TY - JOUR. T1 - Risk assessment among prostate cancer patients receiving primary androgen deprivation therapy. AU - Cooperberg, Matthew R.. AU - Hinotsu, Shiro. AU - Namiki, Mikio. AU - Ito, Kazuto. AU - Broering, Jeanette. AU - Carroll, Peter R.. AU - Akaza, Hideyuki. PY - 2009/9/10. Y1 - 2009/9/10. N2 - Purpose: Prostate cancer epidemiology has been marked overall by a downward risk migration over time. However, in some populations, both in the United States and abroad, many men are still diagnosed with high-risk and/or advanced disease. Primary androgen deprivation therapy (PADT) is frequently offered to these patients, and disease risk prediction is not well-established in this context. We compared risk features between large disease registries from the United States and Japan, and aimed to build and validate a risk prediction model applicable to PADT patients. Methods: Data were analyzed from 13,740 men in the United States community-based Cancer of the Prostate Strategic Urologic Research ...
The trial follow-up period was stopped early (median follow-up, 6.9 years) because a planned interim analysis, reviewed by an independent data and safety monitoring committee, unequivocally demonstrated no difference in survival outcome between the two treatment groups. Median overall survival was 8.8 years on intermittent androgen suppression vs 9.1 years on continuous androgen deprivation (HR = 1.02; 95% CI = 0.86-1.21; P = .009 for noninferiority [HR ≥ 1.25 for intermittent androgen suppression vs continuous androgen deprivation]). Patients on the intermittent androgen suppression arm had more disease-related deaths (122 vs 97) and fewer disease-unrelated deaths (134 vs 146).. Patients receiving intermittent androgen suppression therapy had a reduced incidence of hot flashes, but rates of other adverse events, including myocardial events and osteoporotic fractures, were similar between the two groups. Full testosterone recovery was noted in 35% of men on the intermittent androgen ...
RATIONALE: Radiation therapy uses high-energy x-rays and other types of radiation to kill tumor cells and shrink tumors. Androgens can cause the growth of prostate cancer cells. Androgen-deprivation therapy may lessen the amount of androgens made by the body. It is not yet known whether radiation therapy is more effective with or without androgen-deprivation therapy in treating patients with prostate cancer.. PURPOSE: This randomized phase III trial is studying radiation therapy to see how well it works compared with radiation therapy given together with androgen-deprivation therapy in treating patients with prostate cancer. ...
RATIONALE: Radiation therapy uses high-energy x-rays and other types of radiation to kill tumor cells and shrink tumors. Androgens can cause the growth of prostate cancer cells. Androgen-deprivation therapy may lessen the amount of androgens made by the body. It is not yet known whether radiation therapy is more effective with or without androgen-deprivation therapy in treating patients with prostate cancer.. PURPOSE: This randomized phase III trial is studying radiation therapy to see how well it works compared with radiation therapy given together with androgen-deprivation therapy in treating patients with prostate cancer. ...
Men with advanced prostate cancer had similar survival with intermittent or continuous androgen deprivation therapy, pooled data from two randomized trials showed.
Cancer of the prostate (CaP) is the most frequently diagnosed non-cutaneous malignancy worldwide, and it is the second leading cause of death from cancer in men. In the developing world, majority of patients with CaP present in advanced stage and often times, androgen deprivation therapy (ADT) is the only treatment option available. ADT has been reported to increase the risk of osteopenia and osteoporosis in patients with CaP in studies done predominantly among the Caucasians. There is a dearth of report of the effect of ADT on CaP in the black population most especially Nigerian population despite our high incidence of CaP. The aim of this study was to determine the effect of advanced CaP and its treatment using ADT on bone mineral density (BMD) in our patients. The age of the patients ranged from 54 to 88 years (mean 70.15 ± 6.7) and 50 to 85 years (mean 68.92 ± 8.5) for the case and control groups, respectively. The mean BMD of the control group (0.26 ± 1.5) was significantly higher than the case
Purpose - Use of androgen deprivation therapy (ADT) may be associated with an increased risk of diabetes mellitus but the risk of both acute myocardial infarction (AMI) and cardiovascular mortality remain controversial because few outcomes and conflicting findings have been reported. We sought to clarify whether ADT is associated with these outcomes in a large, representative cohort.. Methods - Using linked administrative databases in Ontario, Canada, men age 66 years or older with prostate cancer given continuous ADT for at least 6 months or who underwent bilateral orchiectomy (n = 19,079) were matched with men with prostate cancer who had never received ADT. Treated and untreated groups were matched 1:1 (ie, hard-matched) on age, prior cancer treatment, and year of diagnosis and propensity-matched on comorbidities, medications, cardiovascular risk factors, prior fractures, and socioeconomic variables. Primary outcomes were development of AMI, sudden cardiac death, and diabetes. Fragility ...
TY - JOUR. T1 - Combined androgen blockade achieved better oncological outcome in androgen deprivation therapy for prostate cancer. T2 - Analysis of community-based multi-institutional database across Japan using propensity score matching. AU - Onozawa, Mizuki. AU - Akaza, Hideyuki. AU - Hinotsu, Shiro. AU - Oya, Mototsugu. AU - Ogawa, Osamu. AU - Kitamura, Tadaichi. AU - Suzuki, Kazuhiro. AU - Naito, Seiji. AU - Namiki, Mikio. AU - Nishimura, Kazuo. AU - Hirao, Yoshihiko. AU - Tsukamoto, Taiji. N1 - Publisher Copyright: © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.. PY - 2018/10. Y1 - 2018/10. N2 - Background: This study investigated how differences in the method of the first-line androgen deprivation therapy (ADT) affected the time to castration-resistant prostate cancer. Methods: The Japan Study Group of Prostate Cancer compiled a nationwide community-based database on prostate cancer patients who underwent ADT. That database included 13 774 patients who were ...
