American Society of Clinical Oncology Recommendations for the Initial Hormonal Management of Androgen-Sensitive Metastatic, Recurrent, or Progressive Prostate Cancer

Loblaw, D.A.; Mendelson, David S.; Talcott, James A.; Virgo, Katherine S.; Somerfield, Mark R.; Ben‐Josef, Edgar; Middleton, Richard; Porterfield, Harry S.; Sharp, Stewart A.; Smith, Thomas J.; Taplin, Mary Ellen; Vogelzang, Nicholas J.; Wade, James L.; Bennett, Charles L.; Scher, Howard I.

doi:10.1200/jco.2004.04.579

Cited by 173 publications

(123 citation statements)

References 49 publications

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“…19 Most respondents (84%) commonly used IAB despite insufficient evidence of equivalent tumour control or survival. Five percent used steroidal antiandrogens with LHRH, despite worse survival demonstrated in an individual patient data meta-analysis showing inferior survival (hazard ratio 1.13, p = 0.04 of cyproterone vs. cyproterone CAB).…”

Section: Discussionmentioning

confidence: 99%

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Hormone use after radiotherapy failure: a survey of Canadian uro-oncology specialists

Loblaw

Pickles

Cheung

et al. 2013

CUAJ

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Introduction: A survey of Canadian uro-oncology specialists was performed to assess practice patterns of patients with recurrent prostate cancer postradiotherapy and to assess the feasibility of conducting a trial in this setting.Methods: There were 14 survey questions and 1 demographic question. Responses were reported by frequency.Results: There were 96 respondents. Most respondents use both prostate-specific antigen doubling time (PSAdt) and PSA level when deciding to start androgen deprivation therapy (ADT) in asymptomatic patients. About half of respondents start ADT when PSA is greater than 10 ng/mL or when the PSAdt is less than 6 months. Eighty-six percent felt that the timing of ADT was an important research question. Over 1500 patients per year were estimated as being available for such a trial. Conclusion:After radiotherapy failure, respondents initiated ADT about half of the time when PSA is less than 10 ng/mL and/or PSAdt is less than 6 months. A clinical trial examining the timing of ADT has strong support and appears to be feasible. Résultats : Quatre-vingt-seize médecins ont participé au sondage. Can UrolLa majorité des répondants se basent sur le temps de doublement de l'APS et les taux d'APS pour décider du moment optimal pour amorcer un traitement antiandrogène chez les patients asymptomatiques. Environ la moitié des répondants entreprennent un traitement antiandrogène lorsque le taux d'APS dépasse 10 ng/mL ou lorsque le temps de doublement de l'APS est inférieur à 6 mois. Quatre-vingt-six pour cent des répondants ont indiqué que le moment optimal pour l'amorce du traitement antiandrogène représentait une importante question de recherche. On estime que plus de 1500 patients par année seraient admissibles à une telle étude. Conclusion :Après l'échec d'une radiothérapie, les répondants entreprennent un traitement antiandrogène dans environ la moitié des cas lorsque l'APS est inférieur à 10 ng/mL et/ou lorsque le temps de doublement de l'APS est inférieur à 6 mois. Un essai clinique portant sur la détermination du moment optimal pour l'amorce du traitement antiandrogène est fortement souhaité et semble faisable.

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Section: Discussionmentioning

confidence: 99%

“…19 The group recommended starting ADT when the patient has symptomatic prostate cancer. The authors were unable to issue a recommendation for the immediate use of ADT due to methodological limitations of the available evidence.…”

Section: Introductionmentioning

confidence: 99%

Hormone use after radiotherapy failure: a survey of Canadian uro-oncology specialists

Loblaw

Pickles

Cheung

et al. 2013

CUAJ

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“…The European Association of Urology and the American Society of Clinical Oncology treatment guidelines do not specifically categorize adjuvant hormonal therapy as being a potentially curative treatment option. 25,26 The origin of the palliative label attached to luteinizing hormone-releasing hormone (LHRH) agonists stems from the historical use of androgen deprivation therapy among men with metastatic cancer. Although the antitumor effects of castration were revolutionary, the vast majority of men developed hormone refractory disease and died within 3 years of starting treatment.…”

Section: Challenging the Historical Paradigm Of Androgen Deprivation mentioning

confidence: 99%

Adjuvant androgen deprivation therapy augments cure and long-term cancer control in men with poor prognosis, nonmetastatic prostate cancer

Fleshner

Keane

Lawton

et al. 2007

Prostate Cancer Prostatic Dis

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Historically, adjuvant androgen deprivation therapy has been viewed as a palliative treatment option for patients with poor-prognosis non-metastatic prostate cancer. In addition, guidelines from bodies such as the European Association of Urology and American Society for Clinical Oncology do not specifically categorize adjuvant hormonal therapy as being curative in intent. We propose that adjuvant androgen deprivation therapy should now be classified as a treatment of curative intent in patients with poor-prognosis, non-metastatic prostate cancer. By applying a carefully considered definition of cure (based on long-term (10-to 15-year) disease-free survival curves) to the findings from randomized controlled clinical trials that have studied adjuvant hormonal treatments in nonmetastatic prostate cancer, we challenged whether this viewpoint should now be considered redundant. According to our review of relevant studies and our definition of cure, goserelin appears to augment cure in a sizeable proportion of men with poor-prognosis non-metastatic prostate cancer when given adjuvant to radical prostatectomy or radiotherapy. Across several trials, the relevant survival curves for the goserelin-treated population became indefinitely flat after long-term followup. This indicates that these patients have a mortality risk comparable to the general population without prostate cancer. On the basis of the evidence presented within this review, we believe that, given it can control disease for a long period of time, adjuvant goserelin should be reclassified as a treatment of curative intent for patients with poor-prognosis non-metastatic prostate cancer.

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“…After an assessment of disease risk, patients should be informed about the benefits and side effects of all options. 4 Bilateral orchiectomy is a simple and cost-effective procedure, but is nonreversible and can carry a significant psychologic burden. Two large randomized trials demonstrated that the LH-RH agonist goserelin is as effective as orchiectomy in terms of survival in patients with metastatic disease.…”

Section: Treatment Choice: Balancing Efficacy and Acceptable Side Effmentioning

confidence: 99%

Case study: management of advanced prostate cancer with soft tissue metastases

Kirby

2005

Prostate Cancer Prostatic Dis

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American Society of Clinical Oncology Recommendations for the Initial Hormonal Management of Androgen-Sensitive Metastatic, Recurrent, or Progressive Prostate Cancer

Cited by 173 publications

References 49 publications

Hormone use after radiotherapy failure: a survey of Canadian uro-oncology specialists

Hormone use after radiotherapy failure: a survey of Canadian uro-oncology specialists

Adjuvant androgen deprivation therapy augments cure and long-term cancer control in men with poor prognosis, nonmetastatic prostate cancer

Case study: management of advanced prostate cancer with soft tissue metastases

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