INTERMITTENT ANDROGEN DEPRIVATION AFTER PSA-COMPLETE RESPONSE AS A STRATEGY TO REDUCE INDUCTION OF HORMONE-RESISTANT PROSTATE-CANCER

Objectives. The increasing interest in exploring the use of intermitte nt androgen deprivation in prostate cancer has prompted a retrospectiv e review of patients who elected to stop treatment. Methods. Case reco rds were reviewed. Results. Twenty patients after 3 to 48 months (medi an 12) of endocrine therapy elected to stop therapy. Thirteen subseque ntly relapsed after a median observation of 9 months. Seven of 20 pati ents continue progression-free for 9 to 42 months (median 33). After s econd-line therapy, 75% of patients with a relapse remain progression- free at 2 years. Progression-free survival was higher in patients at S tage MO (82% at 1 year) versus M+ (29% at 1 year). Conclusions. With 1 0 of 13 patients demonstrating an ongoing second PSA response, 45% of patients showing no progression, and 85% alive at 3 years, these resul ts support findings from previous publications that suggest that there are no major risks with use of intermittent hormone therapy. However, in the future, there is an urgent need that such studies should be ra ndomized and done in the context of audit-based research and developme nt programs. The resources released could then be invested with respec t to further improvements in treatment of prostate cancer, possibly co nsidering such a combined approach with immunotherapy as an alternativ e to surgery or radiotherapy for early disease in elderly patients wit h long PSA-doubling time. Copyright 1997 by Elsevier Science Inc.