Complete androgen blockade for prostate cancer: What went wrong?

Research output: Contribution to journalArticle

Abstract

Purpose: We summarized and critically assessed all available data from phase III clinical trials on complete androgen blockade versus surgical or medical castration alone. Materials and Methods: Published results in journals and abstracts of phase III trials, and published meta-analyses were reviewed. We also reviewed quality of life and toxicity issues associated with the addition of antiandrogens to medical or surgical castration. Finally, we discuss the original rationale for complete androgen blockade in the context of current knowledge. Results: A total of 27 clinical trials using various combinations of androgen deprivation were identified, of which 3 showed a statistically significant benefit for the complete androgen blockade arm. There were 5 publications of meta-analyses that each used different selection criteria for the inclusion of studies in the final analysis. Toxicity and quality of life have not been widely investigated in prospective fashion but the available data suggest a higher toxicity rate and decreased quality of life with complete androgen blockade. Conclusions: The extensive body of data does not support routine use of antiandrogens in combination with medical or surgical castration as first line hormonal therapy in patients with metastatic prostate cancer.

Original languageEnglish (US)
Pages (from-to)3-9
Number of pages7
JournalJournal of Urology
Volume164
Issue number1
StatePublished - Jul 2000

Fingerprint

Androgens
Prostatic Neoplasms
Castration
Androgen Antagonists
Quality of Life
Meta-Analysis
Phase III Clinical Trials
Patient Selection
Publications
Clinical Trials
Therapeutics

Keywords

  • Androgen antagonists
  • Castration
  • Male
  • Neoplasm metastasis
  • Prostate
  • Prostatic neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Complete androgen blockade for prostate cancer : What went wrong? / Laufer, Menachem; Denmeade, Samuel R; Sinibaldi, Victoria; Carducci, Michael A; Eisenberger, Mario.

In: Journal of Urology, Vol. 164, No. 1, 07.2000, p. 3-9.

Research output: Contribution to journalArticle

@article{4be5d00f8a754ce79e4017219f8f57e5,
title = "Complete androgen blockade for prostate cancer: What went wrong?",
abstract = "Purpose: We summarized and critically assessed all available data from phase III clinical trials on complete androgen blockade versus surgical or medical castration alone. Materials and Methods: Published results in journals and abstracts of phase III trials, and published meta-analyses were reviewed. We also reviewed quality of life and toxicity issues associated with the addition of antiandrogens to medical or surgical castration. Finally, we discuss the original rationale for complete androgen blockade in the context of current knowledge. Results: A total of 27 clinical trials using various combinations of androgen deprivation were identified, of which 3 showed a statistically significant benefit for the complete androgen blockade arm. There were 5 publications of meta-analyses that each used different selection criteria for the inclusion of studies in the final analysis. Toxicity and quality of life have not been widely investigated in prospective fashion but the available data suggest a higher toxicity rate and decreased quality of life with complete androgen blockade. Conclusions: The extensive body of data does not support routine use of antiandrogens in combination with medical or surgical castration as first line hormonal therapy in patients with metastatic prostate cancer.",
keywords = "Androgen antagonists, Castration, Male, Neoplasm metastasis, Prostate, Prostatic neoplasms",
author = "Menachem Laufer and Denmeade, {Samuel R} and Victoria Sinibaldi and Carducci, {Michael A} and Mario Eisenberger",
year = "2000",
month = "7",
language = "English (US)",
volume = "164",
pages = "3--9",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Complete androgen blockade for prostate cancer

T2 - What went wrong?

AU - Laufer, Menachem

AU - Denmeade, Samuel R

AU - Sinibaldi, Victoria

AU - Carducci, Michael A

AU - Eisenberger, Mario

PY - 2000/7

Y1 - 2000/7

N2 - Purpose: We summarized and critically assessed all available data from phase III clinical trials on complete androgen blockade versus surgical or medical castration alone. Materials and Methods: Published results in journals and abstracts of phase III trials, and published meta-analyses were reviewed. We also reviewed quality of life and toxicity issues associated with the addition of antiandrogens to medical or surgical castration. Finally, we discuss the original rationale for complete androgen blockade in the context of current knowledge. Results: A total of 27 clinical trials using various combinations of androgen deprivation were identified, of which 3 showed a statistically significant benefit for the complete androgen blockade arm. There were 5 publications of meta-analyses that each used different selection criteria for the inclusion of studies in the final analysis. Toxicity and quality of life have not been widely investigated in prospective fashion but the available data suggest a higher toxicity rate and decreased quality of life with complete androgen blockade. Conclusions: The extensive body of data does not support routine use of antiandrogens in combination with medical or surgical castration as first line hormonal therapy in patients with metastatic prostate cancer.

AB - Purpose: We summarized and critically assessed all available data from phase III clinical trials on complete androgen blockade versus surgical or medical castration alone. Materials and Methods: Published results in journals and abstracts of phase III trials, and published meta-analyses were reviewed. We also reviewed quality of life and toxicity issues associated with the addition of antiandrogens to medical or surgical castration. Finally, we discuss the original rationale for complete androgen blockade in the context of current knowledge. Results: A total of 27 clinical trials using various combinations of androgen deprivation were identified, of which 3 showed a statistically significant benefit for the complete androgen blockade arm. There were 5 publications of meta-analyses that each used different selection criteria for the inclusion of studies in the final analysis. Toxicity and quality of life have not been widely investigated in prospective fashion but the available data suggest a higher toxicity rate and decreased quality of life with complete androgen blockade. Conclusions: The extensive body of data does not support routine use of antiandrogens in combination with medical or surgical castration as first line hormonal therapy in patients with metastatic prostate cancer.

KW - Androgen antagonists

KW - Castration

KW - Male

KW - Neoplasm metastasis

KW - Prostate

KW - Prostatic neoplasms

UR - http://www.scopus.com/inward/record.url?scp=0033934609&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033934609&partnerID=8YFLogxK

M3 - Article

C2 - 10840412

AN - SCOPUS:0033934609

VL - 164

SP - 3

EP - 9

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 1

ER -