Challenging the Current Treatment Paradigm of Androgen-Independent Prostate Cancer

[摘要] Widespread prostate-specific antigen (PSA) screening, lower PSA thresholds for performing prostate biopsy, and increased tissue sampling at the time of prostate biopsy have contributed to the trend of diagnosing smaller and lower grade prostate cancers. Despite the trend of detecting cancers earlier in their natural course, prostate cancer remains the second leading cause of cancer-related deaths in the American male population. It is likely that today’s aggressive screening efforts will have their greatest impact on prostate cancer death rates in decades to come. The persistently high death rate from prostate cancer indicates that urologists, radiation oncologists, and medical oncologists are currently treating a large group of men with androgen-independent prostate cancers. Until recently, androgen-independent prostate cancer was a death sentence associated with mean survival rates of 1 year. Despite decades of clinical investigation, not a single effective chemotherapeutic agent was identified that increased survival for any stage of prostate cancer. Treating androgen-independent prostate cancer was frustrating both for the physician and patient; there was only palliative treatment and no hope. In 2004, 2 large-scale, randomized clinical trials were published demonstrating 20% and 24% survival benefits for docetaxel-based therapies when compared to standard-of-care, palliative-based therapy. The report of a treatment that increased survival for men with androgen-independent prostate cancer has revolutionized the treatment of advanced prostate cancer. This supplement, entitled Challenging the Current Treatment Paradigm of Androgen-Independent Prostate Cancer, provides a contemporary perspective on managing androgen-independent prostate cancer.

[学科分类] 基础医学