Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with prostate cancer

Kanesvaran, Ravindran; Castro, Elena; Wong, Alvin Seng Cheong; Fizazi, Karim; Chua, Melvin Lee Kiang; Zhu, Yu; Malhotra, H; Miura, Yuji; Lee, J.L.; Chong, Flora Li Tze; Pu, Yeong‐Shiau; Yen, Chueh-Chuan; Saad, Marniza; Lee, H.J.; Kitamura, Hiroshi; Prabhash, Kumar; Zou, Qin; Curigliano, Giuseppe; Poon, Eileen; Choo, Su-Pin; Peters, Steffie M B; Lim, Elaine; Yoshino, Takayuki; Pentheroudakis, G.

doi:10.1016/j.esmoop.2022.100518

Cited by 23 publications

(15 citation statements)

References 141 publications

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“…Long-term survival results from that trial concluded that, with a median follow-up of 53.7 months, high-volume and low-volume control groups treated with ADT differed significantly in median OS (34.3 months in the subgroup of high-volume versus not reached in low-volume) ( Kyriakopoulos et al, 2018 ). Since the distinct prognoses of high- and low-volume have also been validated in other studies, volume stratification in mHSPC has gained widespread acceptance and adopted in treatment guidelines ( Kanesvaran et al, 2022 ; Mottet et al, 2022 ; Schaeffer et al, 2022 ). Considering that patients with the high- or low-volume disease may benefit differently from the same therapy, we stratified the data from all therapies according to patients with mHSPC with high versus low volume and performed NMA in the following analysis.…”

Section: Discussionmentioning

confidence: 99%

Combination therapy for high-volume versus low-volume metastatic hormone-sensitive prostate cancer: A systematic review and network meta-analysis

Jian

Yang

et al. 2023

Front. Pharmacol.

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Purpose: To conduct a systematic review and network meta-analysis (NMA) to compare the efficacy of currently available combination therapies in patients with metastatic hormone-sensitive prostate cancer (mHSPC).Methods: Qualified publications were searched in the PubMed, Embase, and Cochrane CENTRAL databases. Overall survival (OS) and radiographic progression-free survival (rPFS) were indirectly compared and assessed using NMA and the surface under the cumulative ranking curve, respectively. Adverse events (AEs) were also compared.Results: Eighteen publications from 12 trials were analyzed in the NMA. In the overall population, triplet therapy was ranked first for OS (hazard ratio [HR]: 0.57, 95% credible interval [CrI]: 0.48–0.67) and rPFS (HR: 0.33, 95% CrI:0.26–0.41) compared with androgen deprivation therapy (ADT) with or without standard non-steroidal antiandrogen. In high-volume mHSPC, triplet therapy was also ranked first in OS (HR, 0.57; 95% CrI:0.44–0.75) and rPFS(HR, 0.29; 95% CrI: 0.23–0.37). Specifically, abiraterone triplet therapy was ranked first in OS (HR, 0.52; 95% CrI:0.38–0.72) and rPFS (HR, 0.28; 95% CrI:0.21–0.38) among all therapies. ADT plus rezvilutamide was ranked first among doublet therapies (OS: HR, 0.58; 95% CrI:0.44–0.77; rPFS: HR, 0.44; 95% CrI:0.33–0.58). In low-volume mHSPC, doublet and triplet therapies were ranked first in OS (HR:0.68, 95% CrI:0.58–0.80) and rPFS (HR:0.37, 95% CrI:0.25–0.55), respectively. ADT plus apalutamide was ranked first in OS among all therapies (HR:0.53, 95% CrI:0.35–0.79), whereas enzalutamide triplet therapy was ranked first in rPFS (HR:0.27, 95% CrI:0.15–0.51). ADT plus rezvilutamide showed a relatively lower incidence of AE among all therapies (OR:1.00, 95% CrI:0.31–3.15), and a lower risk of specific AEs among doublet therapies, particularly regarding seizure (OR, 0.29; 95% CrI:0.01–8.18) and fatigue (OR, 0.96; 95% CrI:0.63–1.46). Docetaxel-based doublet or triplet therapies significantly increased the risk of any AEs or grade ≥3 AEs.Conclusion: Triplet therapy was the best treatment option for the overall population. In high-volume mHSPC, triplet therapy and ADT plus rezvilutamide had the greatest potential to benefit patients. Patients with low-volume mHSPC were most likely to benefit from ADT plus androgen receptor-targeted agents. Triplet therapy was associated with a higher risk of AEs than the other therapies.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022375347, identifier PROSPERO:CRD42022375347.

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Section: Discussionmentioning

confidence: 99%

Combination therapy for high-volume versus low-volume metastatic hormone-sensitive prostate cancer: A systematic review and network meta-analysis

Jian

Yang

et al. 2023

Front. Pharmacol.

