Management of androgen-ablation refractory prostate cancer. Role for somatostatin analogues?

Patients with metastasised prostate cancer survive longer with anti-androgen therapy but eventually all progress into the androgen-ablation refractory (AAR) stage and die. There are only few effective strategies to treat patients with AAR cancers and they include even more effective androgen blockade by for example glucocorticoids or ketoconazole. Some of the tumours differentiate into neuroendocrine tumours and become completely independent of androgen stimulation. It is believed that these tumours over-express somatostatin receptors which may be a new target for the anti-tumour treatment. In this article we present a patient with advanced AAR prostate cancer and intractable retching and vomiting. As the last resort, he was treated with octreotide SC which resulted rapid amelioration of the symptoms and in significantly decreased PSA which could be translated into longer survival. In this article we review rationale for the use of somatostatin analogues in the treatment of patients with hormone-refractory prostate cancer. Adv. Pall. Med. 2010; 9, 4: 145–150Patients with metastasised prostate cancer survive longer with anti-androgen therapy but eventually all progress into the androgen-ablation refractory (AAR) stage and die. There are only few effective strategies to treat patients with AAR cancers and they include even more effective androgen blockade by for example glucocorticoids or ketoconazole. Some of the tumours differentiate into neuroendocrine tumours and become completely independent of androgen stimulation. It is believed that these tumours over-express somatostatin receptors which may be a new target for the anti-tumour treatment. In this article we present a patient with advanced AAR prostate cancer and intractable retching and vomiting. As the last resort, he was treated with octreotide SC which resulted rapid amelioration of the symptoms and in significantly decreased PSA which could be translated into longer survival. In this article we review rationale for the use of somatostatin analogues in the treatment of patients with hormone-refractory prostate cancer. Adv. Pall. Med. 2010; 9, 4: 145–15