RECENT AMERICAN MULTICENTER TRIALS FOR PATIENTS WITH METASTATIC PROSTATE-CANCER

Combined androgen blockade for metastatic prostate cancer has become the standard against which on-going clinical trials are measured. Benefit of combined androgen blockade with an LHRH agonist (leuprolide) and an antiandrogen (flutamide) has been noted, particularly for those with minimal disease. This has led to timely accrual of patients to a trial testing whether orchidectomy with flutamide is superior to orchidectomy alone. Positive findings with permanent and intermittent withdrawal of flutamide has prompted the design and implementation of additional trials. Suramin has been reintroduced in trials of chemohormonal intervention. Past success with combined androgen blockade in lengthening survival and improving quality of life for patients with metastatic prostate cancer has prompted enthusiasm for broadening the base of clinical studies for this disease.