ALEXANDRIA, VirginiaThe American Society of Clinical Oncology (ASCO) has updated its 2004 clinical practice guideline on the initial hormonal management of androgen-sensitive metastatic, recurrent, or progressive prostate cancer (J Clin Oncol 25:1596-1605, 2007).
The update recommends either bilateral orchiectomy or LHRH agonists as initial androgen-deprivation therapy (ADT). Combined androgen blockade (CAB) should be considered in the treatment of locally advanced or metastatic prostate cancer. CAB uses nonsteroidal antiandrogen therapy with an orchiectomy or LHRH agonist. The panel found no overall survival advantage for early vs deferred ADT initiation. Consistent with the 2004 guideline, the update states that current data are insufficient to support the use of intermittent androgen blockade outside of clinical trials.
For the complete guideline, please visit www.asco.org/guidelines.