Hormone-refractory prostate cancer: new horizons.

The eighth session of the 13th International Prostate Cancer Update focused on the mechanisms of androgen-independent cancer growth and on new therapeutic approaches to the treatment of androgen-independent prostate cancer. Three possible mechanisms that might account for the development of hormone resistance are reviewed here. These are: changes in antigen receptor expression, changes in androgen receptor structure, and changes in androgen receptor function. Therapeutic approaches discussed include the endothelin receptor antagonist astrasentan; PS-341, a boronic acid dipeptide that is highly selective for proteosome inhibition; the microtubule-stabilizing agent epothilone B; and exisulind, a selective apoptotic antineoplastic drug. The cooperative cancer study groups will move these treatments from their preliminary phase 1 and 2 studies to comparison against the standard of care for hormone-refractory prostate cancer.