Advanced prostate cancer-a case for adjuvant differentiation therapy - Abstract

The development of novel therapies such as abiraterone acetate and sipuleucel-T has improved the outlook for patients with advanced-stage and castration-resistant prostate cancer.

However, the beneficial effects of these drugs are only measured in months. Moreover, the National Institute for Health and Clinical Excellence in the UK had ruled that the use of abiraterone acetate was not cost-effective before cost revision by the manufacturers. The FDA statement asserting that the use of 5α-reductase inhibitors for prostate cancer chemoprevention could increase the risk of developing high-grade prostate cancer also indirectly questions the value of direct androgen response manipulation for long-term benefit. These reports illustrate the need for a fresh and comprehensive analysis of advanced prostate cancer pathology to promote the next generation of effective adjuvant therapies. One such avenue is that of differentiation therapy, which seeks to promote the differentiation of cancer stem cells into a phenotype more sensitive to anticancer therapy than their parents. Using differentiation therapy with current antiandrogen therapies should augment our armoury of treatment for the management of advanced prostate cancer.

Written by:
Rane JK, Pellacani D, Maitland NJ.   Are you the author?
Yorkshire Cancer Research Unit, Department of Biology (Area 13), University of York, York YO10 5DD, UK.

Reference: Nat Rev Urol. 2012 Aug 14. Epub ahead of print.
doi: 10.1038/nrurol.2012.157


PubMed Abstract
PMID: 22890299

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