Hormonal sensitivity following endocrine withdrawal in hormone-refractory prostate cancer

Background: Prostate cancer is proposed to be classified according to hormo nal sensitivity. The purpose of this study is to examine hormonal sensitivi ty of the patient with refractory prostate cancer subsequent to primary hor monal therapy. Methods: Sixteen patients with refractory prostate cancer su bsequent to primary combination hormonal therapy were enrolled in this stud y, All 16 patients with progressive disease after elimination of oral hormo nal agents or after response following hormonal withdrawal received dexamet hasone (DXM) (initially 1.5 or 1.0 mg, then tapered to 0.5 mg) orally not o nly for the purpose of second-line hormonal therapy but also as an indicato r of hormonal sensitivity. Results: Overall, 4 patients showed a prostate-s pecific antigen (PSA) decrease of >50% from baseline on discontinuation of hormonal agents, while another 7 patients showed a PSA decrease of <50%, Fi ve patients showed PSA level was progressed after the withdrawal. In all pa tients with PSA values that decline not only >50% but also <50% following o ral endocrine withdrawal, the fall in PSA values had been >50% following DX M administration, However, the PSA value in the patients with PSA progressi on following the oral endocrine withdrawal kept rising after DXM administra tion. Conclusions: The findings in this study would just suggest a possible relationship between DXM sensitivity and the response to endocrine withdra wal, The patients whose PSA values decline following oral endocrine withdra wal may maintain hormonal sensitivity, Copyright (C) 2000 S. Karger AG, Bas el.