Back to Journals » OncoTargets and Therapy » Volume 9

Androgen deprivation therapy as backbone therapy in the management of prostate cancer

Authors Merseburger AS, Alcaraz A, von Klot CA

Received 13 July 2016

Accepted for publication 18 September 2016

Published 29 November 2016 Volume 2016:9 Pages 7263—7274

DOI https://doi.org/10.2147/OTT.S117176

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 4

Editor who approved publication: Prof. Dr. Geoffrey Pietersz


Axel S Merseburger,1 Antonio Alcaraz,2 Christoph A von Klot3

1Department of Urology, University Hospital Schleswig-Holstein, Campus Lübeck, Germany; 2Department of Urology, Hospital Clínic, Barcelona, Spain; 3Department of Urology and Urologic Oncology, Hannover Medical School, Hannover, Germany

Abstract: Androgen deprivation therapy (ADT) is well established as a backbone therapy for metastatic prostate cancer (mPCa), and both European and American guidelines emphasize the importance of maintaining ADT after progression to metastatic castration-resistant prostate cancer (CRPC). However, the use of ADT varies widely in clinical practice despite these recommendations. Both research and development of increasingly precise assay technologies have improved our understanding of androgen production and signaling, and the recent data have suggested that a new serum testosterone cutoff value of <0.7 nmol/L should be employed. Most clinical trials to date have used the historical 1.7 nmol/L cutoff, but the <0.7 nmol/L cutoff has been associated with improved patient outcomes. Combining agents with different mechanisms of action to achieve intense androgen blockade may improve survival both before and after progression to CRPC. Data suggest that this intensive approach to androgen deprivation could delay the transition to CPRC and hence improve survival dramatically. Various combinations of backbone ADT with chemotherapy or radiotherapy are under investigation. Administration of ADT is established in patients with intermediate or high-risk localized prostate cancer (PCa) receiving radiotherapy with curative intent. This article reviews the current and potential role of ADT as backbone therapy in both hormone-sensitive PCa and CRPC with a focus on mPCa.

Keywords: prostate cancer, androgen deprivation therapy, ADT, chemotherapy, radiotherapy, treatment guidelines

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]