Androgen Deprivation Therapy for Prostate Cancer
TLDR
Androgen deprivation therapy has clear roles in the management of advanced prostate cancer and high-risk localized disease and the benefits of ADT in other settings need to be weighed carefully against substantial risks and adverse effects on quality of life.Abstract:
ContextProstate cancer is the most common nonskin cancer and second most common
cause of cancer mortality in US men. Androgen deprivation therapy (ADT), specifically
surgical or medical castration, is the first line of treatment against advanced
prostate cancer and is also used as an adjuvant to local treatment of high-risk
disease.ObjectiveTo review systematically the evidence on the risks and benefits of ADT
for prostate cancer as well as clinical management of its adverse effects.Evidence AcquisitionWe performed MEDLINE searches of English-language literature (1966 to
March 2005) using the terms androgen deprivation therapy, hormone treatment, and prostate cancer. We reviewed bibliographies of literature to extract
other relevant articles. Studies were selected based on clinical pertinence,
with an emphasis on controlled study design.Evidence SynthesisAndrogen deprivation therapy is effective for palliation in many patients
with advanced prostate cancer and improves outcomes for high-risk patients
treated with radiation therapy for localized disease. Although patients with
increasing prostate-specific antigen levels after local treatment without
metastatic disease frequently undergo ADT, the benefits of this strategy are
not clear. Adverse effects of ADT include decreased libido, impotence, hot
flashes, osteopenia with increased fracture risk, metabolic alterations, and
changes in cognition and mood.ConclusionsAndrogen deprivation therapy has clear roles in the management of advanced
prostate cancer and high-risk localized disease. The benefits of ADT in other
settings need to be weighed carefully against substantial risks and adverse
effects on quality of life.read more
Citations
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疟原虫var基因转换速率变化导致抗原变异[英]/Paul H, Robert P, Christodoulou Z, et al//Proc Natl Acad Sci U S A
TL;DR: PfPMP1)与感染红细胞、树突状组胞以及胎盘的单个或多个受体作用,在黏附及免疫逃避中起关键的作�ly.
Journal ArticleDOI
Diabetes and Cardiovascular Disease During Androgen Deprivation Therapy for Prostate Cancer
TL;DR: GnRH agonist treatment for men with locoregional prostate cancer may be associated with an increased risk of incident diabetes and cardiovascular disease and the benefits of GnRH agonists should be weighed against these potential risks.
Journal ArticleDOI
Denosumab in men receiving androgen-deprivation therapy for prostate cancer
Matthew R. Smith,Blair Egerdie,Narciso Hernández Toriz,Robert G. Feldman,Teuvo L.J. Tammela,Fred Saad,Jiri Heracek,Maciej Szwedowski,Chunlei Ke,Amy Kupic,Benjamin Z. Leder,Carsten Goessl +11 more
TL;DR: Denosumab was associated with increased bone mineral density at all sites and a reduction in the incidence of new vertebral fractures among men receiving androgen-deprivation therapy for nonmetastatic prostate cancer.
Guidelines on Prostate Cancer
Axel Heidenreich,Joaquim Bellmunt,Michel Bolla,Steven Joniau,Vsevolod Matveev,N. Mottet,Thomas Wiegel,Filiberto Zattoni +7 more
TL;DR: The introduction of an effective blood test, prostate specific antigen (PSA), has made it possible to diagnose more and more men in an earlier stage where they can be offered potentially curative treatments, and this is the subject of the EAU guidelines on prostate cancer.
Journal ArticleDOI
Denosumab and bone-metastasis-free survival in men with castration-resistant prostate cancer : results of a phase 3, randomised, placebo-controlled trial.
Matthew R. Smith,Fred Saad,Robert E. Coleman,Neal D. Shore,Karim Fizazi,Bertrand Tombal,Kurt Miller,Paul Sieber,Lawrence Karsh,Ronaldo Damião,Teuvo L.J. Tammela,Blair Egerdie,Hendrik Van Poppel,Joseph L. Chin,Juan Morote,Francisco Gomez-Veiga,Tomasz Borkowski,Zhishen Ye,Amy Kupic,Roger Dansey,Carsten Goessl +20 more
TL;DR: This large randomised study shows that targeting of the bone microenvironment can delay bone metastasis in men with prostate cancer and significantly increased bone-metastasis-free survival.
References
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疟原虫var基因转换速率变化导致抗原变异[英]/Paul H, Robert P, Christodoulou Z, et al//Proc Natl Acad Sci U S A
TL;DR: PfPMP1)与感染红细胞、树突状组胞以及胎盘的单个或多个受体作用,在黏附及免疫逃避中起关键的作�ly.
Journal ArticleDOI
Studies on prostatic cancer: I. The effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate
TL;DR: Gutman et al. as mentioned in this paper showed that the acid phosphatase of serum is reduced in metastatic carcinoma of the prostate by decreasing the activity of androgens through castration or estrogenic injections and that this enzyme is increased by injecting androgens.
Journal Article
Studies on Prostatic Cancer. I. The Effect of Castration, of Estrogen and of Androgen Injection on Serum Phosphatases in Metastatic Carcinoma of the Prostate
TL;DR: It is demonstrated that a marked rise in acid phosphatase in serum is associated with the appearance or spread of roentgenologically demonstrable skeletal metastases and implies dissemination of the primary tumor and thus is of unfavorable prognostic significance.
Journal ArticleDOI
Natural history of progression after PSA elevation following radical prostatectomy.
Charles R. Pound,Alan W. Partin,Mario A. Eisenberger,Daniel W. Chan,Jay D. Pearson,Patrick C. Walsh +5 more
TL;DR: Several clinical parameters help predict the outcomes of men with PSA elevation after radical prostatectomy, and these data may be useful in the design of clinical trials, the identification of men for enrollment into experimental protocols, and counseling men regarding the timing of administration of adjuvant therapies.
Journal ArticleDOI
Prevalence of Prostate Cancer among Men with a Prostate-Specific Antigen Level ≤4.0 ng per Milliliter
Ian M. Thompson,Donna K. Pauler,Phyllis J. Goodman,Catherine M. Tangen,M. Scott Lucia,Howard L. Parnes,Lori M. Minasian,Leslie G. Ford,Scott M. Lippman,E. David Crawford,John Crowley,Charles A. Coltman +11 more
TL;DR: Biopsy-detected prostate cancer, including high-grade cancers, is not rare among men with PSA levels of 4.0 ng per milliliter or less--levels generally thought to be in the normal range.