How Is Androgen-Dependent Metastatic Prostate Cancer Best Treated?

Dawson, Nancy A.

doi:10.1016/s0889-8588(05)70364-6

Cited by 63 publications

(26 citation statements)

References 126 publications

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“…ADT alleviates bone pain, decreases prostate-specific antigen (PSA) levels, and prolongs survival, and is therefore an effective treatment for metastatic prostate cancer [1]. ADT can be achieved through surgical (i.e., bilateral orchiectomy) or chemical castration.…”

Section: Introductionmentioning

confidence: 99%

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Predictive Clinical Indicators of Biochemical Progression in Advanced Prostate Cancer Patients Receiving Leuplin Depot as Androgen Deprivation Therapy

et al. 2014

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Therapeutic planning and counseling for advanced prostate cancer patients receiving androgen deprivation therapy (ADT) is complicated because the prognoses are highly variable. The purpose of this study is to identify predictive clinical indicators of biochemical progression (BCP). In this retrospective analysis, data from 107 newly diagnosed patients (from November 1995 to April 2008) with advanced prostate adenocarcinoma receiving Leuprorelin acetate depot were analyzed. Data was collected from the computerized registry of two collaborating medical centers in Taiwan. Cox regression and Kaplan-Meier analyses were used to evaluate the relationship between potential predictive parameters and BCP. Univariate analysis revealed that predictors of BCP included (1) initial serum prostate-specific antigen (PSA) (hazard ratio [HR], 1.00; 95% confidence interval [CI] 1.00–1.00); (2) log of initial PSA (HR, 1.35; 95% CI 1.17–1.56); (3) PSA density at diagnosis (HR, 1.00; 95% CI 1.00–1.01), and (4) pathological bone fracture (HR, 2.22; 95% CI 1.20–4.11). Age (HR, 0.94; 95% CI 0.91–0.98) and hemoglobin levels (HR, 0.86; 95% CI 0.76–0.97) were also associated with greater risk of BCP. After adjusting for age, pathologic fracture, and hemoglobin level, the initial PSA and PSA density were no longer significantly associated with BCP. However, age and hemoglobin levels continued to be associated with greater risk of BCP (P≤0.007). Using Kaplan-Meier analysis, patients with higher initial PSA concentration, pathological bone fracture, and low hemoglobin had a greater probability of BCP. Thus, low hemoglobin and age are predictive indicators of BCP and therefore early indicators of BCP despite ADT therapy.

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Section: Introductionmentioning

confidence: 99%

“…Although not a cure, ADT can prolong the survival time of patients [1], [3]; it can also improve 80% of bone pain in these patients [4]–[6]. Although most patients initially respond to ADT, they eventually progress to a hormone-refractory state after approximately 18–24 months, with a median survival time of 24–30 months [7]–[9].…”

Section: Introductionmentioning

confidence: 99%

Predictive Clinical Indicators of Biochemical Progression in Advanced Prostate Cancer Patients Receiving Leuplin Depot as Androgen Deprivation Therapy

et al. 2014

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“…Androgen deprivation therapy is the mainstay of treatment for metastatic prostate carcinoma. Options for androgen deprivation therapy include bilateral orchiectomy, administration of a gonadotropin‐releasing hormone (GnRH) agonist, or combination therapy with a GnRH agonist and an antiandrogen 18, 19. Estrogens are no longer routinely used for androgen deprivation therapy because of excess cardiovascular toxicity 20.…”

Section: Androgen Deprivation Therapy and Osteoporosismentioning

confidence: 99%

Diagnosis and management of treatment-related osteoporosis in men with prostate carcinoma

Smith

2003

Cancer

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Osteoporosis is a complication of androgen deprivation therapy in men with prostate carcinoma. Androgen deprivation therapy, caused by either bilateral orchiectomy or treatment with a gonadotropin-releasing hormone agonist, decreases bone mineral density and increases fracture risk. Other factors including diet and lifestyle may contribute to bone loss. There is limited information regarding the best strategy to prevent osteoporosis in men with prostate carcinoma.

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“…Surgical castration (orchiectomy), administration of antiandrogens (chemical castration), or a combination of these methods removes the androgens necessary for prostatic epithelial growth and induces apoptosis (155,156). Nonsteroidal anti-androgens (flutamide, nilutamide, and bicalutamide) act by competing with androgens for the androgen receptor.…”

Section: Treatmentmentioning

confidence: 99%