V.C. Jordan, B.J.A. Furr (eds). Hormone Therapy in Breast and Prostate Cancer

Abstract

Breast cancer and prostate cancer are two big killers that share a common etiology. In fact, steroid hormones play a major role in the development and progression of both tumors. Some 50 years after the pioneering work of Sir George Beatson and Sir Charles Huggings, hormone therapy represents a major tool for the treatment of these conditions and enormous advances have been made in our knowledge of the molecular mechanisms that allow tumors to respond to endocrine manipulations. This improved knowledge has provided the molecular keys to the selection of suitable patients to benefit from endocrine manipulations and to the development of new drugs and strategies, which have proved to be safer and more effective. It is not an easy task to include in one book appropriate information on preclinical and clinical aspects of hormone therapy, which satisfies the knowledge requirements of both basic researchers and clinicians, but Craig Jordan and Barrington Furr, with the help of leading experts in different fields, have succeeded. All (maybe not quite all) the information one could need to know about the major drug compounds, which are commonly used in the treatment of breast and prostate cancer, can be drawn from consultation of this text. Chapter 1 provides a simple, but exhaustive, introductionto the regulation of sex steroids for the treatment of cancer, which is extremely useful to address the subsequent chapters. Nine chapters are dedicated to antiestrogens, in particular to their mechanisms of action and to those implied in antiestrogen resistance, and to some effects which might have special implications in the clinical setting, such as their carcinogenic effects. The main results achieved with antiestrogens in the palliative setting, as well as the adjuvant treatment of breast cancer, are reviewed, together with the preliminary findings and expectations from the ‘hot’ field of breast cancer prevention. The mechanisms of action of aromatase inhibitors, with a special emphasis on the two different classes of such compounds and the results achieved in major trials in breast cancer, form the subject of the next two chapters. Roger Blamey provides an exhaustive overview of luteinizing hormone-releasing hormone (LH-RH) analog development and its use in breast cancer treatment, including the more recent results achieved with these compounds either alone or in combination with antiestrogens both in advanced disease and the adjuvant setting. Four chapters are dedicated to the elucidation of the molecular mechanisms of androgen action and to the preclinical and clinical aspects in relation to LH-RH analogs and antiandrogens. Old, but still burning, issues such as the role of total androgen deprivation in the management of prostate cancer, and new perspectives, such as intermittent androgen deprivation and antiandrogen monotherapy, are properly addressed by the different authors. Finally, new insights into breast cancer research are provided by the last chapter. I am sure that medical oncologists, radiotherapists, breast surgeons, gynecologists and urologists (but also basic researchers who are concerned with breast or prostate cancer) will find this book valuable for consultation and study.