Faulkner J, Crawford ED, et al. Absolute prostate-specific antigen value after androgen deprivation is a strong independent predictor of survival in new metastatic prostate cancer: data from Southwest Oncology Group Trial 9346 (INT-0162). J Clin Oncol. 2006;24(24):3984–90.

    Article  PubMed  Google Scholar 

  12. D’Amico AV, Chen MH, de Castro M, Loffredo M, Lamb DS, Steigler A, et al. Surrogate endpoints for prostate cancer-specific mortality after radiotherapy and androgen suppression therapy in men with localised or locally advanced prostate cancer: an analysis of two randomised trials. Lancet Oncol. 2012;13(2):189–95.

    Article  PubMed  Google Scholar 

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Correspondence to Ji Youl Lee .

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Lee, K.W., Lee, J.Y. (2018). Intermittent Versus Continuous ADT for Advanced Prostate Cancer. In: Kim, C. (eds) Management of Advanced Prostate Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-10-6943-7_14

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  • DOI: https://doi.org/10.1007/978-981-10-6943-7_14

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-6942-0

  • Online ISBN: 978-981-10-6943-7

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