Current and future therapeutic strategies in metastatic hormonal-resistant prostate cancer. Therapy based on phenotype

Although hormone-refractory disease remains a therapeutic challenge, various treatment options are available that can provide objective tumor regression and palliate the symptoms of the disease. Increased understanding of the biology of the disease has also led to the rapid translation of promising strategies to the clinic. For example, suramin and the combination of estramustine and vinblastine, shown to have activity in vitro and in vivo, have demonstrated significant antitumor activity in men. It is hoped that the importance of direct characterization of the tumor present at the time of relapse from hormonal therapy, with respect to growth factor expression, neuroendocrine differentiation, and monoclonal antibody phenotyping, will lead to more specific therapies for individual patients.