Diagnosis and treatment for clinically localized prostate cancer. Adherence to the European Association of Urology clinical guidelines in a nationwide population-based study – GESCAP group

Gómez-Veiga, F.; Rodrı́guez-Antolı́n, A.; Miñana, B.; Hernández, Carlos; Suárez, José Francisco; Fernandez-Gomez, Jesus; Unda, Miguel; Burgos, Javier; Alcaraz, Antonio; Rodríguez, Pedro; Medina, Rafael; Castiñeiras, J; Moreno, C.; Pedrosa, E.; Cózar, J.M.

doi:10.1016/j.acuroe.2017.05.006

Cited by 10 publications

(7 citation statements)

References 42 publications

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“…Prostate cancer is the second most common malignant tumor in the male population worldwide 1. The current standard treatment approach for patients involves surgery, chemotherapy, and radiation 2. Recent studies confirmed that nitroxoline, an FDA-approved treatment for urinary tract infections, has anticancer activity against human prostate cancer 3, and immunotherapy might prolong patient survival in cases of multiple cancers 4.…”

Section: Introductionmentioning

confidence: 99%

The Novel Combination of Nitroxoline and PD-1 Blockade, Exerts a Potent Antitumor Effect in a Mouse Model of Prostate Cancer

Xu¹,

Huang²,

Li³

et al. 2019

Int. J. Biol. Sci.

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Programmed cell death protein 1 (PD-1) blockade is a promising therapeutic strategy against prostate cancer. Nitroxoline has been found to have effective anticancer properties in several cancer types. We investigated the efficacy of a combination therapy involving nitroxoline and PD-1 blockade in a prostate cancer mouse model. In our in vitro analysis , we found that nitroxoline inhibited the viability and proliferation of the mouse prostate cancer cell line RM9-Luc-PSA. Additionally, nitroxoline downregulated the expressions of phospho-PI3 kinase, phospho-Akt (Thr308), phospho-Akt (Ser473), phospho-GSK-3β, Bcl-2, and Bcl-xL. Nitroxoline also downregulated programmed death-ligand 1 (PD-L1) expression levels in prostate cancer cell line and tumor tissue. In our murine prostate cancer orthotopic model, nitroxoline plus PD-1 blockade synergistically suppressed tumor growth when compared with nitroxoline or PD-1 blockade alone, leading to reductions in tumor weight, bioluminescence tumor signals, and serum prostate-specific antigen levels. Furthermore, fluorescence-activated cell sorting analysis showed that the combination strategy significantly enhanced antitumor immunity by increasing CD44 + CD62L + CD8 + memory T cell numbers and reducing myeloid-derived suppressor cell numbers in peripheral blood. In conclusion, our findings suggest that nitroxoline plus PD-1 blockade may be a promising treatment strategy in patients with prostate cancer.

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Section: Introductionmentioning

confidence: 99%

The Novel Combination of Nitroxoline and PD-1 Blockade, Exerts a Potent Antitumor Effect in a Mouse Model of Prostate Cancer

Xu¹,

Huang²,

Li³

et al. 2019

Int. J. Biol. Sci.

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“…However, the optimal treatment remains a subject of debate. Contemporary guidelines recommend that treatment decisions should be made based on tumor features, baseline prostate specific antigen (PSA) levels, patient age, comorbidity, life expectancy, and quality of life (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

125I low‑dose‑rate prostate brachytherapy and radical prostatectomy in patients with prostate cancer

et al. 2019

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Radical prostatectomy (RP) and low-dose-rate prostate brachytherapy (LDR) are two widely used treatment options for patients with T1c-T3a prostate cancer. In the present study, the efficacy of the two treatments was compared. A total of 429 patients who underwent either LDR (n=218) or RP (n=211) between January 2010 and June 2015 were retrospectively reviewed. Biochemical relapse-free survival time (bRFS) and clinical relapse-free survival time (cRFS) were assessed. The log-rank test compared bRFS between the two modalities, and Cox regression identified factors associated with bRFS. The median follow-up time and patient age were 46.6 months and 71 years, respectively. The bRFS at 1, 2 and 5 years was 89.4, 87.2 and 79.9% for LDR, respectively, and 91.0, 82.8 and 72.2% for RP, respectively (P=0.077). The cRFS at 1, 2 and 5 years was 99.1, 97.7 and 94.9% for LDR, respectively, and 99.0, 96.2 and 94.5% for RP, respectively (P=0.630). It was indicated that LDR produced equivalent bRFS and cRFS rates compared with RP. The risk of biochemical failure (bF) was higher for the RP group compared with the LDR group in patients with a Gleason score ≤3+4 (P=0.022) or initial prostate specific antigen ≤10 ng/ml (P=0.002). Based on the univariate and multivariate logistic regression analysis of all 429 patients, T stage ≥T2b was an independent predictor for bF.

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“…They found that the adherence to EAU recommendations in PCa management is low, finding the highest discrepancies in the need for a prostate biopsy and the diagnostic methods. 11 In this study, the authors stated that a lack of awareness of guidelines is the possible reason, and they suggested that improved information and educational programs could allow a higher adherence to the guidelines and reduce the variability in daily practice. 11 Another important point is highlighted: the need for widely sharing the principles of EAU and international guidelines among clinicians and patients.…”

Section: Adherence To International Guidelines and The Utility For CLmentioning

confidence: 86%

“…Recently, Gomez-Veiga et al 11 assess the adherence to EAU guidelines in the management of prostate cancer (PCa) in Spain. They found that the adherence to EAU recommendations in PCa management is low, finding the highest discrepancies in the need for a prostate biopsy and the diagnostic methods.…”

Section: Adherence To International Guidelines and The Utility For CLmentioning

confidence: 99%

Guidelines in urology: Lights and shadows

et al. 2020

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Clinical practice guidelines have become increasingly important in the decision-making process in many clinical conditions and have been recognized as key instruments to improve the quality of care. On the one hand, guidelines represent a good tool for improving patient’s outcome, and on the other hand, the adherence to guidelines and good practice recommendations is mandatory to reduce the risk of legal disputes. A recent revision by the Italian Parliament of the legal system that rules the responsibilities of health professionals and health care safety stimulated all clinicians to improve their adhesion to clinical guidelines. It is justified by the high-quality level obtained in the recent years by the international guidelines. In the recent years, a revision of the clinical guideline development has been done. In particular, the European Association of Urology Guideline Office changed the “Guidelines for Guidelines,” and a rigorous development process has been established. A clinical recommendation is produced after a rigorous methodological process using an analysis of all published clinical trials, and the expert opinion is not yet considered. For oncological guidelines, the adherence to the producing process is easily feasible due to the high number of clinical trials; for non-oncological guidelines, instead, the small number of clinical trials could represent a problem for obtaining recommendation based on rigorous methodology. Here, on the basis of these considerations, we aim to discuss the lights and the shadows of the clinical applicability of guidelines in urology.

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Diagnosis and treatment for clinically localized prostate cancer. Adherence to the European Association of Urology clinical guidelines in a nationwide population-based study – GESCAP group

Cited by 10 publications

References 42 publications

The Novel Combination of Nitroxoline and PD-1 Blockade, Exerts a Potent Antitumor Effect in a Mouse Model of Prostate Cancer

The Novel Combination of Nitroxoline and PD-1 Blockade, Exerts a Potent Antitumor Effect in a Mouse Model of Prostate Cancer

125I low‑dose‑rate prostate brachytherapy and radical prostatectomy in patients with prostate cancer

Guidelines in urology: Lights and shadows

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