TY - JOUR. T1 - Androgen-deprivation therapy in prostate cancer: A European expert panel review. AU - Schulman, Claude C.. AU - Irani, Jacques. AU - Morote, Juan. AU - Schalken, Jack A.. AU - Montorsi, Francesco. AU - Chlosta, Piotr L.. AU - Heidenreich, Axel. PY - 2010/1/1. Y1 - 2010/1/1. N2 - Context: Androgen-deprivation therapy (ADT) is the mainstay of treatment for metastatic prostate cancer and is also recommended in association with external-beam radiation therapy (EBRT) for patients with high-risk disease. Objective: Our aim was to make recommendations regarding optimal timing of ADT, target serum testosterone levels, intermittent ADT delivery, and quality of life (QoL) during ADT. Evidence acquisition: This review contains recommendations from a European expert panel held in May 2009. Evidence synthesis: There is ongoing debate over whether ADT should be initiated at diagnosis or delayed until biochemical or symptomatic progression. Immediate ADT is recommended for metastatic disease to ...
TY - JOUR. T1 - Long-term follow-up comparing salvage radiation therapy and androgen-deprivation therapy for biochemical recurrence after radical prostatectomy. AU - Matsumoto, Kazuhiro. AU - Niwa, Naoya. AU - Hagiwara, Masayuki. AU - Kosaka, Takeo. AU - Takeda, Toshikazu. AU - Yasumizu, Yota. AU - Tanaka, Nobuyuki. AU - Morita, Shinya. AU - Mizuno, Ryuichi. AU - Shinojima, Toshiaki. AU - Hara, Satoshi. AU - Asanuma, Hiroshi. AU - Oya, Mototsugu. N1 - Publisher Copyright: © 2021, Japan Society of Clinical Oncology.. PY - 2021/4. Y1 - 2021/4. N2 - Background: The salvage treatments for biochemical recurrence (BCR) include local external beam radiation therapy (RT) and systemic androgen-deprivation therapy (ADT). Methods: We reviewed patients who underwent radical prostatectomy (RP) and developed BCR at three institutions. After excluding patients whose nadir prostate-specific antigen (PSA) was higher than 0.2 ng/mL, those who received neoadjuvant/adjuvant therapy, and those whose BCR was not ...
Phase IIIb Randomized Trial Comparing Irradiation Plus Long Term Adjuvant Androgen Deprivation With GnRH Antagonist Versus GnRH Agonist Plus Flare Protection in Patients With Very High Risk Localized or Locally Advanced Prostate Cancer. A Joint Study of t
We know bone-protecting agents can be used to prevent bone loss in men taking androgen-deprivation therapy. Bone-protecting agents can also delay the time to first skeletal-related events in men with metastatic castration-resistant prostate cancer and bone metastasis. There are two different indications with different doses used for men receiving androgen-deprivation therapy and men with metastatic castration-resistant prostate cancer and bone loss, explained Dr. Gillessen.. Background. Osteoporotic fractures are reported in up to 11% of patients treated with androgen-deprivation therapy and an androgen receptor (AR) pathway inhibitor. Skeletal-related events due to osseous metastases are reported in up to 40% of men treated with androgen-deprivation therapy and an AR pathway inhibitor. These skeletal-related events include pathologic bone fracture, spinal cord compression, orthopedic surgery, and palliative radiation.. Osteoporotic fractures in men on androgen-deprivation therapy are probably ...
Health, ...WASHINGTON A study of more than 15000 men with early stage prostate ...The research team led by scientists at Georgetown Lombardi Comprehens...The findings reported Monday in the Journal of Clinical Oncology/...Androgen deprivation therapy suppresses the production of testosterone...,Primary,androgen,deprivation,therapy,ineffective,for,most,men,with,early,prostate,cancer,medicine,medical news today,latest medical news,medical newsletters,current medical news,latest medicine news
TY - JOUR. T1 - Positive and negative mood in men with advanced prostate cancer undergoing androgen deprivation therapy. T2 - Considering the role of social support and stress. AU - Benedict, Catherine. AU - Dahn, Jason R.. AU - Antoni, Michael H. AU - Traeger, Lara. AU - Kava, Bruce. AU - Bustillo, Natalie. AU - Zhou, Eric S.. AU - Penedo, Frank J.. PY - 2015/8/1. Y1 - 2015/8/1. N2 - Advanced prostate cancer patients often undergo androgen deprivation therapy (ADT). Advanced disease and adverse ADT side effects are often debilitating and negatively impact mood. Social support has been shown to mitigate detrimental effects of stress on mood. Objective This study sought to characterize positive and negative mood in this select patient population and determine whether social support moderated relations between stress and mood. Methods Participants (N=80) completed the Interpersonal Support Evaluation List, Perceived Stress Scale, and Derogatis Affect Balance Scale at a single time point. ...
Background: Many elderly men with high-risk nonmetastatic prostate cancer (HRnMPCa) do not receive radical treatment, despite the high mortality associated with conservative management. Objective: To investigate how age and comorbidity affect treatment of men with HRnMPCa. Design, setting, and participants: This was an observational nationwide register study during 2001-2012. We identified 19 190 men of ,80 yr of age diagnosed with HRnMPCa in the National Prostate Cancer Register of Sweden and 95 948 age-matched men without prostate cancer in the register of the total population. Outcome measurements and statistical analysis: The outcome was the proportion of men with HRnMPCa receiving radical treatment (radical prostatectomy or radiotherapy). Vital status and the Charlson comorbidity index (CCI) were obtained from nationwide registers. The 10-yr survival of men without prostate cancer, stratified by age and CCI, was used as a measure of the life expectancy of the men with prostate cancer. ...
Primary androgen deprivation therapy (PADT) was linked with increased all-cause mortality and prostate cancer-specific mortality.
Purpose Principal androgen-deprivation therapy (PADT) is usually often used to take care of clinically localized prostate cancer, but its effects about cause-specific and general mortality never have been established. prostate-cancerCspecific mortality (HR, 1.03; 95% CI, 0.89 to at least one 1.19) after adjusting for all those sociodemographic and clinical characteristics. PADT was connected with decreased threat of all-cause mortality however, not prostate-cancerCspecific mortality. PADT was connected with decreased threat of all-cause mortality just among 141750-63-2 IC50 the subgroup of males with a higher risk of malignancy development (HR, 0.88; 95% CI, 0.78 to 0.97). Summary We discovered no mortality reap the benefits of PADT weighed against no PADT for some males with medically localized prostate malignancy who didnt receive curative intention therapy. Males with higher-risk disease may derive a little clinical reap the benefits of PADT. Our research provides the greatest available ...
