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Nat Clin Pract Urol. 2009 Feb;6(2):76-85. doi: 10.1038/ncpuro1296.

Androgen deprivation therapy: progress in understanding mechanisms of resistance and optimizing androgen depletion.

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  • 1Fred Hutchinson Cancer Research Center and the University of Washington School of Medicine, Seattle, WA 98195, USA.

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  • Nat Clin Pract Urol. 2009 Mar;6(3):173.

Abstract

Androgen deprivation therapy remains a critical component of treatment for men with advanced prostate cancer, and data support its use in metastatic disease and in conjunction with surgery or radiation in specific settings. Alternatives to standard androgen deprivation therapy, such as intermittent androgen suppression and estrogen therapy, hold the potential to improve toxicity profiles while maintaining clinical benefit. Current androgen deprivation strategies seem to incompletely suppress androgen levels and androgen-receptor-mediated effects at the tissue level. Advances in the understanding of mechanisms that contribute to castration-resistant prostate cancer are leading to rationally designed therapies targeting androgen metabolism and the androgen receptor. The results of large trials investigating the optimization of primary androgen deprivation therapy, including evaluation of intermittent androgen suppression and phase III studies of novel androgen synthesis inhibitors, such as abiraterone acetate, are eagerly awaited.

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