A new era in hormone-refractory prostate cancer
Optimal treatment requires multidisciplinary approach

Fred Saad, MD, FRCS et al.

Prostate cancer is the most common cancer in North American males and the third leading cause of death due to cancer. Androgen deprivation therapy (ADT) was introduced in the 1940s,1 but few meaningful therapeutic advances have been made since then.

 

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Top-line summary
Over 60 years ago, Huggins and Hodges discovered androgen deprivation to be an effective first-line therapy for metastatic prostate cancer. While this has led to improved cancer control, in a significant proportion of men prostate cancer ultimately progresses to hormone- refractory prostate cancer (HRPC), resulting in significant morbidity and eventual death. I n 2004, 2 landmark studies using docetaxel-based chemotherapy demonstrated the first survival advantage in HRPC, setting a new standard of care for this disease. Further, treatment with the bisphosphonate zoledronic acid has been shown to significantly reduce bone complications in metastatic HRPC. Building on these advances, several new docetaxel– zoledronic acid combinations as well as novel targeted therapies are under development. The earlier introduction of these therapies for high-risk patients is also under investigation to further improve outcomes. A high level of collaboration between all specialties involved in the care of prostate cancer patients is required to optimize timely use of these new therapeutic options.
 
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