Is intermittent androgen-deprivation therapy beneficial for patients with advanced prostate cancer?

Johannes M. Wolff, Per-Anders Abrahamsson, Jacques Irani, Fernando Calais da Silva

    Research output: Contribution to journalReview articlepeer-review

    11 Citations (SciVal)

    Abstract

    Use of intermittent androgen-deprivation therapy (IADT) in patients with prostate cancer has been evaluated in several studies, in an attempt to delay the development of castration resistance and reduce side-effects associated with ADT. However it is still not clear whether survival is adversely affected in patients treated with IADT. In this review, we explore the available data in an attempt to identify the most suitable candidate patients for IADT, and discuss factors that may inform appropriate patient stratification. ADT is first-line treatment for advanced/metastatic prostate cancer and is also recommended for use with definitive radiotherapy for high-risk localised prostate cancer. The changes in hormone levels induced by ADT can lead to short-and long-term side-effects which, although treatable in most cases, can significantly reduce the tolerability of ADT treatment. IADT has been investigated in several phase II and phase III studies in patients with locally advanced or metastatic prostate cancer, in an attempt to delay time to tumour progression and reduce the side-effect burden of ADT. In selected patient groups IADT is no less effective than continuous ADT, ameliorating the impact of ADT-related side-effects, and, to a degree, their impact on patient health-related quality of life (HRQL). Further comparative study is required, particularly in relation to HRQL and long-term complications associated with ADT.
    Original languageEnglish
    Pages (from-to)476-483
    JournalBJU International
    Volume114
    Issue number4
    DOIs
    Publication statusPublished - 2014

    Subject classification (UKÄ)

    • Urology and Nephrology

    Keywords

    • prostate cancer
    • androgen deprivation
    • intermittent therapy
    • prostate-specific antigen
    • quality of life
    • survival
    • testosterone

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