Rationale and results of primary endocrine therapy in patients with prostatic cancer

The rationale for antiandrogenic therapy, as first proposed by Charles Huggins, is presented. Based on such a theory, several methods are reviewed which permit assessment of antiandrogenic action and which should serve as screening methods for compounds to be used in the treatment of prostatic cancer. These methods include the prostatic fistula preparation in the dog, wet-weight determinations of the prostate glands of rats, measurement of DNA synthesis in rat prostate, and the determination of certain enzyme activities, including 5-alpha reductase and arginase. Such efforts suggest that certain compounds, such as strong progestins, certain non-steroidal antiandrogens, and several chemotherapeutic agents, should be given an adequate, controlled clinical trial. Results of primary endocrine therapy are discussed only briefly, because the results of The Veterans Administration studies were presented in detail at this Conference.