Thromboembolic events are potentially fatal adverse events associated with malignancy as well as androgen deprivation therapy (ADT). In the analysis of the PCBaSe Sweden, the Swedish database that captures 98% of all new prostate cancer diagnoses, the authors compared men with prostate cancer on ADT (anti-androgen = 11,242; GnRH agonist = 26,959; combined blockade = 1091; surgical castration = 3789) with a matched cohort of men without prostate cancer.
PURPOSE To assess the risk of prostate cancer (PCa) specific mortality (PCSM) compared to cardiovascular disease mortality (CVDM), or other-cause mortality (OCM) of men with nonmetastatic PCa according to PCa risk groups, primary treatment, and age. PATIENTS AND METHODS This retrospective population-based cohort study identified 1,908 nonmetastatic PCa patients in the cancer registry Zurich and Zug, diagnosed between 2000 and 2009 living in the City of Zurich. Multiple imputation methods were applied to handle missing PCa information. Fine and Gray competing risk regression analysis was used to estimate subdistribution hazard ratios for the outcomes PCSM, CVDM, or OCM RESULTS: Ten years after diagnosis the cumulative probability of PCSM and CVDM was 16.4% and 10.0%, respectively. We observed an increased adjusted risk of PCSM in men treated with androgen deprivation therapy (ADT) compared to surgery, but could not observe an association between ADT and CVDM. The probability of PCSM was ...
1 Introduction Treatment of metastatic prostate cancer with androgen deprivation therapy (ADT) is effective, but can be associated with debilitating side effects. Oligometastasis describes a state of limited metastatic capacity (Weichselbaum 2011). This may represent an intermediate disease state that is amenable to aggressive local therapy, allowing deferral of ADT. In practice oligometastasis usually refers to five or fewer metastases. These early metastatic lesions may seed further metastases. Therefore, eradication of oligometastases may alter the progression of disease and potentially offer cure in select cases. Surgery or radiation therapy are the two treatment options in this setting. Stereotactic body radiotherapy (SBRT) is relatively non-invasive. It delivers an ablative dose of radiotherapy to target tissues, minimising scatter to adjacent structures. Early evidence in other cancers suggests SBRT is a safe and effective treatment for oligometastatic disease (Tree 2013). Conclusions ...
Androgen deprivation therapy remains to be a critical element of treatment for guys with advanced prostate tumor, and data works with its make use of in metastatic disease and together with medical procedures or rays in specific configurations. such as for example abiraterone acetate, are eagerly anticipated. 1: 34C45 ? Macmillan Web publishers Ltd. All privileges reserved. Abbreviations: AR, androgen receptor; ARA70, androgen receptor linked proteins 70; DHT, dihydrotestosterone; GTA, general transcription activation; HSP, heat-shock proteins; SHBG, sex-hormone-binding globulin. Historically, circulating testosterone amounts have been utilized to assess the efficiency of androgen depletion, using a focus on total testosterone level below 50,ng/dl ( 1.74,nmol/l). This focus on is defined based on the degree of suppression attained with operative castration, and continues to be the standard for analyzing the effectiveness of agents such as for example GnRH agonists.11 In men with prostate ...
Evidence-based recommendations on enzalutamide (Xtandi) for treating high-risk hormone-relapsed non-metastatic prostate cancer in adults
CTLA-4 blockade has demonstrated antitumor efficacy in human clinical trials. The antitumor mechanism is presumably mediated in part by the expansion of tumor-specific T cells. Androgen deprivation, t
Some men receiving Androgen Deprivation Therapy (ADT; also called hormone therapy) report a decline in their thinking skills (eg.memory). But some men may experience more of a change than others. This suggests that there may be factors that make some men more, or less, at risk of a drop in thinking skills after ADT than others. These researchers aim to identify these factors so that men can be given evidence based information before making treatment decisions around hormone therapy. Population based studies like this will give us knew information that might help in developing interventions to manage the side-effects of treatment. ...
This is a multi-center phase III study to compare the clinical benefit of androgen deprivation therapy (+ docetaxel) with or without local radiotherapy with or without abiraterone acetate and prednisone in patient with metastatic hormone-naïve prostate cancer.
Researchers have found an association between androgen deprivation therapy (ADT) for prostate cancer and increased risk for Alzheimers disease…
Background: Prostate cancer (PC) is the most frequent neoplasia in the male population and androgen deprivation therapy (ADT) is frequently used in the management of the disease.Aim: To evaluate the effect of ADT exposure on cognitive status, grey matter volume (GMV) and white matter lesion (WML) load.Methods: Fifty ADT patients and fifteen PC-non-ADT (control) patients were included in the study. A neuropsychological evaluation was performed and a magnetic resonance imaging (MRI), with anatomical T1 and FLAIR sequences, was performed to evaluate the GMV and the WML burden.Results: Most of the patients included in the study presented a significant cognitive impairment (CI). No significant differences were identified in the cognitive assessment between the studied groups, but when considering the educational background intragroup differences were found.No significant difference of GMV and WML volume were identified between groups, but a negative relationship between the ADT period and the GMV was
Immune Responses Enhanced and Sustained When PROVENGE® (sipuleucel-T) is Given After Androgen Deprivation Therapy in Biochemically-Recurrent Prostate Cancer
The paper, titled Enhancing the effectiveness of androgen deprivation in prostate cancer by inducing Filamin A nuclear localization, shows for the first time that GCP keeps filamin A in the nucleus. As long as this protein remains attached to the androgen receptor, the cancerous cells need androgens to survive and grow. They die off when starved of androgens, thus prolonging the effects of androgen deprivation, which ultimately prolongs the patients life.. The teams hypothesis is that metastatic prostate cancer patients with the weakest response to androgen-deprivation therapy could be given GCP concurrently with androgen deprivation therapy to retain Filamin A in the nucleus, thereby allowing cancer cells to die off. De Vere White is now pursuing funding to begin GCP human clinical trials. Because GCP is a natural product rather than a drug, and requires fewer government approvals, its expected that these trials will proceed rapidly once funded.. We should know within the first eight ...
