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Proven Treatments - Other
Introduction
There is another possible category of proven treatments
which for lack of a better name are being called "other" here.
These treatments might
be worth HRPC patients investigating further.
These might be treatments with
relatively low PSA response rates (as determined by clinical trial(s), using the >50% PSA decline criteria), treatments that have reduced the PSA doubling time or
not produced a >50% drop in PSA or treatments that have relatively few
patients in studies done to date, but have produced good results in trials.
Stable disease would also be consistent with the proven-other category.
Note that most of the following can be used in various
contexts -- perhaps to delay starting cytotoxic chemotherapy or during a
break from chemotherapy (intermittent chemotherapy.)
List of Therapies
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Leukine, Leukine/Retinoids,
Leukine/Thalidomide and Leukine/Ketoconazole. Discussed here in
the context of extending the off period during intermittent chemotherapy,
but also potentially useful in delaying the start of chemotherapy.
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Somatostatin analogs
(Sandostatin LAR). The combination of a somatostatin analog with either
dexamethasone or an estrogen looks promising as an off chemotherapy option,
although data is limited. Possible use as a 2nd-line hormone therapy.
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Ketoconazole/dutasteride(Avodart).
Some benefit has been seen when ketoconazole is failing by adding dutasteride.
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Revlimid (lenalidomide) with
leukine (gm-csf). Based on the leukine/thalidomide combination - this
combination may have fewer side effects. Revlimid might be effective by itself.
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Nilandron (nilutamide). This is normally an
antiandrogen used with combined hormone therapy -- as a part of 1st line
hormone therapy. It can also be used as a part of 2nd line hormone
therapy. *** Not written yet ***
Author: Howard Hansen, updated 3/4/08
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