Effect of Prednisone on Prostate-Specific Antigen in Patients With Hormone-Refractory Prostate Cancer

Weinberger, M.; Moore, Amy; Li, A.; Figg, William D.

doi:10.1016/s0022-5347(01)62160-8

Cited by 18 publications

(26 citation statements)

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“…Among these treatment options, glucocorticoid therapy has been shown to be an advantageous treatment modality due to its considerable prostate-specific antigen (PSA) response and palliative effects. Several reports have been published de- scribing the clinical effects of hydrocortisone, prednisone and dexamethasone (DXM) [7][8][9][10][11]. However, there have been few studies in which complicating factors, including AWS or external beam radiotherapy (EBR) that may potentially affect serum PSA levels and/or palliative effects, were excluded.…”

Section: Introductionmentioning

confidence: 99%

Prostate-Specific Antigen Levels and Prognosis in Patients with Hormone-Refractory Prostate Cancer Treated with Low-Dose Dexamethasone

Morioka¹,

Kobayashi²,

Furukawa³

et al. 2002

Urol Int

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Objective: The efficacy of low-dose dexamethasone (DXM) therapy in patients with hormone-refractory prostate cancer (HRPC) was evaluated. Patients and Methods: Prostate-specific antigen (PSA) response and survival following DXM therapy were analyzed in 27 Japanese patients exhibiting HRPC. Concurrent therapies and antiandrogen withdrawal syndrome, which may affect PSA levels and palliative effects, were excluded from the study. A dose of 1.5 mg of DXM was administered, and androgen deprivation therapy was maintained during DXM therapy. A decline in PSA levels of at least 50% from baseline was considered a significant PSA response. Prognostic factors for PSA response and survival were examined by univariate and multivariate analyses. Results: A significant PSA response was observed in 16 of the 27 cases (59.3%). Median survival period of patients exhibiting significant PSA response was 15.9 months and was significantly longer than that of patients demonstrating a decline in PSA of less than 50% (median 7.7 months, p < 0.0001). Effect on pain control also correlated with the significant PSA response. No meaningful prognostic factors for PSA response were detected; however, a PSA decline of greater than 50% was the prognostic factor for survival. Conclusion: DXM therapy remains one of the most beneficial treatment modalities in patients with HRPC.

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Section: Introductionmentioning

confidence: 99%

Prostate-Specific Antigen Levels and Prognosis in Patients with Hormone-Refractory Prostate Cancer Treated with Low-Dose Dexamethasone

Morioka¹,

Kobayashi²,

Furukawa³

et al. 2002

Urol Int

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“…Most angiogenesis-inhibiting agents are cytostatic and theoretically could provide additional benefit in combination with other chemotherapeutic agents, particularly where the overall tumour burden is low . A reduction in serum PSA of at least 50%, as seen in three men in the current study, may predict a relatively prolonged survival (Kelly et al, 1993;Sartor et al, 1998). Consequently, low-dose thalidomide may have potential as an adjunct to hormonal manipulation and other agents in therapy of poor prognosis or advanced prostate cancer, although further work is required to identify those likely to benefit.…”

Section: Discussionmentioning

confidence: 74%

“…A significant fall in SNAP occurred in seven men receiving thalidomide 100 mg daily for a 6-month period (B). (Kelly et al, 1993;Sartor et al, 1998). However, it should be remembered that selection of disease markers is a problem in clinical trials for metastatic prostate cancer (Morris and Scher, 2002).…”

Section: Discussionmentioning

confidence: 99%

An open-label phase II study of low-dose thalidomide in androgen-independent prostate cancer

et al. 2003

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The antiangiogenic effects of thalidomide have been assessed in clinical trials in patients with various solid and haematological malignancies. Thalidomide blocks the activity of angiogenic agents including bFGF, VEGF and IL-6. We undertook an open-label study using thalidomide 100 mg once daily for up to 6 months in 20 men with androgen-independent prostate cancer. The mean time of study was 109 days (median 107, range 4 -184 days). Patients underwent regular measurement of prostate-specific antigen (PSA), urea and electrolytes, serum bFGF and VEGF. Three men (15%) showed a decline in serum PSA of at least 50%, sustained throughout treatment. Of 16 men treated for at least 2 months, six (37.5%) showed a fall in absolute PSA by a median of 48%. Increasing levels of serum bFGF and VEGF were associated with progressive disease; five of six men who demonstrated a fall in PSA also showed a decline in bFGF and VEGF levels, and three of four men with a rising PSA showed an increase in both growth factors. Adverse effects included constipation, morning drowsiness, dizziness and rash, and resulted in withdrawal from the study by three men. Evidence of peripheral sensory neuropathy was found in nine of 13 men before treatment. In the seven men who completed six months on thalidomide, subclinical evidence of peripheral neuropathy was found in four before treatment, but in all seven at repeat testing. The findings indicate that thalidomide may be an option for patients who have failed other forms of therapy, provided close follow-up is maintained for development of peripheral neuropathy.

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“…Corticosteroids have historically been used alongside prostate cancer chemotherapy regimens to manage treatment and tumor-related sideeffects, 40 and have a modest effect on PSA decline. 41 However, corticosteroids are associated with important toxicities of their own, including hypertension, weight gain, hyperglycemia, steroid-induced myopathy and infections. 40 In light of the toxicity profile, and because OS benefits were seen with and without corticosteroids, it is justifiable to omit them from daily use while receiving chemohormonal therapy.…”

Section: Discussionmentioning

confidence: 99%

Chemotherapy for metastatic castration‐sensitive prostate cancer

Parimi

2016

Int J of Urology

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Incorporation of docetaxel into metastatic castration-sensitive prostate cancer treatment has added a new treatment option to a disease state that had previously not seen change for decades. Early attempts of a chemo-hormonal approach for castration-sensitive prostate cancer were not successful. With the demonstration of survival benefits using docetaxel in patients with metastatic castration-resistant prostate cancer, this encouraged continued research with docetaxel given earlier in the disease course. Three randomized phase III trials have defined the benefits of docetaxel in the metastatic castration-sensitive prostate cancer setting; however, there remain questions and controversies on the appropriate and optimal patient selection.

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Effect of Prednisone on Prostate-Specific Antigen in Patients With Hormone-Refractory Prostate Cancer

Cited by 18 publications

References 0 publications

Prostate-Specific Antigen Levels and Prognosis in Patients with Hormone-Refractory Prostate Cancer Treated with Low-Dose Dexamethasone

Prostate-Specific Antigen Levels and Prognosis in Patients with Hormone-Refractory Prostate Cancer Treated with Low-Dose Dexamethasone

An open-label phase II study of low-dose thalidomide in androgen-independent prostate cancer

Chemotherapy for metastatic castration‐sensitive prostate cancer

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