New Targets in the Management of Prostate Cancer

Elisabeth I. Heath, Michael A Carducci

Research output: Contribution to journalArticle

Abstract

Our understanding of growth factors and growth-factor receptors, signal transduction pathways, cellular survival pathways, angiogenesis, and their potential roles in prostate-cancer tumorigenesis remains a work in progress. Novel agents targeting these key mechanisms are showing promise in clinical trials. Many more agents, including those not discussed in this article, such as radiopharmaceuticals, bisphosphonates, nutriceuticals, immunotherapy, and newer generation chemotherapy, are also showing promise as emerging treatments for prostate cancer. It is important to recognize when designing clinical trials of novel agents that traditional endpoints of disease response may not be applicable in measuring success of biologic compounds. Especially in a disease where tumor marker levels are critical for both patient and physician, additional biomarkers are necessary to better assess response. Halting drug development due to lack of response in serum PSA may lead to an unnecessary demise of an active agent. As expected, the combination of biologic agent with cytotoxic chemotherapy has a higher traditional response rate compared with biologic agent alone. The challenge of combination trials is to determine if the combination of agents will produce a higher traditional response rate compared with chemotherapy alone. For several of the agents discussed, the clinical benefit derived from a combination of biologic agent and cytotoxic chemotherapy may not justify additional drug toxicity. Efficient trial design, appropriate selection of correlative markers, and close toxicity monitoring will help improve our ability to identify promising novel agents.

Original languageEnglish (US)
Pages (from-to)985-999
Number of pages15
JournalHematology/Oncology Clinics of North America
Volume20
Issue number4
DOIs
StatePublished - Aug 2006

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Prostatic Neoplasms
Biological Factors
Drug Therapy
Clinical Trials
Growth Factor Receptors
Radiopharmaceuticals
Diphosphonates
Tumor Biomarkers
Dietary Supplements
Drug-Related Side Effects and Adverse Reactions
Immunotherapy
Signal Transduction
Intercellular Signaling Peptides and Proteins
Carcinogenesis
Biomarkers
Physicians
Survival
Serum
Pharmaceutical Preparations
Therapeutics

ASJC Scopus subject areas

  • Oncology
  • Hematology

Cite this

New Targets in the Management of Prostate Cancer. / Heath, Elisabeth I.; Carducci, Michael A.

In: Hematology/Oncology Clinics of North America, Vol. 20, No. 4, 08.2006, p. 985-999.

Research output: Contribution to journalArticle

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