Current strategies in the management of hormone refractory prostate cancer.

摘要: Prostate cancer is the most common diagnosed in American males, and second leading cause of cancer-related deaths. Most patients who develop metastatic disease will initially respond to androgen deprivation, but response invariably temporary. androgen-independent ("hormone-refractory") that results progressive clinical deterioration ultimately death. This progression independence accompanied by increasingly evident DNA instability alterations genes gene expression, including mutations p53, over-expression Bcl2, receptor gene, among others. Treatment options for hormone refractory include intensive supportive care, radiotherapy, bisphosphonates, second-line hormonal manipulations, cytotoxic chemotherapy investigational agents. A post-treatment reduction level prostate specific antigen (PSA) 50% has been shown correlate with survival accepted consensus as a valid endpoint trials. Chemotherapeutic agents such mitoxantrone, estramustine, taxanes have yielded improved rates palliative benefit, not survival. Therefore, current efforts must be focused on enrolling onto trials novel mechanisms action, using survival, time progression, quality life end points routine practice.