CURRENT STATUS OF INTERMITTENT ANDROGEN SUPPRESSION IN THE TREATMENT OF PROSTATE-CANCER

Treatment of advanced prostate cancer by continuous androgen suppressi on results in excellent short-term response but poor long-term surviva l. Intermittent androgen suppression (IAS) aims to maintain androgen r esponsiveness of tumor cells by regular cycles of treatment cessations and tumor regrowth to specific prostate-specific antigen limits. Firs t clinical trials demonstrate consistent responses and improved qualit y of life in most patients on androgen suppression retreatment for up to five cycles, with mean off-treatment periods of approximately 5 to 16 months. Most patients with metastatic disease exhibit early disease progression or androgen independency under IAS, but a subgroup includ ing patients with metastatic disease respond to a single androgen supp ression cycle with off-treatment times for up to 48 months. in conclus ion, IAS improves the quality of life in patients with primarily hormo ne-dependent tumors without adverse effects and seems to be most effec tive in patients with prostate cancer with asymptomatic biochemical pr ogression and low tumor burden. Patients should be treated within the framework of randomized trials and characterized for survival and prog nostic factors associated with response to IAS treatment. UROLOGY 52: 353-359, 1998. (C) 1998, Elsevier Science Inc. All rights reserved.