Non-hormone chemotherapy for XXXX : principles of treatment and application to the testing of new drugs.

@entity1 @entity263 @entity146 @entity5 @entity3
@entity263 , one of the commonest @entity5 in western society, remains a major challenge in management. Although the typical @entity1 is elderly and may not withstand @entity146 approaches to treatment, increasing numbers of our population survive to old age, while remaining healthy and active. As @entity263 is a disease of old age, it is therefore likely that there will be an increased requirement to combat this disease in a fit @entity1 population. Although hormonal manipulation provides effective first-line treatment for 70%-80% of @entity1 with @entity3 , the majority of these ultimately relapse. Cytotoxic chemotherapy has not provided a panacea for relapsed, hormone-resistant @entity263 . Despite the significant subjective and objective responses that can be achieved by the use of single agents, the median survival of @entity1 with hormone-resistant disease remains less than 12 months. The use of combination cytotoxic regimens has not altered this. New approaches, perhaps including the development of new cytotoxic agents, innovative uses of established drugs, or the application of the biological response modifiers will be required before this problem is resolved. Until then, we must not be satisfied with inadequate indices of success. The reporting of response rates and of survival statistics drawn from the small group of responding @entity1 is no true indicator of success. Until truly effective treatment is available, we must learn to define more useful indicators of @entity1 benefit, to be more effective in palliating the symptoms of this disease, and to be more critical of the limitations of our progress.
