Intermittent androgen blockade in prostate cancer: Rationale and clinical experience

Cancer of the prostate continues to be one of the most common malignancies in men in Europe, with a large number of patients presenting with advanced disease. The current standard treatment for metastatic cancer of the prosta te, permanent androgen withdrawal, is palliative. Patients treated with per manent androgen blockade usually relapse and die secondary to prostate canc er's ability to progress to an androgen-independent state of growth. Based on experimental and preclinical studies, intermittent androgen blockade app ears to be a potential alternative to permanent androgen blockade. Through the cycling of reversible androgen suppression, there appears to be recover y of apoptosis and subsequent slower progression to an androgen-independent state. In this paper experimental and preclinical studies concerning inter mittent androgen blockade are reviewed. At present several prospective rand omized trials are under way to test intermittent androgen blockade as an al ternative treatment in various stages of cancer of the prostate. However, u ntil the results of these trials a re available, this approach remains expe rimental. Copyright (C) 2000 S. Karger AG, Basel.