Prostate Cancer: Translational and Emerging Therapies PDF

Preface
 
Prostate cancer is the most common malignancy in men and its incidence will dramatically increase over the next several decades due to the ‘‘baby boomers'' reaching maturity. While the majority of patients can be cured with local radiotherapy or surgical modalities, many will progress with metastatic disease for which there is, currently, a limited number of treatment options. However, research in prostate cancer has made significant progress over the last decade, providing us with a better understanding of the critical events that lead to the development and progression of this disease and novel targets for therapies. This book will provide state-of-the-art information on evolving translational therapies in prostate cancer, which will translate into better outcomes for our patients.
 
It is appropriate that Drs. Nelson and De Marzo set the stage and describe the initial events of the development and progression of prostate cancer and identify the key elements that could be potential targets for preventing prostate cancer. However, identifying the target does not always lead to an effective therapy, as Dr. Sausville illustrates, and clinical investigations with these new targeted therapies require the integration of unique tumor markers, imaging modalities, and trial designs to show the clinical or biologic effect of the drug. Many therapies have overcome these hurdles and are now showing clinical benefit in patients.
 
Some agents that have shown promise include the endothelial receptor antagonists, vitamin D analogs, monoclonal antibodies to the prostate-specific membrane antigen, angiogenesis inhibitors, and many other small molecules such as the tyrosine kinase inhibitors. Drs. Qian and Pili and his colleagues describe a new class of agents called posttranscription modifiers, which include the histone deacetylase inhibitors and demethylation agents, while others have been investigating antisense oligonuclitides to inhibit specific proteins and kinases such as Bcl-2, clusterin, and other vital proteins that are critical in the growth of prostate cancer. Therapies that inhibit telomerase, proteasomes, and heat shock proteins have been promising avenues for the treatment of prostate cancer and these therapies are described by Drs. Burger, Dreicer, and Solit.
 
Immunologic and gene therapy approaches continue to be pursued and the data showing that these therapies may one day be a standard treatment is strengthening. Dr. Small and his researchers update us on the exciting data of several novel vaccine approaches and other new modalities that modify the immune response.
 
Investigators are also developing a better understanding of the pathophysiology of osteoblastic metastasis and androgen receptor. Dr. Hamdy and associates have reviewed the advancements in bone-targeted therapies and new agents that will be entering into the clinics while Dr. Mellinghoff highlights novel therapies that will inhibit the androgen receptor.
 
For decades, hormone-refractory prostate cancer was thought to be resistant to chemotherapy; however recent data has shown that prostate cancer is sensitive to chemotherapy and improves survival, which has renewed the interest in identifying novel cytotoxic drugs for this disease. Dr. Hussain reviews this ongoing research and highlights the new agents that are in clinical trials-many of which are in Phase III testing.
 
Compared to a decade ago, we have made great advancements in the understanding of prostate cancer and the targets that may treat this disease, but this was only possible from the strong support of dedicated researchers and patients.
 
Author: Dawson, Nancy A.