International Medical Journal, Vol. 22., Iss. 3, 2016, P. 59−64.
ANDROGEN DEPRIVATION THERAPY IN COMBINATION WITH CHEMOTHERAPY IN PATIENTS WITH CASTRATE-NAIVE METASTATIC PROSTATE CANCER
Kharkiv National Medical University, Ukraine
The presented review paper covers one of the major problems in the field of oncourology, combination treatment of patients with castrate−naive metastatic prostate cancer that includes the combination of androgen deprivation therapy and chemotherapy. The results of the early 15 studies on the use of various chemotherapeutic agents in this group of patients, which were carried out over the past 30 years are reported. Chemotherapeutic treatment regimens, their success rate and side effects are described. The above mentioned facts formed the basis for conclusions that there is no practicability in applying hormone therapy and chemotherapy for metastatic prostate cancer as the first−line treatment. However, recent studies of GETUG−AFU 15, CHAARTED−E3805 and STAMPEDE demonstrated the rationality of treatment with docetaxel in combination with ADT for hormone−naive patients with metastatic disease. These studies have captured a significant improvement in progression−free survival favoring patients who received docetaxel in addition to ADT compared to those who only received ADT. A significant improvement in overall survival was also noted during CHAARTED−E3805 study favoring patients from the group of chemo−hormonal therapy. The effective use of mitoxantrone in patients with castrate−resistant prostate cancer is of great interest, as well as fair advantage of such approach in terms of pain relief and for improving patients' quality of life. However, there are currently no results for clinical trials with the use of mitoxantrone in addition to standard ADT. Therefore, combination therapy including hormonal therapy concurrent with docetaxel drugs has demonstrated during recent studies certain advantages for patients with castrate−naive prostate cancer. However, their results were not totally unambiguous, considering data given by the overall and progression free survival. The role of mitoxantrone in combination with hormonal deprivation for patients' treatment of this group has not been studied yet.
Key words: metastatic prostate cancer, androgen deprivation therapy, chemotherapy, chemohormonal therapy.