New horizons for treating castration resistant prostate cancer: Bipolar Androgen Therapy

The treatment of metastatic prostate cancer has evolved over the decades focusing on manipulation of the androgen receptor pathway with or without chemotherapy. Despite new drugs discovered with incrementing survival benefits, the disease continues to be fatal after development of castration resista...

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Main Authors: Pedro Henrique Isaacsson Velho, Katia Regina Marchetti, Gabriel Passos Souza
Format: Article
Language:English
Published: Thieme Revinter Publicações Ltda. 2018-04-01
Series:Brazilian Journal of Oncology
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.5935/2526-8732.20180003
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author Pedro Henrique Isaacsson Velho
Katia Regina Marchetti
Gabriel Passos Souza
author_facet Pedro Henrique Isaacsson Velho
Katia Regina Marchetti
Gabriel Passos Souza
author_sort Pedro Henrique Isaacsson Velho
collection DOAJ
description The treatment of metastatic prostate cancer has evolved over the decades focusing on manipulation of the androgen receptor pathway with or without chemotherapy. Despite new drugs discovered with incrementing survival benefits, the disease continues to be fatal after development of castration resistance and progression on abiraterone and enzalutamide. In this context, attempts of androgen pathway manipulation have led to the development of the Bipolar Androgen Therapy (BAT), which consists of a rapid transition from a castration state to supraphysiologic levels of testosterone and then back to castration levels. Pilot studies have shown this strategy to be safe and supported the development of further clinical trials. Phase II trials have demonstrated PSA response and disease control in a significant number of patients, including a possible resensitizing effect to enzalutamide. This promising strategy may in the future become another available option for these patients.
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issn 2526-8732
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publishDate 2018-04-01
publisher Thieme Revinter Publicações Ltda.
record_format Article
series Brazilian Journal of Oncology
spelling doaj-art-9b4e9feeaa7b42bf99effc10cd6f3bd82025-08-20T02:00:34ZengThieme Revinter Publicações Ltda.Brazilian Journal of Oncology2526-87322018-04-01144811010.5935/2526-8732.20180003New horizons for treating castration resistant prostate cancer: Bipolar Androgen TherapyPedro Henrique Isaacsson Velho0Katia Regina Marchetti1Gabriel Passos Souza2Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USAServiço de Oncologia Clínica – Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, BrasilServiço de Oncologia Clínica – Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, BrasilThe treatment of metastatic prostate cancer has evolved over the decades focusing on manipulation of the androgen receptor pathway with or without chemotherapy. Despite new drugs discovered with incrementing survival benefits, the disease continues to be fatal after development of castration resistance and progression on abiraterone and enzalutamide. In this context, attempts of androgen pathway manipulation have led to the development of the Bipolar Androgen Therapy (BAT), which consists of a rapid transition from a castration state to supraphysiologic levels of testosterone and then back to castration levels. Pilot studies have shown this strategy to be safe and supported the development of further clinical trials. Phase II trials have demonstrated PSA response and disease control in a significant number of patients, including a possible resensitizing effect to enzalutamide. This promising strategy may in the future become another available option for these patients.http://www.thieme-connect.de/DOI/DOI?10.5935/2526-8732.20180003Prostatic NeoplasmCastration-ResistantTestosteroneProstate-Specific AntigenNeoplasias da PróstataResistente à CastraçãoTestosteronaAntígeno Prostático Específico
spellingShingle Pedro Henrique Isaacsson Velho
Katia Regina Marchetti
Gabriel Passos Souza
New horizons for treating castration resistant prostate cancer: Bipolar Androgen Therapy
Brazilian Journal of Oncology
Prostatic Neoplasm
Castration-Resistant
Testosterone
Prostate-Specific Antigen
Neoplasias da Próstata
Resistente à Castração
Testosterona
Antígeno Prostático Específico
title New horizons for treating castration resistant prostate cancer: Bipolar Androgen Therapy
title_full New horizons for treating castration resistant prostate cancer: Bipolar Androgen Therapy
title_fullStr New horizons for treating castration resistant prostate cancer: Bipolar Androgen Therapy
title_full_unstemmed New horizons for treating castration resistant prostate cancer: Bipolar Androgen Therapy
title_short New horizons for treating castration resistant prostate cancer: Bipolar Androgen Therapy
title_sort new horizons for treating castration resistant prostate cancer bipolar androgen therapy
topic Prostatic Neoplasm
Castration-Resistant
Testosterone
Prostate-Specific Antigen
Neoplasias da Próstata
Resistente à Castração
Testosterona
Antígeno Prostático Específico
url http://www.thieme-connect.de/DOI/DOI?10.5935/2526-8732.20180003
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AT katiareginamarchetti newhorizonsfortreatingcastrationresistantprostatecancerbipolarandrogentherapy
AT gabrielpassossouza newhorizonsfortreatingcastrationresistantprostatecancerbipolarandrogentherapy