Intermittent Androgen Suppression in Patients With Advanced Prostate Cancer: An Update of the Tulp Survival Data

Langenhuijsen, J.F.; Schasfoort, E.M.C.; Heathcote, Peter; Lock, M.T.W.T.; Zerbib, Marc; Dijkema, H.E.; Vergunst, H.; Srougi, Miguel; Beek, C. van de; Ríos, M. de los; Kiemeny, Lambertus A; Mulders, Peter F.A.

doi:10.1016/s1569-9056(08)60534-5

Cited by 15 publications

(18 citation statements)

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“…However, it is important to note that testosterone recovery after discontinuation of GnRH agonist is often delayed and may depend on treatment duration, age, baseline testosterone, and ethnicity (Gulley, et al 2008). In a trial of intermittent versus continuous ADT for advanced prostate cancer, 193 patients were randomized and, after a mean follow-up of 34 months, no difference in survival was observed ( P value not stated) (Langenhuijsen, et al 2008). A larger trial randomized 312 men to continuous and 314 men to intermittent ADT (Calais da Silva, et al 2009).…”

Section: Resultsmentioning

confidence: 99%

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An update on androgen deprivation therapy for prostate cancer

Sharifi¹,

Gulley²,

Dahut³

2010

Endocrine-Related Cancer

183

158

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Androgen deprivation therapy (ADT) with gonadal testosterone depletion is the frontline treatment for advanced prostate cancer. Other hormonal interventions have a role in the treatment of prostate cancer. We sought to examine systematically the evidence for hormonal interventions in prostate cancer, risks of ADT and interventions that mitigate these risks. PubMed and Web of Science were searched for English-language articles using the terms prostate cancer, androgen deprivation therapy and hormone treatment between 1966 and February 2010. Bibliographies from selected articles and meeting abstracts were also reviewed. The highest quality data was emphasized. Results for therapeutic studies were focused primarily on randomized controlled clinical trials and the Jadad scale criteria was used to evaluate the quality of these studies. Four trials of the efficacy of intermittent versus continuous ADT were included. One randomized study analysis and 6 postrandomization analyses were included on the effects of ADT on cardiovascular mortality. Seven randomized controlled trials were included of pharmacologic interventions for the treatment of metabolic effects due to ADT. One randomized trial of gonadotropin-releasing hormone (GnRH)-antagonist versus GnRH-agonist was included. Six phase I/II clinical trials of secondary hormonal therapies with novel mechanisms of action were included. Randomized studies completed to date indicate that intermittent might be equivalent to continuous ADT. Although adverse effects of ADT include risk factors for cardiovascular disease, effects on cardiovascular mortality are uncertain. Bone loss and increased risk of fracture may be effectively treated with pharmacologic interventions. Benefits of ADT must be balanced with a consideration of the risks.

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Section: Resultsmentioning

confidence: 99%

“…It should be noted that the randomization criteria for all of these trials is a PSA decline of 80%–90%, or to < 4 ng/mL, on initial ADT. Furthermore, ADT for all of these trials included treatment with an AR antagonist (Calais da Silva et al 2009; Langenhuijsen et al 2008; Miller et al 2007). …”

Section: Resultsmentioning

confidence: 99%

An update on androgen deprivation therapy for prostate cancer

Sharifi¹,

Gulley²,

Dahut³

2010

Endocrine-Related Cancer

183

158

View full text Add to dashboard Cite

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“…Finally, no differences in QoL in IAD and CAD treatment groups have been observed in studies carried out by Mottet et al 39 . and Langenhuijsen et al 36 …”

Section: Resultsmentioning

confidence: 84%

“…We identified and reviewed publications from 25 IAD studies; of these, 13 were selected for the present literature review based on their relevance to assess safety and tolerability of IAD (Tables 2,3). Of these 13 studies, eight were randomized , active-controlled studies comparing IAD with CAD (Table 2; n = 68 to 1386 patients), 28,29,[31][32][33][34][35][36][37][38][39] and five were observational, non-randomized studies ( Table 3; n = 19 to 250 patients). 9,[40][41][42][43] Of these eight active-controlled studies, two 31,32 were published in full, whereas preliminary results have been reported in abstract format for the remaining six studies.…”

Section: Resultsmentioning

confidence: 99%

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Safety and tolerability of intermittent androgen deprivation therapy: A literature review

2012

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Androgen deprivation therapy is commonly used in men with advanced prostate cancer; however, it is associated with many short‐ and long‐term side‐effects. Intermittent androgen deprivation therapy was first suggested as an alternative regimen in the early 1990s and is now part of treatment guidelines as a result of its ability to reduce adverse events associated with continuous androgen deprivation therapy without decreasing its efficacy. Although many publications evaluated intermittent androgen deprivation therapy's efficacy, the safety and tolerability information of this regimen is relatively limited. The goal of this literature review was to analyze clinical trials that have reported safety and tolerability data in prostate cancer patients treated with intermittent androgen deprivation therapy, as well as assessing quality of life outcomes. A literature search was carried out using biomedical and pharmaceutical databases for published information comparing intermittent androgen deprivation therapy with continuous androgen deprivation therapy. A total of 13 randomized and non‐randomized studies were selected and reviewed based on their relevance to the safety, tolerability and quality of life of intermittent androgen deprivation therapy. Benefits for intermittent androgen deprivation therapy were observed for the short‐term side‐effects (hot flushes and sexual functions) mainly during the off‐treatment phase, whereas the data for the long‐term side‐effects were not as conclusive. Quality of life evaluations are more in support of intermittent androgen deprivation therapy. Although there are some safety, tolerability and quality of life benefits associated with intermittent androgen deprivation therapy, the overall evidence is still limited.

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