NDLI: Chimiothérapies du cancer de prostate métastatique hormonoréfractaire ou hormonorésistant.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Timsit, M-O Lebret, T. Méjean, A.
Description	Country affiliation: France Author Affiliation: Timsit MO ( Service d'Urologie, Université Paris Descartes, France. marc-olivier.timsit@nck.aphp.fr)
Abstract	Since 2004 and the first improvement in overall survival in hormone refractory prostate cancer patients (HRPC) brought about by docetaxel, numerous phase II and III studies have been initiated. Considering the lack of efficacy in terms of overall survival, hormonal manipulations such as antiandrogen withdrawal, di-ethylstilbesterol or dexamethason are only indicated in 'rising PSA' patients without clinical or radiological evidence of metastases. As first line treatment, the optimal chemotherapy regimen is docetaxel (75 mg/m(2) every 3 weeks) in association with prednisone (5 mg twice daily). Second line chemotherapies (mitoxantron, ixabepilon, docetaxel as a re-treatment, vinorelbin, doxorubicin...) provide modest results only in terms of progression-free survival. A phase III study of Straplatin has been prematurely interrupted. Targeted anti-angiogenic therapies have shown encouraging results in patients with metastatic localizations, and underline the need to identify target patients early through cellular markers (mTOR or EGFR overexpression) as well as the uselessness of PSA dosage to monitor efficacy. An ongoing phase III study is evaluating bevacizumab in association with docetaxel to improve overall survival. Both the Provenge vaccine and DN 101 (calcitriol) showed a survival gain of a few months in phase III studies. An ongoing EORTC phase II trial is evaluating antisense oligonucleotids in HRPC. Early introduction of docetaxel raises the issue of when to start chemotherapy as it may be relevant to initiate this treatment before the onset of hormone independence. GETUG 15 trial will try to answer this question.
File Format	HTM / HTML
ISSN	11667087
Issue Number	Suppl 7
Volume Number	18
Journal	Progr`es en Urologie
Language	French
Publisher	Elsevier
Publisher Date	2008-11-01
Publisher Place	France
Access Restriction	Subscribed
Subject Keyword	Antineoplastic Agents, Hormonal Discipline Urology Humans Drug Therapy Antineoplastic Agents Drug Resistance, Neoplasm Male Therapeutic Use English Abstract Journal Article Prostatic Neoplasms Pathology Neoplasm Metastasis Taxoids
Alternative Title	Chemotherapy of hormonorefractory and hormonoresistant metastatic prostate cancer
Content Type	Text
Resource Type	Article
Subject	Urology

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