Introduction. To assess the role of adjuvant androgen deprivation therapy (ADT) in high-risk prostate cancer patients (PCa) after surgery. Materials and Methods. The analysis case matched 172 high-risk PCa patients with positive section margins or non-organ confined disease and negative lymph nodes to receive adjuvant ADT (group 1, n=86 ) or no adjuvant ADT (group 2, n=86). Results. Only 11.6% of the patients died, 2.3% PCa related. Estimated 5-10-year clinical progression-free survival was 96.9% (94.3%) for group 1 and 73.7% (67.0%) for group 2, respectively. Subgroup analysis identified men with T2/T3a tumors at low-risk and T3b margins positive disease at higher risk for progression. Conclusion. Patients with T2/T3a tumors are at low-risk for metastatic disease and cancer-related death and do not need adjuvant ADT. We identified men with T3b margin positive disease at highest risk for clinical progression. These patients benefit from immediate adjuvant ADT ...
Introduction. To assess the role of adjuvant androgen deprivation therapy (ADT) in high-risk prostate cancer patients (PCa) after surgery. Materials and Methods. The analysis case matched 172 high-risk PCa patients with positive section margins or non-organ confined disease and negative lymph nodes to receive adjuvant ADT (group 1, n=86 ) or no adjuvant ADT (group 2, n=86). Results. Only 11.6% of the patients died, 2.3% PCa related. Estimated 5-10-year clinical progression-free survival was 96.9% (94.3%) for group 1 and 73.7% (67.0%) for group 2, respectively. Subgroup analysis identified men with T2/T3a tumors at low-risk and T3b margins positive disease at higher risk for progression. Conclusion. Patients with T2/T3a tumors are at low-risk for metastatic disease and cancer-related death and do not need adjuvant ADT. We identified men with T3b margin positive disease at highest risk for clinical progression. These patients benefit from immediate adjuvant ADT ...
August 12, 2009 - There are higher rates of both osteoporosis and nonpathologic fractures for men with nonmetastatic prostate cancer using androgen-deprivation therapy (ADT). The role of ADT in men with metastatic prostate cancer - especially patients who receive external beam radiotherapy or who have node-positive disease - has been prospectively established. However, the most common use of ADT in the U.S. is for nonmetastatic prostate-specific antigen failure, for which prospective evidence of benefit is lacking.. Bisphosphonates have been widely used to lower incidence of skeletal events (e.g., pathologic fractures in patients with metastatic disease) and to attenuate development of osteoporosis. However, use of this class of drugs carries a small but real risk for development of renal insufficiency and osteonecrosis. A novel compound that might be used in this setting is denosumab, a human monoclonal antibody that binds to the receptor activator of nuclear factor-B ligand (a key mediator of ...
One of the major treatments for prostate cancer is androgen-deprivation therapy (ADT), and about 50% of prostate cancer patients are treated with ADT at some point in their disease. ADT is used most frequently for patients with local but advanced prostate cancer or metastatic prostate cancer.
At a median follow-up of 29 months, median OS was 44 months in the ADT group versus 57.6 months in the ADT-docetaxel group, or a 39% higher likelihood of survival in the combination arm at any time point during the study (haz-ard ratio 0.61, P = .0003).. Among 520 patients with high-volume disease (visceral metastases and/or 4 or more bone metastases), adding docetaxel to ADT improved median OS by 17 months (32.2 months in the ADT-only group vs 49.2 months in the combi-nation group). The median OS in patients with low-volume disease has not yet been reached.. Combination therapy favored all subgroups. Patients were stratified according to age, volume of disease, bone and vis-ceral metastases, race, Gleason score, prior local therapy, use of anti-androgen therapy beyond 30 days, and skeletal-related events.. Docetaxel also delayed disease progression. At 1 year, the percentage of patients with prostate-specific antigen (PSA) levels less than 0.2 ng/mL was 11.7% in the ADT group versus 22.7% in ...
Purpose: To initiate a phase 1/2 trial to examine the tolerability of a condensed combined-modality protocol for high-risk prostate cancer. Methods and Materials: Men scoring ≥3 on the Vulnerable Elderly Scale (VES) or refusing conventionally fractionated treatment for high-risk prostate cancer were eligible to participate. Androgen suppression was delivered for 12 months, and radiation therapy was delivered using 25 Gy to pelvic nodes delivered synchronously with 40 Gy to the prostate given as 1 fraction per week over 5 weeks. The phase 1 component included predetermined stopping rules based on 6-month treatment-related toxicity, with trial suspension specified if there were ≥6 of 15 patients (40%) or ≥3 of 15 (20%) who experienced grade ≥2 or ≥3 gastrointestinal (GI) or genitourinary (GU) toxicity, respectively. Results: Sixteen men were enrolled, with 7 men meeting the criteria of VES ≥3 and 9 men having a VES ,3 but choosing the condensed treatment. One man was not treated owing ...
RATIONALE: Zoledronate may prevent bone loss in patients with prostate cancer undergoing radiation therapy and hormone therapy. It is not yet known whet
This trial will investigate the efficacy and tolerability of vandetanib [Zactima] in prostate cancer patients undergoing intermittent androgen deprivation
When LAPC patients are treated with RT+ADT, LT-ADT is generally defined as the administration of ADT over 2 years, usually prescribed as an adjuvant. A total of five phase III trials have reported long-term follow-up results from approximately 2,500 patients [4-7,10,12-16] (Table 4). As described previously, the purposes of those five studies were to compare the clinical outcomes of LT-ADT+RT with RT alone (RTOG 8531 and EORTC 22863) [4-7,10], or with ADT alone (NCIC CTG/MRC and SPCG-7/SFUO-3) [12-14] or with ST-ADT (RTOG 9202) [15,16] in LAPC patients. In most studies, the median age was around 70 years but, in SPCG-7/SFUO-3, it was 66 years [14]. RTOG 8531 enrolled a larger proportion of node-positive disease (29%) cases than the others (3%-4%) [4,6,7]. Patients with locally advanced stage (cT3-4) accounted for over 70% of the cohort, except for RTOG 9202 (cT2c 45%, cT3-4 55%). A total dose of 65-70 Gy was delivered to the prostate target (approximately 45-50 Gy of pelvic RT followed by 20-25 ...
Serum Lipids prior to Starting Androgen Deprivation Therapy and Risk of Castration Resistant Prostate Cancer and Metastasis: Results from the SEARCH Database.
