Health-related quality of life for immediate versus delayed androgen-deprivation therapy in patients with asymptomatic, non-curable prostate cancer (TROG 03.06 and VCOG PR 01-03 [TOAD]): a randomised, multicentre, non-blinded, phase 3 trial

Duchesne, Gillian; Woo, Henry H.; King, Madeleine; Bowe, Steven J.; Stockler, Martin R.; Ames, Alice; DʼEste, Catherine; Frydenberg, Mark; Loblaw, Andrew; Malone, Shawn; Millar, Jeremy; Tai, Keen Hun; Turner, Sandra

doi:10.1016/s1470-2045(17)30426-6

Cited by 48 publications

(13 citation statements)

References 21 publications

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“…Side effects of ADT include hot flashes, decreased libido, fatigue, osteoporosis, weight gain, sarcopenia, and increased risk of cardiovascular disease. In general, side effects from ADT increase with the length of treatment duration ( 11 , 12 ). Intermittent ADT (I-ADT) is a treatment option for men with biochemically recurrent prostate cancer with the aim of decreasing long term side effects from ADT ( 9 , 13 ).…”

Section: Intermittent Androgen Deprivation Therapymentioning

confidence: 99%

Rationale for Involved Field Stereotactic Body Radiation Therapy-Enhanced Intermittent Androgen Deprivation Therapy in Hormone-Sensitive Nodal Oligo-Recurrent Prostate Cancer Following Prostate Stereotactic Body Radiation Therapy

et al. 2021

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Lymph node recurrent prostate cancer is a common clinical scenario that is likely to increase significantly with the widespread adoption of novel positron emission tomography (PET) agents. Despite increasing evidence that localized therapy is disease modifying, most men with lymph node recurrent prostate cancer receive only systemic therapy with androgen deprivation therapy (ADT). For men who receive localized therapy the intent is often to delay receipt of systemic therapy. Little evidence exists on the optimal combination of local and systemic therapy in this patient population. In this hypothesis generating review, we will outline the rationale and propose a framework for combining involved field SBRT with risk adapted intermittent ADT for hormone sensitive nodal recurrent prostate cancer. In patients with a limited number of nodal metastases, involved field stereotactic body radiation therapy (SBRT) may have a role in eliminating castrate-resistant clones and possibly prolonging the response to intermittent ADT. We hypothesize that in a small percentage of patients, such a treatment approach may lead to long term remission or cure.

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Section: Intermittent Androgen Deprivation Therapymentioning

confidence: 99%

Rationale for Involved Field Stereotactic Body Radiation Therapy-Enhanced Intermittent Androgen Deprivation Therapy in Hormone-Sensitive Nodal Oligo-Recurrent Prostate Cancer Following Prostate Stereotactic Body Radiation Therapy

et al. 2021

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“…The timing and duration of ADT in the setting of biochemical failure have been investigated to reduce side effects in these patients who have a relatively long life expectancy and are asymptomatic from their local/biochemical recurrence. Two phase III trials, Timing of Androgen Deprivation (TOAD) ( 20 ) and Early vs. Late Androgen Ablation Trial (ELAAT) (NCT00439751) have explored the timing of ADT. The TOAD trial randomized 293 patients between immediate or delayed ADT.…”

Section: Adtmentioning

confidence: 99%

The role of salvage brachytherapy for local relapse after external beam radiotherapy for prostate cancer

Tisseverasinghe

Crook

2018

Transl. Androl. Urol.

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Prostate cancer is the most prevalent cancer amongst men. For localized disease, there currently exist several reliable treatment modalities including surgery, radiotherapy and brachytherapy. Our growing understanding of this disease indicates that local control plays a very important role in prevention of subsequent dissemination. Many improvements to external beam radiotherapy over recent years have decreased toxicity and improved outcomes, but nonetheless, local relapse remains common. Many salvage options exist for locally recurrent prostate cancer, but are rarely offered, partly because of the fear of toxicity. Many men with isolated local recurrence therefore do not receive potentially curative second line treatment and are instead treated with palliative androgen suppression. Selection plays an important role in determining which individuals are likely to benefit from salvage. Those at high risk of pre-existing micro-metastatic disease despite negative staging scans are unlikely to benefit. Prostate brachytherapy has evolved over the more than 3 decades of experience. Modern techniques allow more precise tumor localization and dose delivery. Better understanding of dosimetric parameters can distinguish optimal from suboptimal implants. Salvage brachytherapy can be an effective treatment for locally recurrent prostate cancer after prior external beam radiotherapy. We review the literature pertaining to both low dose rate (LDR) and high dose rate (HDR) salvage brachytherapy and discuss patient selection, optimal dose, treatment volume and toxicity avoidance.

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“…Moul et al report that initiating hormone therapy after biochemical recurrence will delay the onset of clinical metastasis, especially in those with high‐risk features on their initial pathology . Another trial randomized men who had a prostate‐specific antigen relapse to receive either immediate or delayed ADT and reported that 5‐year overall survival (OS) was higher in those who received immediate therapy …”

Section: Prostate Cancermentioning

confidence: 99%

Cost considerations for systemic therapy for patients with advanced genitourinary malignancies

Henry

Leung

Filson

2018

Cancer

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The rising cost of health care in the United States has been the focus of intense debate within the medical, legal, and legislative arenas, with the cost of cancer care representing an important component. Cost effectiveness is not always easy to define, and there is no standard metric in assessing this measure related to cancer therapies. Significant controversy surrounds exactly what is the appropriate cost per added year of life. This review examines cost, effectiveness, and comparative cost effectiveness of novel systemic therapies for patients with urologic malignancies. Cancer 2018;124:2897-905. © 2018 American Cancer Society.

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Health-related quality of life for immediate versus delayed androgen-deprivation therapy in patients with asymptomatic, non-curable prostate cancer (TROG 03.06 and VCOG PR 01-03 [TOAD]): a randomised, multicentre, non-blinded, phase 3 trial

Cited by 48 publications

References 21 publications

Rationale for Involved Field Stereotactic Body Radiation Therapy-Enhanced Intermittent Androgen Deprivation Therapy in Hormone-Sensitive Nodal Oligo-Recurrent Prostate Cancer Following Prostate Stereotactic Body Radiation Therapy

Rationale for Involved Field Stereotactic Body Radiation Therapy-Enhanced Intermittent Androgen Deprivation Therapy in Hormone-Sensitive Nodal Oligo-Recurrent Prostate Cancer Following Prostate Stereotactic Body Radiation Therapy

The role of salvage brachytherapy for local relapse after external beam radiotherapy for prostate cancer

Cost considerations for systemic therapy for patients with advanced genitourinary malignancies

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