Prostate cancer: Towards appropriate use of androgen deprivation therapy

摘要

In Nobel-prize-winrilng research done in the 1940s, Charles Huggins used a series of preclinical and clinical studies to demonstrate that prostatic epithelium-both normal and malignant-is dependent on androgens for growth. These simple, but elegant, observations eventually translated into the development of androgen deprivation therapy (ADT) for prostate cancer. More than a half century later, ADT remains the cornerstone of palliative management of metastatic prostate cancer. However, developments over the past decade and a half have complicated the story, and include the growing recognition of potentially serious adverse effects of the therapy, as well as a broadening of the use of ADT to earlier stages of disease, often without clear evidence of benefit. Two recently published papers are illustrative of these issues.