Primary androgen deprivation therapy (PADT) has played an important role in the treatment of prostate cancer. We sought to identify factors of PSA progression in our series of patients with localized and locally advanced prostate cancer treated with PADT. Six-hundred forty-nine patients with localized and locally advanced prostate cancer who received PADT from 1998 to 2005 by Nara Uro-Oncology Research Group were enrolled. Age, T classification, stage, PSA level at diagnosis, Gleason score, laterality of cancer detected by biopsy and seminal vesicle involvement (SVI) were adopted as parameters of PSA progression. Coxs proportional hazards model was used to determine the predictive factors for PSA progression. The median follow-up period and the median PSA level at diagnosis were 49 months and 15 ng/mL. The 5-year disease specific survival rate, overall survival rate and PSA progression-free survival (PFS) rate were 97.9 %, 91.9 % and 71.2 %, respectively. The univariate analysis showed that the PSA
Davis M.K., Rajala J.L., Tyldesley S., Pickles T., Virani S.A.. Journal of Oncology 2015 2015 Article Number 820403. Background. While androgen deprivation therapy (ADT) reduces the risk of prostate cancer-specific mortality in high-risk localized prostate cancer, it adversely affects cardiovascular (CV) risk factor profiles in treated men. Methods. We retrospectively reviewed the charts of 100 consecutive men with intermediate- or high-risk localized prostate cancer referred to the British Columbia Cancer Agency for ADT. Data on CV risk factors and disease were collected and Framingham risk scores were calculated. Results. The median age of the study cohort was 73 years. Established cardiovascular disease was present in 25% of patients. Among patients without established CV disease, calculated Framingham risk was high in 65%, intermediate in 33%, and low in 1%. Baseline hypertension was present in 58% of patients, dyslipidemia in 51%, and diabetes or impaired glucose tolerance in 24%. ...
TY - JOUR. T1 - Exercise medicine to arrest bone loss in men with prostate cancer undergoing androgen deprivation therapy. T2 - 18th Asia-Pacific Prostate Cancer Conference. AU - Newton, Robert U.. AU - Galvao, Daniel A.. AU - Spry, Nigel. AU - Joseph, David. AU - Chambers, Suzanne K.. AU - Gardiner, Robert A.. AU - Hayne, Dickon. AU - Hart, Nicolas H.. AU - Wall, Brad A.. AU - Bolam, Kate A.. AU - Taaffe, Dennis R.. PY - 2017/8. Y1 - 2017/8. M3 - Abstract/Meeting Abstract. VL - 120. SP - 15. EP - 15. JO - British Journal of Urology International. JF - British Journal of Urology International. SN - 1464-410X. Y2 - 30 August 2017 through 2 September 2017. ER - ...
TY - JOUR. T1 - Bone mass behavior after 1 year of different treatment strategies in prostate cancer patients subjected to androgen deprivation therapy. AU - Planas Morin, J.. AU - Celma Domenech, A.. AU - Placer Santos, J.. AU - Trilla Herrera, E.. AU - Salvador Lacambra, C.. AU - Lorente Garcia, D.. AU - Regis, L.. AU - Carles Galceran, J.. AU - Morote Robles, J.. PY - 2014/1/1. Y1 - 2014/1/1. N2 - © 2014, Springer-Verlag Berlin Heidelberg. The aim of this study was to evaluate bone mass changes after 1 year of four different types of pharmacological intervention. Ninety-seven prostate cancer patients treated with androgen deprivation therapy, and severe osteopenia or osteoporosis were retrospectively studied. Patients were divided in four groups. Group 1: 28 patients treated with denosumab, Group 2: 24 patients treated with alendronate, Group 3: 24 patients with no antiresorptive treatment and Group 4: 21 patients previously treated with alendronate and switched to denosumab. Dual X-ray ...
Purpose: Prostate cancer survivors (PCS) on androgen deprivation therapy (ADT) experience adverse side effects such as skeletal muscle loss and adiposity gain, together called sarcopenic obesity, and changes in cardiometabolic factors that increase risk of metabolic syndrome (MetS). Resistance exercise can increase skeletal muscle mass, but no exercise interventions to date in PCS on ADT have concomitantly improved sarcopenic obesity and cardiometabolic risk factors. Utilizing a 12-week intervention of progressive resistance exercise designed to target skeletal muscle mass, this ongoing pilot trial investigates sarcopenic obesity and as a secondary analyses, MetS components, in PCS on ADT.. Methods: Eighteen PCS (65.6±8.8 yr) on current or previous ADT were recruited from the USC Norris Comprehensive Cancer Center and randomized to resistance training (RT; n=9) or a control stretching program (CS; n=9). Body composition, measured through dual-x-ray absorptiometry, and MetS outcomes, including ...
U.S., Jan. 30 -- ClinicalTrials.gov registry received information related to the study (NCT03031821) titled Metformin in Patients Initiating ADT as Prevention and Intervention of Metabolic Syndrome on Jan. 20. Brief Summary: This is a multi-centre, double-blind, randomized phase III trial comparing metformin to placebo in patients with advanced prostate cancer starting intermittent androgen deprivation therapy. Study Start Date: Study Type: Interventional Condition: Prostate Cancer Metabolic Syndrome Intervention: Drug: Metformin Metformin Duration: 18 months 850 mg PO OD x 30 days then 850 mg PO BID for duration Other Name: Glucophage Drug: Placebo Oral Tablet Placebo Oral Tablet Duration 18 months 1 tablet (850 mg) PO OD x 30 days then 1 tablet PO BID for duration Other Name: Placebo Recruitment Status: Not yet recruiting Sponsor: British Columbia Cancer Agency Information provided by (Responsible Party): British Columbia Cancer Agency ...
A combination regimen plus androgen-deprivation therapy prolongs overall survival (OS) and radiographic progression-free survival (PFS) in newly diagnosed patients with metastatic, castration-sensitive prostate cancer, according to a recent study published in the New England Journal of Medicine (July 27, 2017;377:352-360).. -----. Related Content. Metastatic Hormone-Naïve Prostate Cancer Effectively Treated With Combination Therapy. Lower Dosage of Prostate Cancer Drug Equally Effective When Taken With Low-Fat Meal. -----. Abiraterone acetate in combination with prednisone has demonstrated effectiveness in patients with metastatic, castration-resistant prostate cancer who have not received prior chemotherapy or in those who have received previous docetaxel. Including androgen-deprivation therapy in this regimen has been shown to reduce tumor burden in men with high-risk, localized prostate cancer who are receiving neoadjuvant therapy.. Karim Fizazi, MD, PhD, and colleagues conducted a study to ...
