Navigation Links
Intermittent androgen deprivation at least as effective as continuous androgen deprivation

Arnhem, December 2009 'Potential Benefits of Intermittent Androgen Suppression Therapy in the Treatment of Prostate Cancer: A Systematic Review of the Literature' is the title of an article by P-A. Abrahamsson in the January issue of European Urology, the official journal of the European Association of Urology. The author evaluates available evidence regarding the efficacy and tolerability of intermittent androgen deprivation (IAD) and assess its value in the treatment of prostate cancer (PCa).

Prostate cancer (PCa) is the second most common male cancer worldwide and the most frequently occurring in Europe (20.3% of the total in 2006). Androgen-deprivation therapy (ADT) has progressed since 1941 when surgical castration was shown to improve PCa outcomes. The well-known side effect profile of ADT has significant quality-of-life implications such as sexual dysfunction, hot flushes, fatigue etc. Furthermore, it appears that androgen suppression causes a change in stem cells from an androgen-dependent to an androgen-independent phenotype. Because this progression to androgen independence is thought to begin early after treatment initiation, stopping androgen deprivation prior to this change occurring should restore apoptotic potential and help tumour cells remain sensitive to re-initiating treatment.

The strategy behind IAD, therefore, is to alternate androgen blockade with treatment cessation, allowing hormonal recovery between treatment periods, thus potentially improving tolerability and quality of life.

The author wishes to evaluate available evidence regarding the efficacy and tolerability of IAD and assess its value in the treatment of PCa. Key phase 2/3 clinical trials of IAD in PCa published within the last 10 years were identified on Medline using different search terms.

The conclusions were that IAD seems to be as effective as continuous androgen deprivation while showing tolerability and quality of life advantages, especially recovery of sexual potency. IAD has been a treatment option for >20 years and the EAU considers that its status should no longer be regarded as investigational.

However, QoL data are surprisingly limited given that this, rather than survival, is the key driver for IAD and considering the length of time this approach has been under evaluation.

Based on available evidence and general clinical opinion, IAD is a valid treatment option in nonmetastatic PCa cases, i.e. patients with locally advanced disease with or without lymph node involvement and those experiencing relapse following curative treatment. These patients have a higher chance of survival than those with more advanced disease, making QoL a key consideration. Full results from phase 3 trials, which include both locally advanced and metastatic patients, will further clarify target populations.

IAD has come of age, and many clinicians believe it has earned its place in the management of PCa; however, there are still insufficient data to determine whether IAD has the potential to prevent or reverse the long-term complications associated with ADT.


Contact: Lindy Brouwer
European Association of Urology

Related medicine news :

1. Meckels diverticulum masked by intermittent recurrent subocclusive episodes
2. New Analysis: Light and Intermittent Smokers Overlooked in Traditional Tobacco Research
3. Intermittent Catheter Market to Surpass 40% CAGR Between 2008 and 2012
4. Rochester Medical Applauds Improved U.S. Medicare Coverage Policy for Intermittent Catheters
5. BUSM researchers propose a relationship between androgen deficiency and cardiovascular disease
6. Protein that suppresses androgen receptors could improve prostate cancer diagnosis, treatment
7. Androgen Production Continues in Prostate Cancer Tumors
8. How advanced prostate cancer becomes resistant to androgen-deprivation therapy
9. Pharmacopeia Acquires Selective Androgen Receptor Modulator (SARM) Program from Bristol-Myers Squibb
10. Study shows that sleep deprivation can negatively affect information processing
11. Sleep Deprivation Might Lead to Alzheimers
Post Your Comments:
(Date:11/27/2015)... PITTSBURGH, PA (PRWEB) , ... November 27, 2015 ... ... of how filthy the toilets were," said an inventor from Hillside, N.J. "Many ... this improved seat cover so that individuals will always be protected from germs." ...
(Date:11/27/2015)... ... November 27, 2015 , ... Consistent with the ... 2016 Building Better Radiology Marketing Programs meeting will showcase some of the ... 2016, at Caesars Palace in Las Vegas with a pre-conference session on a ...
(Date:11/27/2015)... ... November 27, 2015 , ... CBD College is proud ... Education Programs (CAAHEP) awarded accreditation to its Diagnostic Medical Sonography program. CBD College is ... only one of twelve colleges and universities in the state of California make the ...
(Date:11/26/2015)... ... November 26, 2015 , ... Patients at Serenity Point ... come together on Thanksgiving Day to share the things that they are most ... Serenity Point YouTube channel, patients displayed what they wrote on index cards, describing ...
(Date:11/26/2015)... ... November 26, 2015 , ... Jobs in hospital medical laboratories and in ... by healthcare staffing agency Aureus Medical Group . These fields, as ... among those searching for healthcare jobs through the company’s website, , ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... -- Research and Markets ( ) has ... Horizons and Growth Strategies in the Italian Therapeutic ... Forecasts, Competitive Intelligence, Emerging Opportunities" report to ... --> This new 247-page report provides ... monitoring market, including emerging tests, technologies, instrumentation, sales ...
(Date:11/25/2015)... global healthcare industry is expected to grow at a rate ... has the highest projected growth at 12.7%, and ... is second with growth projected at 11.5%. ... 2013-2014, total government funded healthcare was nearly 68%. Federal government ... 2013-2014. In real terms, out of pocket expenditure increased by ...
(Date:11/25/2015)... , Nov. 25, 2015 AAIPharma ... planned investment of at least $15.8  Million to ... Wilmington, NC . The expansion will ... to meet the growing demands of the pharmaceutical ... site expansion will provide up to 40,000 ...
Breaking Medicine Technology: