Secondary Hormonal Treatments
Introduction
Several secondary hormonal treatments have clinical activity and the sequential use of these may lead to prolonged periods of clinical response. Secondary hormonal therapies can provide a safe and effective treatment option in patients with rising PSA despite a castrate testosterone level. The use of steroids and adrenal androgen suppressors, such as ketoconazole, aminoglutethimide and (recently) abiraterone, has resulted in symptomatic improvement and a greater than 50% PSA decrease in a substantial percent of patients. A similar clinical benefit has been demonstrated with estrogen based therapies. Other agents are in clinical trials that may provide more complete blockade of testosterone.
PCRI Resources:
- Hormone-Refractory Prostate Cancer: A Continuum of Diseases and Options • Oliver Sartor, MD 2005
- Listening to the Biology of PC • Stephen Strum, MD 2001
- Anti-androgen Withdrawal Response (AAWR)
- High Dose Ketoconazole Plus Hydrocortisone (HDK+ HC) 2004
- Abiraterone Acetate for Advanced Prostate Cancer 2010
- Androgen Resistance (Part 1-3) • Charles Myers, MD 2002,3
Related Resources:
- Parenteral oestrogen in the treatment of prostate cancer: a systematic review Br J Cancer. 2008 February 26; 98(4): 697–707. Norman et al
- Androgen deprivation therapy: progress in understanding mechanisms of resistance and optimizing androgen depletion Nat Clin Pract Urol. 2009 Feb;6(2):76-85. Harris et al
Page updated 8/1/11