Prostate cancer is the most commonly diagnosed non-cutaneous malignancy in U.S. men. While tumors initially respond to androgen-deprivation therapy, the standard care for advanced or metastatic disease, tumors eventually recur as castration-resistant prostate cancer. Upregulation of the insulin-like growth factor signaling axis drives growth and progression of prostate cancer by promoting proliferation, survival, and angiogenesis. Ganitumab (formerly AMG 479) is a fully human antibody that inhibits binding of IGF-1 and IGF-2 to IGF-1R. Ganitumab decreased IGF-1 induced phosphorylation of the downstream effector AKT and reduced proliferation of multiple androgen-dependent and castration-resistant human prostate cancer cell lines in vitro albeit to varying extents. We evaluated the therapeutic value of ganitumab in several pre-clinical settings including androgen-dependent prostate cancer, castration-resistant (recurrent) prostate cancer, and in combination with androgen-deprivation therapy.
Richman EL, Kenfield SA, Stampfer MJ, Paciorek A, Carroll PR, Chan JM. Physical Activity after Diagnosis and Risk of Prostate Cancer Progression: Data from the Cancer of the Prostate Strategic Urologic Research Endeavor. Cancer Res. 2011 May 24;71(11):3889-95. • Rosario DJ, Lane JA, Metcalfe C, Donovan JL, Doble A, Goodwin L, et al. Short term outcomes of prostate biopsy in men tested for cancer by prostate specific antigen: prospective evaluation within ProtecT study. BMJ. 2012;344:d7894 ...
Clinical Scenario. A 77-year-old man presents to his primary care physician for evaluation after a single episode of rectal bleeding, which is found to be related to his known history of hemorrhoids. At the time of examination, he is found to have a firm prostate with prominent bilateral nodularity. Due to suspicion for prostate cancer, a prostate-specific antigen (PSA) test is given, which returns at 16.2 ng/mL. He then undergoes transrectal ultrasound-guided biopsy and is found to have Gleason score 4 + 4 disease in 8 of 12 cores, with 30% to 80% involvement of each core. Staging reveals no evidence for skeletal metastasis, but shows a single enlarged right internal iliac lymph node. The patient has good urinary and sexual function, and is otherwise in excellent health. After obtaining his diagnosis of high-risk prostate cancer (cT2c, Gleason score 4+4, PSA 16.2), he consults a physician who recommends androgen-deprivation therapy (ADT) alone. He presents to you seeking a second opinion, with ...
Purpose: To evaluate the survival outcomes for patients with lymph node-positive, nonmetastatic prostate cancer undergoing definitive local therapy (radical prostatectomy [RP], external beam radiation therapy [EBRT], or both) versus no local therapy (NLT) in the US population in the modern prostate specific antigen (PSA) era. Methods and Materials: The Surveillance, Epidemiology, and End Results database was queried for patients with T1-4N1M0 prostate cancer diagnosed from 1995 through 2005. To allow comparisons of equivalent datasets, patients were analyzed in separate clinical (cN+) and pathologically confirmed (pN+) lymph node-positive cohorts. Kaplan-Meier overall survival (OS) and prostate cancer-specific survival (PCSS) estimates were generated, with accompanying univariate log-rank and multivariate Cox proportional hazards comparisons. Results: A total of 796 cN+ and 2991 pN+ patients were evaluable. Among cN+ patients, 43% underwent EBRT and 57% had NLT. Outcomes for cN+ patients favored ...
Longer Duration of Androgen Deprivation Therapy Increases Risk of Depression in Early Prostate Cancer (04-25-2016) Among men with early prostate cancer, the risk of depression is increased with the use of androgen-deprivation therapy (ADT), particularly among men who are treated with ADT for 12 months or longer. It is important for patients receiving ADT to speak... Continue Reading. ...
Kristine Lacuna, Class of 2018. Androgen Deprivation Therapy With or Without Docetaxel for Men With Non-Metastatic, Castration Sensitive Prostate Cancer Who Biochemically Relapse After Prostatectomy (TAX3503): A Randomized, Open-Label, Phase 3 Trial. The optimal treatment of patients with non-metastatic, castration sensitive prostate cancer (CSPC) who biochemically relapse following a radical prostatectomy (RP) is unknown.. Lacunas study examined the effects of adding docetaxel to androgen deprivation therapy (ADT) in non-metastatic CSPC patients.. The study concluded the clinical benefit of adding docetaxel to ADT in non-metastatic CSPC patients with biochemical recurrence following an RP appears to be marginal. However, there is a statistical trend toward improved progression-free survival.. Mentors/collaborators: Ilyse Acosta, Andrew J. Armstrong, MD; Michael Anthony Carducci, MD; Erica Simone Dayan, Julie Filipenko, Martin Edwin Gleave, MD; Glenn Heller, PhD; Patrick Hilden, Michael J. ...
Red and processed meat may increase risk of advanced prostate cancer. Data on postdiagnostic diet and prostate cancer are sparse, but postdiagnostic intake of poultry with skin and eggs may increase risk of disease progression. Therefore, we prospectively examined total, unprocessed, and processed red meat, poultry, and eggs in relation to risk of lethal prostate cancer (e.g., men without cancer at baseline who developed distant organ metastases or died from prostate cancer during follow-up) among 27, 607 men followed from 1994 to 2008. We also conducted a case-only survival analysis to examine postdiagnostic consumption of these foods and risk of lethal prostate cancer among the 3,127 men initially diagnosed with nonmetastatic prostate cancer during follow-up. In the incidence analysis, we observed 199 events during 306,715 person-years. Men who consumed 2.5 or more eggs per week had an 81% increased risk of lethal prostate cancer compared with men who consumed less than 0.5 eggs per week (HR: ...
Prostate Cancer News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website ...
