Time for revival of estrogens in the treatment of advanced prostatic carcinoma? Pharmacokinetics, and endocrine and clinical effects, of a parenteral estrogen regimen

  title={Time for revival of estrogens in the treatment of advanced prostatic carcinoma? Pharmacokinetics, and endocrine and clinical effects, of a parenteral estrogen regimen},
  author={Peter Henriksson and Kjell Carlstr{\"o}m and {\AA}ke Pousette and P O Gunnarsson and Carl J. Johansson and Birgitta Eriksson and Ann Kristin Altersg{\aa}rd‐Brorsson and {\"O}rjan Nordle and Reinhard Stege},
  journal={The Prostate},
The present pilot study tested the clinical performance of a new pharmacokinetically guided dosing regimen of parenteral estrogen in patients with advanced prostatic carcinoma. The aim was to accelerate endocrine effects and to avoid cardiovascular side effects. 

Pharmacodynamic model of testosterone suppression after intramuscular depot estrogen therapy in prostate cancer

A model is described predicting the effect on testosterone flux achieved with this estrogen drug, PEP, which has been in clinical use for several years in combination therapy and pharmacokinetically and clinically as a single treatment.

Phase II study of transdermal estradiol in androgen‐independent prostate carcinoma

The authors tested the safety and efficacy of transdermal estradiol (TDE), as well as the effect of therapy on hot flashes, sex hormones, the procoagulant cascade, and bone turnover in patients with AIPC.

Diethylstilboestrol for the treatment of prostate cancer: past, present and future

The most relevant clinical studies using DES in castration-refractory prostate cancer (CRPC) were identified from the literature and the efficacy of oestrogen therapy in CRPC is highlighted.

Parenteral estrogens for prostate cancer: can a new route of administration overcome old toxicities?

The data for parenteral estrogen use in prostate cancer, the antineoplastic mechanisms of action of estrogen in prostate Cancer, the potential advantages of parenTERal estrogen compared with conventional ADT, and the remaining barriers in the use of p Karenteralosterone in prostatecancer are reviewed.

Parenteral Estrogen versus Combined Androgen Deprivation in the Treatment of Metastatic Prostatic Cancer - Scandinavian Prostatic Cancer Group (SPCG) Study No. 5

High-dose polyestradiol phosphate (PEP) has an equal anticancer efficacy to CAD and does not increase cardiovascular mortality, and is considerably cheaper than CAD.

Therapy Insight: parenteral estrogen treatment for prostate cancer—a new dawn for an old therapy

Parenteral estrogen therapy has the advantage of giving protection against the effects of andropause, which are induced by conventional androgen suppression and include osteoporotic fracture, hot flashes, asthenia and cognitive dysfunction.

androgen deprivation therapy for prostate cancer - the potential of parenteral estrogen

Parenteral estrogen therapy is protection against the effects of the andropause (cf female menopause), which with conventional androgen suppression causes significant morbidity including osteoporotic fracture, hot flushes, lethargy and cognitive dysfunction.

Parenteral oestrogens for prostate cancer: a systematic review of clinical effectiveness and dose response

The great majority of evidence was concerned with i.m. PEP, but was largely of poor quality or was poorly reported, and the largest and highest quality trials included in the review do not provide long-term survival data.

The evolving role of estrogen therapy in prostate cancer.

  • W. Oh
  • Medicine, Biology
    Clinical prostate cancer
  • 2002
There remain many unanswered questions about the role of estrogen therapy in prostate cancer, including differences between specific drugs, optimal dose, timing, and patient selection.



Pharmacokinetics and testosterone suppression of a single dose of polyestradiol phosphate (Estradurin®) in prostatic cancer patients

The pharmacokinetics and endocrine effects of polyestradiol phosphate (PEP; Estradurin®) were studied by determination of the concentrations of estradiol (E2), unconjugated (E1) and total estrone

Possible bone‐preserving capacity of high‐dose intramuscular depot estrogen as compared to orchidectomy in the treatment of patients with prostatic carcinoma

Treatment of prostatic disease with GnRH agonists or by orchidectomy affects bone mass negatively. Estrogen treatment has beneficial effects on bone mass in women and might hypothetically have a bone

Cost Comparison of Parenteral Estrogen and Conventional Hormonal Treatment in Patients With Prostatic Cancer

  • P. HenrikssonR. Stege
  • Medicine, Biology
    International Journal of Technology Assessment in Health Care
  • 1991
The initial cost of orchidectomy as compared to nonoral estrogen treatment was shown not to be balanced within the expected survival time of patients with advanced prostatic cancer, and surgical castration causes psychological trauma to the patient.

Cardiovascular follow‐up of patients with prostatic cancer treated with single‐drug polyestradiol phosphate

Patients with cancer of the prostate treated with strict parenteral estrogen in the form of monthly polyestradiol phosphate injections have responded to therapy and there have been no cardiovascular complications at a mean follow‐up of 12.9 ± 0.7 months.

Single‐drug parenteral estrogen treatment in prostatic cancer: A study of two maintenance‐dose regimens

Treatment of 17 patients with prostatic cancer with 320 mg polyestradiol phosphate (PEP) as intramuscular injections every fourth week suppressed serum testosterone (T) values to orchidectomy levels

A comparison of androgen status in patients with prostatic cancer treated with oral and/or parenteral estrogens or by orchidectomy

Both estrogen treatment regimens were as effective as orchidectomy in reducing circulating levels of T and A‐4 and the more pronounced effects of oral estrogens on circulating adrenal androgens may reflect an altered liver metabolism associated with this route of administration.

Effect of parenteral oestrogen on the coagulation system in patients with prostatic carcinoma.

Parenteral administration of oestrogen caused a less marked change in the coagulation system than oral administration and should be the treatment of choice for prostatic carcinoma.

Prediction of cardiovascular complications in patients with prostatic cancer treated with estrogen.

If patients with prostatic cancer are examined by means of exercise stress tests and blood tests for luteinizing hormone, cholesterol, and follicle-stimulating hormone prior to treatment, the discriminant function enables the authors to identify an extremely high-risk group for cardiovascular complications if estrogen therapy is commenced.

Orchidectomy versus oestrogen for prostatic cancer: cardiovascular effects.

The substantially increased risk of cardiovascular complications in patients given oestrogen for prostatic cancer warrants careful consideration when choosing treatment for this disorder.

The oestrogenic effects of ethinyl oestradiol/polyoestradiol phosphate and estramustine phosphate in patients with prostatic carcinoma. A comparative study of oestrogen sensitive liver proteins, gonadotrophins and prolactin.

Thirty previously untreated patients with carcinoma of the prostate were prospectively randomised to one of the following treatments: ethinyl oestradiol (Etivex) combined with polyoestradiol