There are now increasing numbers of choices available for treating CRPC in addition to GnRH agonists. In 2012, chemotherapy, immune therapy, and secondary hormonal www.selleckchem.com/products/VX-770.html therapy were approved for the treatment of CRPC.2 For example, in 2010, the US Food and Drug Administration (FDA) approved sipuleucel-T (Provenge®; Dendreon Corporation, Seattle, WA), a cancer treatment vaccine using a patient’s own immune cells. GnRH antagonists, by immediately stopping luteinizing

hormone (LH) secretion, produce rapid T suppression without the initial #http://www.selleckchem.com/products/U0126.html keyword# LH and T surge. Other clinical trials are investigating new treatments such as molecularly targeted agents and biomarkers. However, there are unanswered questions regarding the cost/benefit analysis and safety of these new Inhibitors,research,lifescience,medical treatments as well as a paucity of data regarding the most ideal sequencing and/or combination implementation strategies. ADT is first-line treatment for advanced/metastatic prostate cancer

and recommended for use before, during, or after definitive radiotherapy for intermediate- and high-risk localized Inhibitors,research,lifescience,medical prostate cancer. ADT is also commonly used for shorter intervals to Inhibitors,research,lifescience,medical reduce prostate gland volume in patients contemplating brachytherapy, cryotherapy, and high-intensity focused ultrasound therapy, especially when gland volume exceeds 50 g; however, this utilization Inhibitors,research,lifescience,medical does not have an FDA- or European Medicines Agency-approved indication. ADT does not have an FDA-labeled indication for PSA relapse. ADT may be accomplished by surgical castration (bilateral orchiectomy) or via pharmacologic therapy, for example, GnRH agonists and antagonists. According to the

American Urological Association AV-951 (AUA) guidelines, “primary ADT may be employed with the goal of providing symptomatic control of prostate cancer for patients in whom definitive treatment with surgery or radiation is not possible or acceptable.”3 According to the European Association of Urology (EAU), GnRH agonists have become the leading therapeutic option for ADT because they avoid the physical and psychological discomforts associated with orchiectomy.4,5 However, GnRH agonists display several shortcomings including T surge (“clinical flare”) and microsurges.