Comparison of an LH&amp;ndash;RH Analogue (Goeserelin Acetate, &amp;lsquo;Zoladex&amp;rsquo;) with Combined Androgen Blockade in Advanced Prostate Cancer: Final Survival Results of an International Multicentre Randomized&amp;ndash;Trial

Cj, Tyrrell; Altwein, J. E.; Klippel, F; Jurincic-Winkler, C.; Varenhorst, Eberhard; Lunglmayr, G; Boccardo, Francesco; Holdaway, I. M.; Haefliger, Jacques‐Antoine; Jordaan, J. P.

doi:10.1159/000020119

Cited by 16 publications

(5 citation statements)

References 22 publications

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“…We identified nine trials [10,[16][17][18][19][20][21][22][23] involving a total of 5168 patients: 951 (18%) patients receiving Doc-ADT, 1462 (28%) patients receiving MAB and 2755 (53%) patients receiving ADT alone. The contribution plot in Figure 1 presents the network of evidence.…”

Section: Nma Resultsmentioning

confidence: 99%

“…We found some interesting trends in median OS in the ADT arm. For studies conducted before the 2000s [16,17,[19][20][21], the median OS of the ADT arm ranged from 26.4 to 31 months, whereas for studies conducted after the 2000s [10,18,22,23], it ranged from 47.2 to 76.8 months. We attribute this extension of survival time to improvements in prostate screening programs for the early detection of disease, improved medical and nursing conditions for orchiectomy surgery and use of several novel drugs, docetaxel, cabazitaxel, abiraterone acetate, enzalutamide, etc.…”

Section: Discussionmentioning

confidence: 99%

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Comparative clinical effects and cost–effectiveness of maximum androgen blockade, docetaxel with androgen deprivation therapy and ADT alone for the treatment of mHSPC in China

Liu

Qu²,

Liu³

et al. 2019

J. Comp. Eff. Res.

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Aim: To compare the clinical effects and cost–effectiveness of maximum androgen blockade (MAB), docetaxel to androgen deprivation therapy (Doc-ADT) and ADT alone for the treatment of patients with metastatic hormone-sensitive prostate cancer in China. Methods: A network meta-analysis and a Markov model were adopted for effectiveness and economic evaluation. Results: The hazard ratios of overall survival and progression-free survival were 0.782 and 0.628 for Doc-ADT versus ADT alone; 0.897 and 0.824 for MAB versus ADT alone. Doc-ADT was cost-effective compared with MAB and ADT alone, with an incremental cost–effectiveness ratio of CNY 96,848 and CNY 67,758 per quality-adjusted life year, respectively. MAB was cost-effective compared with ADT alone, with an incremental cost–effectiveness ratio of CNY 137,487 per quality-adjusted life year. Conclusion: Doc-ADT is likely the optimal option from the perspective of both clinical outcomes and economic considerations.

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Section: Nma Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparative clinical effects and cost–effectiveness of maximum androgen blockade, docetaxel with androgen deprivation therapy and ADT alone for the treatment of mHSPC in China

Liu

Qu²,

Liu³

et al. 2019

J. Comp. Eff. Res.

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“…STAMPEDE is comparing ADT monotherapy versus ADT plus chemotherapy, anti-androgen treatment and/or radiotherapy, and has recruited more than 7,000 patients to date (Table 3). 23,25,26 Results are now available for 2,962 patients randomized to four arms (control/ADT monotherapy, ADT plus six cycles of 75 mg/m 2 docetaxel [with 10 mg prednisolone], ADT plus zoledronic acid, or ADT plus docetaxel and zoledronic acid) 26,27. Adding docetaxel (but not zoledronic acid) to ADT significantly improved OS, with a 10-month extension in median survival from 71 months on ADT alone to 81 months on ADT plus docetaxel (Table 4).…”

Section: Optimizing Treatment Regimens In Hormone-sensitive Pcamentioning

confidence: 99%

Androgen deprivation therapy as backbone therapy in the management of prostate cancer

