Le traitement des cancers de la prostate hormonorésistants

Two recent randomized Phase-III studies (TAX 327 and SWOG 9916) have demonstrated that Docetaxel improved the survival rate of patients with hormone-resistant prostate cancer. Other drugs such as Mitoxantrone, Vinorelbine, Saraplatin and Epothilone are recommended as second-line treatment where Docetaxel treatment has failed. Treatment with Atrasentan, an endothelin-receptor antagonist, or other inhibitors of angiogenesis combined with Docetaxel is presently under evaluation. Zoledronic acid, alone or in association with chemotherapy, and the use of radioisotopes (strontium-89, samarium 153 and radium 223) are palliative treatment options for multiple painful bone metastases in hormone-resistant cancer. Collectively, these treatment options reduce the risk of mortality, prevent the complications associated with disease progression and improve the patients' quality of life. Better understanding of the alternative pathways for androgen receptor signaling, the role of estrogen receptors, cytokines and stromal growth factors contributing to hormone resistance may lead to new treatment strategies.