Of 26 screened patients, 17 were included. The median age was 44 (range 20-75) years. The median time interval between baseline and first follow-up was 13 (6-27) weeks. Compared to baseline, an 81% decrease was observed for median total testosterone (to 3.4 nmol/L (0.4-12.2); P , 0.0001) and free testosterone (to 0.06 nmol/L (0.01-0.18); P , 0.0001). Median total estradiol decreased by 71% (to 17.6 pmol/L (4.7-35.6); P , 0.0001). Increased serum calcium (P , 0.0001) and phosphate (P = 0.0016) was observed, paralleled by decreased PTH (P = 0.0156) and 1,25-dihydroxyvitamin D3 (P = 0.0134). The stable calcium isotope ratio (δ44/42Ca) decreased (P = 0.0458), indicating net calcium loss from bone. Bone-specific alkaline phosphatase and osteocalcin decreased (P , 0.0001 and P = 0.0056, respectively), periostin tended to decrease (P = 0.0500), whereas sclerostin increased (P , 0.0001), indicating suppressed bone formation. Serum bone resorption markers (TRAP, CTX) were unaltered. ...
The purpose of this study is to determine the safety and efficacy of a short course of radiotherapy (40Gy/5 fractions/29 days) for the treatment of high
Androgen deprivation therapy, one of the standard treatments for prostate cancer, induces apoptosis as well as autophagy in androgen-responsive PCa cells. As modulation of autophagy is a new paradigm for enhancing the therapeutic efficacy of various cancer therapies, we sought to determine the functions of autophagy during androgen deprivation. In this study, we confirmed that androgen removal or inhibition induces autophagy in two different hormone sensitive prostate cancer cells. Androgen deprivation also caused depletion of lipid droplets which was abrogated on inhibition of autophagy by pharmacological means (3-methyladenine, bafilomycin A1) or using a genetic approach (Atg5 siRNA). In addition, colocalization of lipid droplets and autophagic vesicles was observed in LNCaP cells, which was further enhanced by blocking the autophagic flux. These findings suggest that autophagy mediates lipid droplet degradation and lipolysis in androgen sensitive prostate cancer cells. Furthermore, inhibition of
Prostate cancer often develops antiandrogen resistance, possibly via androgen receptor (AR) mutations, which change antagonists to agonists. Novel therapies with increased anticancer activity, while overcoming current drug resistance are urgently needed. Enobosarm has anabolic effects on muscle and bone while having no effect on the prostate. Here, we describe the activity of novel chemically modified enobosarm analogues. The rational addition of bis‐trifluoromethyl groups into ring B of enobosarm, profoundly modified their activity, pharmacokinetic and tissue distribution profiles. These chemical structural modifications resulted in an improved AR binding affinity-by increasing the molecular occupational volume near helix 12 of AR. In vitro, the analogues SK33 and SK51 showed very potent antiandrogenic activity, monitored using LNCaP/AR‐Luciferase cells where growth, PSA and luciferase activity were used as AR activity measurements. These compounds were 10-fold more potent than bicalutamide ...
Use of androgen suppression therapy may negatively impact survival in African American patients with favorable-risk prostate cancer.
Darolutamide was approved in the U.S. under the FDA Priority Review designation; approval granted three months ahead of target FDA action date / Approval based on Phase III ARAMIS trial evaluating the efficacy and safety of darolutamide plus androgen deprivation therapy (ADT) compared to placebo plus ADT
A new analysis has found that men diagnosed with nonmetastatic prostate cancer who consumed more than 140 μg a day of supplemental selenium had over a two-and-a-half-fold excess risk for death from prostate cancer compared with nonsupplement users. On the other hand, there was a modest 12% inverse association between selenium supplementation and the risk […]. ...
BACKGROUND: Metastatic prostate cancer is a clonally heterogeneous disease state characterized by progressive somatic perturbations. The aim of this study was to identify cell free DNA- (cfDNA-) based alterations and their associations with outcomes in progressive metastatic prostate cancer. METHODS: In this longitudinal prospective cohort study plasma cfDNA/circulating tumor DNA (ctDNA) was analyzed before, during, and after androgen deprivation therapy (ADT) in 4 independent patient groups ranging from untreated metastatic hormone sensitive prostate cancer (mHSPC) to metastatic castrate resistant prostate cancer (mCRPC). Next generation sequencing was performed on ctDNA and germline DNA to characterize alterations and associations with clinical outcomes were determined for each group. FINDINGS: cfDNA yields were different in progressive mHSPC and mCRPC states (P | .001). In mHSPC, a higher than median ctDNA fraction was predictive of shorter time to ADT failure (HR, 2.29 [95% CI, 1.13-4.65]; Log-Rank
Androgen deprivation therapy (ADT) is highly effective therapy for men with advanced or metastatic prostate cancer, providing at least temporary disease control in over 80 percent of cases. However, the vast majority eventually develop progressive di
In men with de novo metastatic castration-sensitive prostate cancer treated in the phase 3 PEACE-1 study, the addition of abiraterone acetate and prednisone to androgen-deprivation therapy and docetaxel improved radiographic progression-free surviva.
Androgen deprivation therapy (ADT) is a common treatment option for patients with advanced stage prostate cancer. But nearly 80 percent of patients who receive ADT report experiencing hot flashes during and after treatment. Moffitt Cancer Center researchers are working to determine what genetic factors and other characteristics might make prostate cancer patients more likely to experience hot flashes during and after therapy.
Results from the second interim analysis of the Phase 3 SPARTAN study featured in an oral presentation at ESMO 2019 and simultaneously published in Annals of Oncology BARCELONA, Spain, Sept. 27, 2019 /PRNewswire/ -- The Janssen Pharmaceutical Companies of Johnson & Johnson announced today updated, longer-term results from the pivotal Phase 3 SPARTAN study following a second interim analysis. Treatment with ERLEADA® (apalutamide) plus androgen deprivation therapy (ADT) resulted in a 25 percent reduction in the risk of death compared with placebo plus ADT in patients with non-metastatic castration-resistant prostate cancer (nmCRPC) who were at high risk of developing metastases.1 The updated findings showed overall survival (OS) results supported the first interim analysis, despite a crossover of patients receiving placebo to the ERLEADA® treatment group.1 Results were presented in an oral session at the 2019 European Society for Medical Oncology (ESMO) Annual Congress (abstract #843O), and
This trial is comparing the efficacy and tolerability of neo-adjuvant docetaxel + androgen deprivation comprising leuprorelin + goserelin + radical
Several men with metastatic, hormone-sensitive prostate cancer live longer on constant androgen-deprivation therapy, (hormone therapy), than intermittent therapy, states a study led by SWOG.
