| Abstract: |
Biochemical-only recurrent prostate cancer presents the ideal setting for assessing novel agents or approaches for prostate cancer treatment. There is no clear evidence that delay in initiation of more definitive androgen-deprivation therapy is harmful, and a simple blood test-the prostate-specific antigen (PSA) level-is readily available to screen for potential antineoplastic activity. Current novel approaches include vaccines, cyclooxygenase-2 (COX-2) inhibitors, selective apoptotic antineoplastic drugs, endothelin-A receptor antagonists, chemotherapy, vitamin D, and peroxisome proliferator-activated receptor-γ agonists. In this screening process, certain therapies have emerged as delaying PSA progression or decelerating PSA velocity. These therapies, such as the COX-2 inhibitors, will need to proceed to phase 3 trials to answer the more important question of whether this change in PSA dynamics translates into improved survival. Patients enrolling in these trials need to be clearly informed of the limited expectations of these novel exploratory approaches. © 2003 Elsevier Inc. |
| Keywords: |
cancer chemotherapy; cancer survival; unclassified drug; genetics; androgen; clinical trial; review; cancer recurrence; salvage therapy; antineoplastic agents; liver dysfunction; antineoplastic agent; neoplasm; adenocarcinoma; biological marker; prostate specific antigen; dendritic cell vaccine; sensory neuropathy; classification; neoplasm proteins; membrane proteins; cancer screening; transcription factor; platelet derived growth factor receptor; tumor antigen; transcription factors; prostate cancer; prostate-specific antigen; prostatic neoplasms; cytokine; blood; immunology; cytokines; drug antagonism; antigens, neoplasm; cancer vaccine; cancer vaccines; celecoxib; cyclooxygenase 2 inhibitor; cyclooxygenase 2 inhibitors; cyclooxygenase 2; nonsteroid antiinflammatory agent; anti-inflammatory agents, non-steroidal; vitamin d; immunogenicity; prostate tumor; ptgs2 protein, human; membrane protein; tumor protein; gene therapy; headache; alopecia; peroxisome proliferator activated receptor gamma; leg edema; androgens; clinical trials; recombinant vaccine; isoenzymes; receptors, platelet-derived growth factor; keyhole limpet hemocyanin; neoplasms, hormone-dependent; gpi 0100; oligonucleotides, antisense; receptors, cytoplasmic and nuclear; atrasentan; glycolipid; ganglioside; rhinitis; isoenzyme; active immunization; cell receptor; antisense oligonucleotide; flurbiprofen; prostaglandin synthase; prostaglandin-endoperoxide synthases; prostaglandin synthase inhibitor; immunotherapy, active; carbohydrate vaccine; sulindac sulfone; cyclooxygenase inhibitors; peroxisome proliferator activated receptor agonist; humans; human; male; priority journal; cp 461; endothelin a receptor antagonist; levo flurbiprofen; n (2 cyclohexyloxy 4 nitrophenyl)methanesulfonamide; endothelin a receptor; receptor, endothelin a
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