Drug therapy is one of the efficient methods for prostate cancer treatment. However, drug resistance greatly hindered the treatment of prostate cancer patients. Herein, the mechanisms of drug resistance in prostate cancer have been exhaustively reviewed, and that can provide an alternative strategy and new targets for anti-prostate cancer therapy.
Drug Resistance, Neoplasm ; Humans ; Male ; Prostatic Neoplasms ; drug therapy

In some patients with prostate cancer and who manifest disease progression during maximal androgen blockade(MAB) therapy, discontinuation of antiandrogen treatment might result in a significant fall in the level of serum prostate-specific antigen(PSA), and this is often correlated with clinical improvement(antiandrogen withdrawal syndrome). However, a decline in the PSA level after the withdrawal of estramustine phosphate is extremely rare. We report here on a case of dramatic decline in the PSA level after withdrawal of estramustine phosphate in a patient with hormone refractory prostate cancer.
Disease Progression ; Drug Therapy ; Estramustine* ; Humans ; Prostate* ; Prostatic Neoplasms*

Eleven patients with advanced prostatic cancer who had received single agent chemotherapy with cyclophosphamide were evaluated. All patients had pathologically confirmed prostatic adenocarcinoma and were unresponsive to or in relapse after hormonal therapy. They were treated intravenously with 200mg/m2 cyclophosphamide daily for four days every four weeks. The National prostatic Cancer Project(NPCP) response criteria were used. so objective response included patients with complete or partial response as well as objectively stable disease as defined by NPCP response criteria. The response rate was 54.6 %. with three partial response(27.3 8 ) and three objectively stable disease(27.3) of the eleven patients. All the six patients with partial response and objectively stable disease lived longer than 4 year, whereas for the five patients with objective progression. only two patient lived longer than 1 year. Toxicity was mild and tolerable. Mild and asymptomatic cyclophosphamide-induced hyponatremia was observed in two patients and hemorrhagic cystitis of mild degree was observed in one patient Severe hematologic and gastrointestinal toxicities were not observed.
Adenocarcinoma ; Cyclophosphamide* ; Cystitis ; Drug Therapy* ; Humans ; Hyponatremia ; Prostatic Neoplasms* ; Recurrence

The management of advanced prostate cancer has evolved rapidly. Androgen deprivation therapy, through surgical or medical castration, is the cornerstone of first-line therapy for hormone-naive metastatic prostate cancer. Recently reported results of clinical trials have given answers to questions regarding the best therapeutic agents and strategies, and these have broadened the scope of evidence-based therapy in this field. Although hormone therapy is very effective, the majority of patients eventually develop resistance to hormonal manipulation, leading to so-called castration-resistant prostate cancer. For castration-resistant prostate cancer, docetaxel-based chemotherapy had been the only approved agent to show a survival benefit for several years. However, over the last five years, significant advances in the field have led to the approval of several new agents with different mechanisms of action, such as the new androgen pathway inhibitors abiraterone and enzalutamide, a new cytotoxic agent, cabazitaxel, and new bone-seeking agents such as radium-223, which have all been associated with improved quality of life and pain palliation and an increase in survival. Herein, recent developments in hormone therapy and chemotherapy for advanced prostate cancer are reviewed and some of the trials with important results are summarized. As treatment options have expanded and developed rapidly, the selection of the most appropriate agent and administration method through multidisciplinary management is much more important than simply giving newly approved agents to maximize the clinical outcome for patients with advanced, especially castration-resistant, prostate cancer.
Castration ; Drug Therapy* ; Humans ; Neoplasm Metastasis ; Prostatic Neoplasms* ; Quality of Life

Research regarding the treatment of metastatic prostate cancer has been undergoing dramatic progress. Treatment of hormone-naïve metastatic prostate cancer includes surgical castration and medical castration that lowers androgen level in the blood using drugs. Although these androgen deprivation therapies are very effective, hormone-naïve metastatic prostate cancer finally leads to castration-resistant prostate cancer because resistance to surgical or medical castration occurs. The treatment at this stage includes not only docetaxel, but also new androgen synthesis inhibitor or androgen receptor inhibitors such as abiraterone or enzalutamide, new cytotoxic anticancer agents such as carbazitaxel, and radioisotope treatment such as radium-223. Recently, studies on the effect of chemotherapy on hormone-naïve metastatic prostate cancer before the development of castration-resistant prostate cancer have been actively published. As a result, various guidelines have recommended docetaxel as the first-line therapy for hormone-naïve metastatic prostate cancer. In this manuscript, we will summarize the basic concepts of androgen deprivation therapy for hormone-naïve metastatic prostate cancer and the main results of research on chemotherapy for hormone-naïve metastatic prostate cancer.
Antineoplastic Agents ; Castration ; Drug Therapy* ; Prostate* ; Prostatic Neoplasms* ; Receptors, Androgen