Despite current risk stratification systems using traditional clinicopathologic factors, many localized and locally advanced prostate cancers fail radical treatment (ie, radical prostatectomy, radiation therapy with or without androgen deprivation therapy). Therefore, a pressing need exists for enhanced methods of
Background: Androgen deprivation therapy (ADT) is a cornerstone of treatment for advanced prostate cancer (PCa); however, it accelerates the loss of bone mineral density (BMD), which increases fracture risk. Guidelines recommend BMD testing when initiating ADT to assess baseline fracture risk properly. The objective of this study was to examine the proportion of BMD testing in men initiating ADT in Quebec and to identify factors associated with receipt of this testing. Methods: The study cohort consisted of men extracted from Quebec public healthcare insurance administrative databases who initiated continuous ADT from 2000 to 2015 for ,12 months. The primary study outcome was receipt of BMD testing in the period from 6 months before through 12 months after ADT initiation. Multivariable generalized linear mixed regression modeling with a logit link was performed to identify variables associated with BMD testing. Results: We identified 22,033 patients, of whom 3,910 (17.8%) underwent BMD testing. ...
Following the results of the TAX-327 study, questions have been raised as to whether administering chemotherapy to patient with prostate cancer before symptomatic disease progression when receiving standard hormonal treatment can improve the duration and quality of survival. The GETUG-AFU-15 and CHAARTED studies assessed the effi cacy and tolerability of androgen deprivation therapy (ADT) with or without docetaxel in patients with metastatic hormone-naive prostate cancer. Both studies included a mix of patients with de novo metastatic disease (~75%) and patients with metastases following treatment of localized disease. A short course of ADT was allowed in both trials prior to accrual. Key differences between the two studies include the number of patients with high-volume metastases (GETUGAFU- 15: 52%; CHAARTED: 65%) and number of docetaxel cycles (GETUG-AFU-15: up to nine cycles; CHAARTED six cycles). Both studies reported an improvement in progression-free survival with docetaxel plus ADT ...
A prescription of short-term exercise for patients with advanced prostate cancer would help to reduce the side effects of hormone therapy, according to new research.. Researchers from the Norfolk and Norwich University Hospital (NNUH) and University of East Anglia (UEA) led a trial which involved patients who were due to start androgen deprivation therapy (ADT).. Fifty patients took part in the research study, with half of the participants taking part in two supervised exercise sessions a week for three months at specialist exercise science facilities at UEA.. The trial aimed to reduce the adverse side effects of hormone therapy such as weight gain and an increased risk of heart problems and assessed participants health three months after their exercise programme.. The findings, which have been published in the British Journal of Urology International (BJUI), showed that the three month programme of aerobic and resistance training intervention prevented adverse changes in cardiopulmonary ...
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Locally advanced prostate cancer is often associated with elevated recurrence rates. Despite the modest response observed, external-beam radiotherapy has been the preferred treatment for this condition. More recent evidence from randomised trials has demonstrated clinical benefit with the combined use of androgen suppression in such cases. The aim of this meta-analysis is to compare the combination of distinct hormone therapy modalities versus radiotherapy alone for overall survival, disease-free survival and toxicity. Databases (MEDLINE, EMBASE, LILACS, Cochrane databases and ClinicalTrials.gov) were scanned for randomised clinical trials involving radiotherapy with or without androgen suppression in local prostate cancer. The search strategy included articles published until October 2011. The studies were examined and the data of interest were plotted for meta-analysis. Survival outcomes were reported as a hazard ratio with corresponding 95% confidence intervals. Data from ten trials published from
Astellas Pharma Inc. (TSE: 4503, President and CEO: Kenji Yasukawa, Ph.D., Astellas) and Pfizer Inc. (NYSE: PFE) announced today results of the final overall survival (OS) analysis from the Phase 3 PROSPER trial, which evaluated XTANDI® (enzalutamide) plus androgen deprivation therapy (ADT
Group-based exercise in daily clinical practice to improve physical fitness in men with prostate cancer undergoing androgen deprivation therapy: study protocol ...
(PRWEB) August 22, 2017 -- It is well known that men who receive androgen deprivation therapy (ADT) after diagnosis of prostate cancer can experience
There is limited evidence supporting the use of local treatment (LT) for prostate cancer (PCa) patients with clinically pelvic lymph node-positive (cN1) disease.To examine the efficacy of any form of LT±androgen deprivation therapy (ADT) in treating these individuals.
Prostatic adenocarcinoma (PCa) is the most frequently diagnosed non-cutaneous malignancy and second leading cause of cancer death in men in the US. Although organ-confined disease is manageable, treatment options for disseminated PCa are limited. First-line therapy for metastatic PCa targets the androgen receptor (AR) via androgen deprivation therapy (ADT); however, tumors often recur, displaying reactivation of AR signaling despite continued therapeutic targeting. There is currently no durable treatment for this advanced disease stage, termed castrate-resistant PCa (CRPC). While most localized PCa express wild-type p53, recent high-profile, genome-wide studies identified increased TP53 gene mutation rates in advanced disease (specifically CRPC). Using these data, we noted that the patient-derived, CRPC-specific p53 mutations observed are relatively unique to prostate cancer. These mutations occur in hotspot clusters altered in other tumor types, but represent distinct amino acid changes ...
Newswise - PHILADELPHIA-A common hormone therapy to treat prostate cancer may double a mans risk of dementia, regardless of his age, Penn Medicine researchers reported in a study published online today in JAMA Oncology.. Last year, researchers discovered a dramatic association between Alzheimers disease and androgen deprivation therapy (ADT), a mainstay of treatment for prostate cancer since the 1940s currently used in over a half million men in the United States. This new study suggests a broader neurocognitive risk associated with the testosterone-lowering therapy.. While the findings do not prove that ADT increases the risk of dementia, the analysis comparing the medical records of almost 9,500 prostate cancer patients who received ADT vs. those who did not strongly supports that possibility.. This is not an academic question anymore; this is really a clinical question that needs to be answered, said lead author Kevin T. Nead, MD, MPhil, a resident in the department of Radiation Oncology ...