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Adrenal Androgen Synthesis Inhibitor Therapies in Castration-Resistant Prostate Cancer

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Drug Management of Prostate Cancer

Abstract

It is well recognized that the vast majority of prostate cancers rely on testosterone for growth. Even after medical or surgical castration, a significant number of men will unfortunately experience disease progression manifested as an increasing prostate-specific antigen (PSA) or objective tumor growth. Left untreated, castration-resistant prostate cancer (CRPC) is uniformly fatal. It causes close to 30,000 deaths annually in the United States, with most men living only 2–4 years from the time castration resistance develops. In recent years, research has shown that despite castration resistance these tumors still retain sensitivity to low levels of circulating testosterone and other androgens. By inhibiting androgen synthesis, targeted adrenal androgen synthesis inhibitors slow the growth of castration-resistant tumors. The major agents in use today include corticosteroids, ketoconazole, aminoglutethimide, estrogens and progestins, as well as the novel CYP17 inhibitors abiraterone acetate, TAK-700 and TOK-001. The following article reviews the clinical data supporting the use of each of these adrenal androgen synthesis inhibitors in advanced prostate cancer, including the dosing, schedules, and common side effects.

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Authors and Affiliations

  1. Department of Medicine, University of California San Francisco, San Francisco, CA, USA

    Charles J. Ryan

Authors
  1. Terence W. Friedlander
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  2. Charles J. Ryan
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Correspondence to Charles J. Ryan .

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Editors and Affiliations

  1. Medical Oncology Branch, NIH National Cancer Institute, Rockville Pike 9000, Bethesda, 20892, Maryland, USA

    William D. Figg

  2. Medical Oncology Branch, NIH National Cancer Institute, Rockville Pike 9000, Bethesda, 20892, Maryland, USA

    Cindy H. Chau

  3. School of Medicine, Dept. Urology, University of California, San Francisco, Divisadero Street 1600, San Francisco, 94115, California, USA

    Eric J. Small

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Friedlander, T.W., Ryan, C.J. (2010). Adrenal Androgen Synthesis Inhibitor Therapies in Castration-Resistant Prostate Cancer. In: Figg, W., Chau, C., Small, E. (eds) Drug Management of Prostate Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-60327-829-4_8

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  • DOI: https://doi.org/10.1007/978-1-60327-829-4_8

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  • Online ISBN: 978-1-60327-829-4

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