Humans ; Male ; Prostatectomy ; Prostatic Neoplasms ; drug therapy ; radiotherapy ; surgery

Prostate cancer is usually managed by androgen deprivation therapy after failure of primary treatment. However, such therapies are only temporarily effective in prostate cancer patients, and the most patients experience the progression to castration-resistant prostate cancer (CRPC). Docetaxel chemotherapy is conventional effective treatment for CRPC but has many adverse effects. In CRPC patients, treatment decisions were not typically base on the recognitions of inter-individual differences. Therefore, there are growing interests for precision medicine in CRPC. In this review, we summarized the precision medicine such as candidate target genes and potential therapies in CRPC.
Drug Therapy ; Humans ; Precision Medicine ; Prostate ; Prostatic Neoplasms

Saw palmetto fruit extract (SPE), as a herbal product, is widely used for the treatment of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). Recent studies show that SPE also has some therapeutic effects on chronic prostatitis, prostate cancer, sexual dysfunction, and so on. This article presents an overview on the application of SPE in the treatment of BPH, prostate cancer, and chronic prostatitis/chronic pelvic pain syndrome, with a discussion on its action mechanisms.
Chronic Disease ; Fruit ; chemistry ; Humans ; Lower Urinary Tract Symptoms ; drug therapy ; Male ; Pelvic Pain ; drug therapy ; Plant Extracts ; therapeutic use ; Prostatic Diseases ; drug therapy ; Prostatic Hyperplasia ; drug therapy ; Prostatic Neoplasms ; drug therapy ; Prostatitis ; drug therapy ; Syndrome

Diosgenin, a steroidal sapogenin, obtained from Trigonella foenum-graecum, Dioscorea, and Rhizoma polgonati, has shown high potential and interest in the treatment of various cancers such as oral squamous cell carcinoma, laryngeal cancer, esophageal cancer, liver cancer, gastric cancer, lung cancer, cervical cancer, prostate cancer, glioma, and leukemia. This article aims to provide an overview of the in vivo, in vitro, and clinical studies reporting the diosgenin's anticancer effects. Preclinical studies have shown promising effects of diosgenin on inhibiting tumor cell proliferation and growth, promoting apoptosis, inducing differentiation and autophagy, inhibiting tumor cell metastasis and invasion, blocking cell cycle, regulating immunity and improving gut microbiome. Clinical investigations have revealed clinical dosage and safety property of diosgenin. Furthermore, in order to improve the biological activity and bioavailability of diosgenin, this review focuses on the development of diosgenin nano drug carriers, combined drugs and the diosgenin derivatives. However, further designed trials are needed to unravel the diosgenin's deficiencies in clinical application.
Male ; Humans ; Carcinoma, Squamous Cell/drug therapy* ; Diosgenin/metabolism* ; Mouth Neoplasms/drug therapy* ; Apoptosis ; Prostatic Neoplasms/drug therapy*

Prostate-specific membrane antigen (PSMA) is a type II integral membrane glycoprotein, specifically expressed in prostatic epithelial cells and strongly upregulated in prostate cancer. PSMA is also present in the neovasculature of other solid tumors. These findings have spurred the development of PSMA-targeted therapies for prostate cancer, including immunotherapy, radioimmunotherapy, chemotherapy and gene therapy, and initiated the clinical trials of the first-generation products. However, general clinical application of these therapies still requires extensive clinical studies to test their clinical safety, stability and efficacy.
Antigens, Surface ; Genetic Therapy ; Glutamate Carboxypeptidase II ; Humans ; Immunotherapy ; Male ; Prostatic Neoplasms ; drug therapy ; therapy ; Radioimmunotherapy