Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a number of studies the important role of neuroendocrine structures during the development of aggressive prostate cancer has been reported. We have recorded serum Chromogranin A and PSA values (CIS biointernational, France) in responders and nonresponders to both hormone therapy (Mab) and chemohormonal treatment (Estracyt) using (BPH) subjects as controls. In BPH patients (12 subjects) the mean CgA serotest value (+/- SD) was 23.3 + 13.9 ng/ml (range 7.2-55.9). In responders (24) and nonresponders (14) to Mab, respective values were 39.5 + 18.3 (7.6-78.4) and 214.8 + 250.3 (9.9-1084.3), while in responders (19) and nonresponders (12) to Estracyt, the mean CgA level was 47.6 +/- 22.7 (4.4-101.2) and 366.7 +/- 291.4 (82.0-925.7). In all patients osseous metastates were detected. Statistical P-values were > 0.05 in the correlation between both responders to hormonal therapy and Estracyt (P = 0.194) and nonresponders to these two therapies (P = 0.179). All other recorded P-values were < 0.01. In some nonresponders to Estracyt (3/12) the normal total PSA value together with %FPSA well below 20 indicated contribution of anaplastic tumor. Cessation of Estracyt therapy in 4/14 responders caused the sharp elevation of CgA serotest level. Accordingly, Estracyt may control the activity of CgA positive structure(s). In accordance with these preliminary data, we advocate the CgA serotest assessment in candidates for hormonal therapy as well as during follow-up of pharmacological treatment.
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PMID:Serum chromogranin A in monitoring metastatic prostate cancer patients. 1069 37

Estramustine phosphate is associated with estrogenic complications. However, hypertriglyceridemia has not yet been associated with estramustine phosphate. We describe a patient in whom severe hypertriglyceridemia and pancreatitis developed after treatment with estramustine phosphate. A 59-year-old man with hormone-refractory prostate cancer was treated with estramustine phosphate, docetaxel, and carboplatin. After three cycles, the patient was admitted with triglyceride levels of 12,210 mg/dl and pancreatitis. After resolution of hypertriglyceridemia and pancreatitis, chemotherapy with docetaxel and carboplatin was continued without recurrence of hypertriglyceridemia. We conclude that estramustine phosphate has the potential to cause hypertriglyceridemia in susceptible individuals.
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PMID:Hypertriglyceridemia and pancreatitis associated with estramustine phosphate. 1215 61

Polyamine (PA) deprivation is effective in prostate carcinoma models. We have assessed the observance by patients, tolerance and side effects of a PA-reduced diet (PRD) and intestinal decontamination (ID), in order to reduce PA dietary and intestinal bacterial pools, in metastatic, hormone-refractory prostate cancer (HRPC) patients. A total of 13 volunteers (mean age, 67+/-10 years) with metastatic HRPC were proposed for PRD and ID (0.75 g/day of oral neomycin every other week). The mean time from HRPC diagnosis to the start of the diet was 12+/-8 months. Of the total 13, seven patients had received prior chemotherapy or Estramustine phosphate. PRD was obtained after HPLC assessment of PA contents in current foods and given 5 days a week. Toxicity, performance and pain status were assessed according to the World Health Organisation and EORTC scales. Prostatic specific antigen (PSA), blood counts, ionograms, transaminases and erythrocyte PA spermidine (Spd) and spermine (Spm; assessed by HPLC) were evaluated regularly. Mean observance was 8+/-7 months (range, 2-26 months). One case of grade II toxicity to neomycin was observed. Cancer-specific survival (after the diet) was 14+/-7 months, and two patients are still alive. All the other patients have died of their cancer at 12+/-6 months (range, 4-20 months). Cancer-specific survival after hormonal escape was 27+/-11 months (range, 9-45 months). Performance status was improved during the regimen and deteriorated 3 months after stopping. Pain score was improved (1.3 versus 0.6; P =0.04) during the diet and increased (2.1 versus 0.3) 3 months after stopping. Erythrocyte Spd (11.6+/-7 versus 7.7+/-2 nmol/8 x 10(9) erythrocytes; P =0.036) and Spm (7+/-6 versus 3.9+/-1.6 nmol/8 x 10(9) erythrocytes; P =0.036) levels were significantly reduced at 3 months. One patient had a >50% reduction in PSA, three patients had PSA stabilization for 6 months. PSA progression was observed in all other patients. No significant modification of other studied biological parameters was noted. Reducing PA dietary intake and ID is a well-observed and tolerated regimen and seems to be beneficial for patient quality of life and pain control. Patients with low initial PSA can experience durable stabilization. These encouraging results in such an aggressive disease certainly warrant further investigation.
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PMID:Polyamine-reduced diet in metastatic hormone-refractory prostate cancer (HRPC) patients. 1265 44

Estramustine phosphate (EMP) is a compound widely used for the treatment of hormone-refractory prostate cancer. In order to better understand the precise molecular mechanism(s) by which EMP exerts its effects on hormone-resistant PC3 prostate cancer cells, we have utilized microarray to interrogate 22,215 known genes to determine the gene expression profiles altered by EMP treatment. The purpose of this investigation was to identify gene expression profile first and then in future studies determine the specific role of these genes in EMP-induced apoptosis in prostate cancer cells. We found a total of 726 genes which showed >2 fold change after EMP treatment. Clustering analysis showed 12 different types of expression alteration. These genes were also subjected to cluster analysis according to their biological functions. We found that EMP regulated the expression of genes, which are critically involved in the regulation of cell growth, cell cycle, apoptosis, iron homeostasis, cytoskeleton and cell signaling transduction. Real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR) analysis was used to confirm the results of microarray, and the results of real-time quantitative RT-PCR were consistent with the microarray data. From these results, we conclude that EMP caused changes in the expression of a large number of genes that are related to the control of cell survival and physiological behaviors. The gene expression profiles may provide comprehensive molecular mechanism(s) by which EMP exerts its pleiotropic effects on prostate cancer cells. EMP-induced regulation of these genes may be further exploited for devising therapeutic strategies for prostate cancer.
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PMID:Gene expression profiling reveals novel targets of estramustine phosphate in prostate cancer cells. 1515 21

