Current Status of Combined Androgen Blockade in Prostate Cancer Patients

, Sung-Woo Park

Review Article

The Korean Journal of Urological Oncology 2012;10(1):6-12.
Published online April 30, 2012.

전립선암에 대한 복합 남성호르몬차단요법의 역할

박성우

부산대학교 의학전문대학원 비뇨기과학교실

Current Status of Combined Androgen Blockade in Prostate Cancer Patients

Sung-Woo Park

Department of Urology, Pusan National University School of Medicine, Yangsan, Korea

Correspondence: Sung-Woo Park

Abstract

Androgen deprivation therapy with gonadal testosterone depletion is the frontline treatment for advanced prostate cancer. In theory, however, combined androgen blockade (CAB) with an antiandrogen plus castration should be more effective because castration alone does not completely eliminate androgens in the prostate. Therefore, a number of randomized clinical trials were conducted in the 1990s to investigate the efficacy of CAB with an antiandrogen (nilutamide or flutamide) plus castration. However, several debates about the efficacy of CAB, the lack of data on safety, quality of life and cost-effectiveness has been a hindrance to the adoption of CAB for the treatment of prostate cancer. Nevertheless, discussion on CAB for the treatment of prostate cancer has continued for over 20 years. In the 2000s, commencing of bicalutamide has made slightly different situation in CAB. In this article, we discuss the feasibility of CAB for the treatment of prostate cancer by reviewing the theoretical background and the results of clinical trials of CAB. (Korean J Urol Oncol 2012;10:6-12)

Key Words: Androgen deprivation, Antiandrogen, Castration, Prostate cancer