Current role of diethylstilbestrol in the management of advanced prostate cancer
BJU International, 05/14/2012
Bosset PO et al. – Low–dose diethylstilbestrol (DES) appears to be safe and effective for castrate–resistant prostate cancer (CRPC) before initiating chemotherapy. The cost/efficiency ratio may encourage physicians to consider DES as a therapy option before chemotherapy in non–symptomatic CRPC.
- Diethylstilbestrol (DES) has been found to have anti-tumour properties and clinical effectiveness in prostate cancer that is resistant to the first-line hormonal therapy.
- This review found that low-dose DES has anti-tumour efficacy with limited cardiovascular side effects and should be considered for secondary hormone manoeuvres.
- Relevant clinical studies using 1 mg of DES in castrate-resistant prostate cancer (CRPC) were identified from the literature, clinical trial databases, websites and conference abstracts.
- The efficacy and safety outcomes were summarized.
- DES in CRPC produced a biological response (change in PSA level) and improved the median survival of patients when used as a second-line hormone therapy after standard androgen deprivation with bicalutamide and LHRH analogues.
- These findings were for low doses of DES.
- The 1-mg dose is associated with a reduced toxicity, including fewer thromboembolic and cardiovascular events.