Androgen ablation is palliative and does not cure advanced prostate cancer. The hormone-sensitive cells die and the hormone-resistant cells overgrow, resulting in disease progression. The drug of choice for secondary treatment is estramustine (Estracyt). The success of the therapy is followed by changes of the prostate-specific antigen level and Karnofsky scale. In the present study, the results of estramustine treatment of 79 patients with advanced prostate cancer in 12 hospitals were evaluated. The mean prostate-specific antigen level improved for 6 months, but rose from the ninth month on. The improvement in the subjective condition of the patients paralleled the change in the prostate-specific antigen level. The short time of improvement was a consequence of the very high prostate-specific antigen level and the poor general condition. Estramustine administration is recommended when the prostate-specific antigen level becomes more than doubled following primary treatment. At a starting prostate-specific antigen level of > 100 ng/ml, the treatment leads to total androgen blockade. If the prostate-specific antigen level has not decreased after treatment for 3 months, the secondary strategy is to apply chemotherapy.
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PMID:Administration of estramustine in response to changes in the prostate-specific antigen and Karnofsky index in the treatment of prostate cancer. 1599 50

Many constitutional analogues of estrogen have been reported. In this review, the application, action(s), and mechanism(s) of clinically used synthetic estrogens are described. Estramustine and phosphestrol have been used for many years in the treatment of advanced prostate cancer. Estramustine phosphate is a prodrug that is rapidly on oral administration to the five metabolites, estramustine, estromustine, estradiol, estrone and anticancer drug, nitrogen mustards. Estramustine induces dose- and time-dependent metaphase arrest and breakdown of interphase microtubules. Raloxifene is a selective estrogen receptor modulator from the benzothiophene class that binds to the estrogen receptor and has estrogen-agonist effects on bone. Raloxifene has used in female patients with postmenopausal osteoporosis.
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PMID:[Synthetic estrogens: some new pharmacological actions and mechanisms]. 1818 55

Estracyt(R) is an antimitotic drug used for the treatment of prostate cancer, and its most common adverse effects are nausea and vomiting. In this study, we investigated the effect of a 5-HT3 receptor antagonist, granisetron, on emesis induced in ferrets by estramustine phosphate sodium (EMP), the active ingredient of Estracyt. To clarify the mechanism of action of EMP-induced emesis, we also investigated the effect of EMP on the release of serotonin (5-HT) in the isolated rat ileum. EMP (3 mg/kg, per os) induced 75.3+/-10.2 retching episodes and 7.5+/-1.3 vomiting episodes during a 2-h observation period. The latency to the first emetic response was 58.0+/-13.5 min. Granisetron (0.1 mg/kg, per os) administered 1 h before the administration of EMP reduced the number of EMP-induced retching and vomiting episodes to 1.3+/-1.3 and 1.0+/-1.0, respectively, and prolonged the latency by a factor of almost two. EMP (10-5 and 10-4 M) increased 5-HT release from isolated rat ileum, and 10 -7 M granisetron almost completely inhibited the increase induced by 10-4 M EMP. These results suggest that EMP induces nausea and vomiting via 5-HT release from the ileum, and that 5-HT3 receptor antagonists may be useful to prevent gastrointestinal adverse effects that occur during treatment with Estracyt.
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PMID:[Effect of the 5-HT3 receptor antagonist granisetron on estramustine phosphate sodium (Estracyt)-induced emesis in ferrets]. 2072 8

If androgen deprivation, chemical with LH-RH analogs or surgical with bilateral orchiectomy, still remains the stone edge of treatment of prostate cancer, in the metastatic setting, this hormonosensitivity, most of the time long, finally move on in hormonal-failure. If rare changes in the therapeutic strategy have been achieved in this setting since 2004 and the arrival of docetaxel, it is the global perception of the disease that has been modified and the definition of one specific entity: the castrate-resistant prostate cancer. This new definition and the changes of design and end-points of clinical trials testing new agents with strong recruitment during the past years have conducted to a real revolution in the management of castrate-refractory prostate cancer. The place of secondary hormonal manipulations, such as withdrawal of the anti-androgen, oestrogen or ketoconazole, still exists for a selected group of patients. In case of aggressive disease and symptoms, chemotherapy should be selected, docetaxel, in a three weeks schedule, and may be combined with Estracyt. It is time to consider the revolution of the post-chemotherapy setting with the arrival of two new drugs ; a cytotoxic one, the cabazitaxel and hormonal for the second one, the abiraterone acetate. The place of the immunotherapy with the sipuleucel-T may be more difficult to precise, especially in Europe, even if it has been finally indicated in the United States in the metastatic setting. Concerning bone metastasis, zoledronic acid was during a long time the only bone-targeted agent, effective in reducing the incidence of skeletal related events, and was recently exceeded by the denosumab, an anti-RANK ligand. Finally, let us hope that other changes will be achieved in the near future, with the cabazitaxel-docetaxel confrontation in the first-line setting, and the introduction of the abiraterone acetate before chemotherapy with docetaxel, already tested in ongoing trials.
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PMID:[Strategy in advanced castration-resistant prostate cancer]. 2252 82


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