Safety and efficacy of neoadjuvant chemohormonal and hormonal treatment followed by radical prostatectomy for patients with high- and very high risk prostate cancer: Initial results of prospective, randomized, phase III clinical trial

Berkut, M.; Рева, С. А.; Проценко, Светлана; Buevich, N.; Велиев, Е И; Петров, С. Б.

doi:10.1016/s1569-9056(16)15023-7

Cited by 3 publications

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“…Chemotherapy, in combination with prostatectomy, has not been associated with improved outcomes. VACSPftS53 trial [40] and SPCG12 did not demonstrate any benefit for docetaxel after RP [39], and no recurrence-free survival benefit was shown for docetaxel + degarelix at 1 yr when compared with degarelix alone in the neoadjuvant setting [51]. Neoadjuvant ADT + RP is not recommended by international guidelines as a result of the lack of OS improvement in the settings where it was studied, mostly intermediate-or moderately high-risk disease [28].…”

Section: 7mentioning

confidence: 99%

Systematic Review of Systemic Therapies and Therapeutic Combinations with Local Treatments for High-risk Localized Prostate Cancer

et al. 2019

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Context: Systemic therapies, combinedwith local treatment for high-risk prostate cancer, are recommended by the international guidelines for specific subgroups of patients; however, for many of the clinical scenarios, it remains a research field. Objective: To perform a systematic review, and describe current evidence and perspectives about the multimodal treatment of high-risk prostate cancer. Evidence acquisition: We performed a systematic review of PubMED, Embase, Cochrane Library, European Society of Medical Oncology/American Society of Clinical Oncology Annual proceedings, and clinicalTrial.gov between January 2010 and February 2018 following the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. Evidence synthesis: Seventy-seven prospective trials were identified. According to multiple randomized trials, combining androgen deprivation therapy (ADT) with external-beam radiotherapy (EBRT) outperforms EBRT alone for both relapse-free and overall survival. Neoadjuvant ADT did not show significant improvement compared with prostatectomy alone. The role of adjuvant ADT after prostatectomy in patients with high-risk disease is still debated, with lack of data from phase 3 trials in pNO patients. Novel androgen pathway inhibitors have been tested only in early-phase trials in addition to primary treatment. GETUG 12, RTOG 0521, and nonmetastatic subgroup of the STAMPEDE trial showed improved relapse-free survival for docetaxel in patients treated with EBRT plus ADT, although mature metastasis-free survival data are still pending. Both the SPCG-12 and the VACSP#553 trial showed no improvement in relapse free survival for adjuvant docetaxel after prostatectomy. Conclusions: In contrast to the clearly demonstrated survival benefits of long-term adjuvant ADT when used with EBRT, its role after prostatectomy remains unclear especially in pNO patients. Adding docetaxel to EBRT-ADT improves relapse-free survival, with immature results on overall survival. Novel androgen receptor pathway inhibitors are currently being tested in the neoadjuvant and adjuvant setting. Patient summary: Treatment of high-risk prostate cancer is based on a multimodality approach that includes systemic treatments. The best treatment or therapy combination remains to be defined.

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