Merseburger¹,

Alcaraz²,

Klot³

2016

OTT

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Androgen deprivation therapy (ADT) is well established as a backbone therapy for metastatic prostate cancer (mPCa), and both European and American guidelines emphasize the importance of maintaining ADT after progression to metastatic castration-resistant prostate cancer (CRPC). However, the use of ADT varies widely in clinical practice despite these recommendations. Both research and development of increasingly precise assay technologies have improved our understanding of androgen production and signaling, and the recent data have suggested that a new serum testosterone cutoff value of <0.7 nmol/L should be employed. Most clinical trials to date have used the historical 1.7 nmol/L cutoff, but the <0.7 nmol/L cutoff has been associated with improved patient outcomes. Combining agents with different mechanisms of action to achieve intense androgen blockade may improve survival both before and after progression to CRPC. Data suggest that this intensive approach to androgen deprivation could delay the transition to CPRC and hence improve survival dramatically. Various combinations of backbone ADT with chemotherapy or radiotherapy are under investigation. Administration of ADT is established in patients with intermediate or high-risk localized prostate cancer (PCa) receiving radiotherapy with curative intent. This article reviews the current and potential role of ADT as backbone therapy in both hormone-sensitive PCa and CRPC with a focus on mPCa.

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“…With such dismal results, the retropubic freehand approach to brachytherapy was abandoned and was replaced by transperineal ultrasound or computed tomography scan‐guided implantation of radioactive agents. Iodine 125 and palladium 103 are the most commonly used radioisotopes. They are both enclosed in small titanium shells, or “seeds.” Both isotopes emit low‐energy gamma radiation, although with different dose‐delivery rates and half‐lives.…”

Section: Treatment Of Localized Prostate Cancermentioning

confidence: 99%

“…This study might have been flawed because most of orchiectomies were subcapsular, with some Leydig's cells potentially remaining after surgery, creating a bias in favor of patients who received the antiandrogen. More recently, several large multicenter randomized trials 102,103 have shown no benefit to adding an antiandrogen to medical or surgical castration. Schroder 104 performed a meta‐analysis on the subject, reviewing more than 20 studies, and concluded that the advantage of maximal androgen blockade was 3.5% in overall 5‐year survival rate.…”

Section: Treatment Of Advanced Stage Prostate Cancermentioning

confidence: 99%

The Treatment of Prostate Cancer.

2001

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Purpose: The purpose of this report is to discuss the current treatment options available to the patient with prostate cancer in all stages of the disease. Overview: With the exception of skin cancer, prostate cancer is the most common cancer in men in the United States. Most patients in the current era will present with organ‐confined disease, amenable to curative treatment. Treatment for organ‐confined disease includes watchful waiting, radical prostatectomy, radiation therapy, and cryosurgery in selective cases. Hormone therapy is the cornerstone of treatment of patients with advanced prostate cancer. There is no curative treatment for hormone‐refractory prostate cancer. Clinical implications: The availability of several therapeutic options for localized prostate cancer warrants careful consideration when planning treatment with curative intent. Patients need to be active participants in decision making, and they must be aware of the benefits and possible complications of the different types of treatment. Patients with advanced prostate cancer need to be aware that hormone treatment will provide temporization and palliation in the majority of cases. Hormone‐resistant prostate cancer is refractory to most forms of conventional and experimental therapy.

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Comparison of an LH–RH Analogue (Goeserelin Acetate, ‘Zoladex’) with Combined Androgen Blockade in Advanced Prostate Cancer: Final Survival Results of an International Multicentre Randomized–Trial

Cited by 16 publications

References 22 publications

Comparative clinical effects and cost–effectiveness of maximum androgen blockade, docetaxel with androgen deprivation therapy and ADT alone for the treatment of mHSPC in China

Comparative clinical effects and cost–effectiveness of maximum androgen blockade, docetaxel with androgen deprivation therapy and ADT alone for the treatment of mHSPC in China

Androgen deprivation therapy as backbone therapy in the management of prostate cancer

The Treatment of Prostate Cancer.

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