Novel concept of antisurvival factor (ASF) therapy produces an objective clinical response in four patients with hormone-refractory prostate cancer: Case report
M. Koutsilieris et al., Novel concept of antisurvival factor (ASF) therapy produces an objective clinical response in four patients with hormone-refractory prostate cancer: Case report, PROSTATE, 38(4), 1999, pp. 313-316
BACKGROUND. Osteoblasts and osteoblast-derived survival growth factors, suc
h as insulin-like growth factor I (IGF I), inhibit chemotherapy apoptosis o
f prostate cancer cells, thereby producing cytotoxic drug-resistant tumor g
rowth, in vitro.
METHODS. We tested a novel therapeutic approach, referred to as antisurviva
l factor (AFS) therapy, that aimed at reduction of osteoblast-derived IGFs,
using dexamethasone (4 mg per os, go) and growth hormone (GH)-dependent Li
ver-derived IGFs, using a somatostatin-analog (lanreotide, 30 mg, intramusc
ularly (IM), q14D) in combination with triptorelin (3.75 mg, intramuscularl
y, q28D) to produce a clinical response in 4 patients with progressing horm
one-refractory prostate cancer.
RESULTS. The patients given ASF therapy exhibited an excellent improvement
of clinical performance and a decline of prostate-specific antigen (PSA) wi
thin 2 months of ASF therapy. One of them experienced excellent clinical re
sponse (normalization of PSA), two experienced good clinical response (decl
ine of PSA of more than 50%), and one experienced stabilization (decline of
PSA of less than 50%).
CONCLUSIONS. We conclude that this novel concept of combination therapy, us
ing ASF with hormone ablation, is a promising salvage therapy that should b
e further assessed with a randomized clinical trial. (C) 1999 Wiley-Liss, I
nc.