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“…The internationally recognized second‐line option for HER2‐positive metastatic breast cancer includes T‐DXd and T‐DM1 3,5‐8 . However, in China, T‐DM1 was not covered by medical insurance until March 2023 and T‐DXd was not approved until February 2023.…”

Section: Discussionmentioning

confidence: 99%

“…With the development of anti‐HER2 therapies, substantial improvement in outcomes has been achieved in patients with HER2‐positive breast cancer. Various anti‐HER2 agents, including monoclonal antibodies (including trastuzumab, pertuzumab and margetuximab), antibody‐drug conjugates (ADCs, including trastuzumab emtansine [T‐DM1] and trastuzumab deruxtecan [T‐DXd]) and tyrosine kinase inhibitors (TKIs, such as lapatinib, neratinib and tucatinib) are used across different settings 2‐8 …”

Section: Introductionmentioning

confidence: 99%

“…Human epidermal growth factor receptor 2 (HER2) is a wellestablished treatment target, and approximately 15% to 20% of patients with breast cancer have HER2 protein overexpression and/or gene amplification, 1 ) and tyrosine kinase inhibitors (TKIs, such as lapatinib, neratinib and tucatinib) are used across different settings. [2][3][4][5][6][7][8] Pyrotinib is an irreversible pan-HER TKI targeting HER1, HER2 and HER4. It has been approved for the treatment of HER2-positive relapsed or metastatic breast cancer in China based on results from randomized phase 2 and 3 trials.…”

Section: Introductionmentioning

confidence: 99%

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Real‐world treatment patterns and outcomes of pyrotinib‐based therapy in patients with HER2‐positive advanced breast cancer (PRETTY): A nationwide, prospective, observational study

Tong

et al. 2023

Intl Journal of Cancer

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Pyrotinib, an irreversible pan‐ErbB inhibitor, has been approved for treating HER2‐positive advanced breast cancer in China. We conducted a nationwide, prospective observational study to examine the real‐world data of pyrotinib‐based therapy in this population. Patients from 61 sites across China were included. Pyrotinib‐based regimens were prescribed at local physician's discretion. Demographics, treatment patterns, prognosis and safety were evaluated. The primary outcome was real‐world progression‐free survival (rwPFS). Of 1129 patients, pyrotinib‐based therapy was prescribed as first‐, second‐ and third‐ or later‐line treatment in 437 (38.7%), 476 (42.2%) and 216 (19.1%) patients, respectively. Median rwPFS (mrwPFS) was 14.3 (95% CI, 13.3‐15.2) months in the total population, with the longest mrwPFS of 17.8 (95% CI, 15.2‐24.9) months in the first‐line setting, followed by 14.4 (95% CI, 12.9‐15.3) months in the second‐line setting. Patients with third‐ or later‐line treatment also achieved a mrwPFS of 9.3 (95% CI, 8.4‐11.8) months. Patients with trastuzumab‐ or trastuzumab‐pertuzumab‐treated disease achieved a mrwPFS of 14.3 and 13.6 months, respectively. Dual HER2 blockade with pyrotinib plus trastuzumab showed a mrwPFS of 16.2 months in the total population, with data not mature in the first‐line setting. For patients with baseline brain metastases, the mrwPFS was 11.7 months. The most common adverse event was diarrhea (any grade, 73.5%; grade ≥ 3, 15.3%). In real world, pyrotinib‐based therapy shows promising effectiveness in the first‐, as well as second‐ and later‐line treatment, with acceptable tolerability. Further investigations regarding front‐line use or novel combinations of pyrotinib might facilitate to maximize its anti‐tumor potential.

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“…Castration-resistant PC is defined as progressive disease while having sufficiently low serum testosterone concentrations that reflect adequate castration. The generally recommended testosterone castration cutoff (TCC) of 1.7 nmol/l (50 ng/dl) to define adequate castration treatment was initially based on the lowest possible detection level of historical testosterone measurement systems and has largely remained unchanged in clinical guidelines [1] , [2] , [3] . Recent investigations have shown that lower testosterone castration levels correlate with better survival.…”

mentioning

confidence: 99%

Current Routine Testosterone Immunoassays Are Unsuitable for Lowering the General Castration Cutoff Recommendation to <0.7 nmol/l (20 ng/dl)

Rossum

Winden

Bergman

et al. 2023

European Urology Open Science

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Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with prostate cancer

Cited by 23 publications

References 141 publications

Combination therapy for high-volume versus low-volume metastatic hormone-sensitive prostate cancer: A systematic review and network meta-analysis

Combination therapy for high-volume versus low-volume metastatic hormone-sensitive prostate cancer: A systematic review and network meta-analysis

Real‐world treatment patterns and outcomes of pyrotinib‐based therapy in patients with HER2‐positive advanced breast cancer (PRETTY): A nationwide, prospective, observational study

Current Routine Testosterone Immunoassays Are Unsuitable for Lowering the General Castration Cutoff Recommendation to <0.7 nmol/l (20 ng/dl)

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