Survival benefit of early androgen receptor inhibitor therapy in locally advanced prostate cancer: Long-term follow-up of the SPCG-6 study

Thomsen, Frederik Birkebæk; Brasso, Klaus; Christensen, Ib Jarle; Johansson, Jan‐Erik; Angelsen, Anders; Tammela, Teuvo L.J.; Iversen, Peter

doi:10.1016/j.ejca.2015.03.021

Cited by 18 publications

(4 citation statements)

References 31 publications

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“…Radical treatment may possibly be beneficial in men with PSA higher than 100 ng/mL as suggested by two recent observational studies in PCBaSe [8,26], however, there are no data from RCT in support of these observations. Correct staging is also important in men in whom hormonal therapy is considered since men with non-metastatic, locally advanced prostate cancer can be safely managed with antiandrogen monotherapy [27,28], whereas men with metastases are best managed with castration therapy [29]. Finally, tumour extent on bone imaging has recently become an indication for additional treatment to androgen deprivation therapy in men with metastatic prostate cancer [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Prediction of metastatic prostate cancer by prostate-specific antigen in combination with T stage and Gleason Grade: Nationwide, population-based register study

et al. 2020

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The objective was to investigate the proportion of men with metastatic prostate cancer in groups defined by T stage, Gleason Grade Group (GGG) and serum levels of prostate-specific antigen (PSA) and if PSA can be used to rule in metastatic prostate cancer when combined with T stage and GGG. We identified 102,076 men in Prostate Cancer data Base Sweden 4.0 who were diagnosed with prostate cancer in 2006-2016. Risk of metastases was assessed for PSA stratified on T stage and five-tiered GGG. For men who had not undergone bone imaging, we used multiple imputation to classify metastatic prostate cancer. Advanced T stage, high GGG and high PSA were related to bone metastases. For example: only 79/38 190 (0.2%) of men with T1-2 and GGG 1 had PSA above 500 ng/mL, and 29/79 (44%) of these men had metastases; whereas 1 154/7 018 (16%) of men with T3-4 and GGG 5 had PSA above 500 ng/ml and 1 088/1 154 (94%) of these men had metastases. However, no PSA cutoff could accurately identify the majority of men with metastatic prostate cancer (i.e. high sensitivity) while also correctly classifying most men without metastasis (i.e. high specificity). In conclusion, these results support the use of imaging to confirm bone metastases in men with advanced prostate cancer as no PSA level in combination with T stage and GGG could accurately rule in metastatic prostate cancer and thereby safely omit bone imaging.

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Section: Discussionmentioning

confidence: 99%

Prediction of metastatic prostate cancer by prostate-specific antigen in combination with T stage and Gleason Grade: Nationwide, population-based register study

et al. 2020

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“…Bicalutamide or placebo lasted until progression. After a follow-up of almost 15 yr, the treatment arm improved OS (HR 0.77; 95% Cl 0.63-0.94, p = 0.01) compared with the control arm for locally advanced patients [27].…”

Section: 1mentioning

confidence: 90%

“…Discussion and iimitations High-quality RcTs showed that EBRT ÷ ADT prolongs survivai in the neoadjuvant-concomitant [16,17], neoadJuvant-concomitantadjuvant [18,20,21,23,26J, and concomitant-adjuvant [5,19,22,27] settings. In general, the current evidence supports the following: (1) any ADT duration is better than no ADT [5,16 -18], (2) long-term ADT (eg, 3 yr) is slightly better in OS than a short duration (6 mo) [22], but (3) it remains unknown whether a duration of<3yr [25] in some patients or > 3 yr in very high-risk patients is more appropriate.…”

Section: 7mentioning

confidence: 99%

Systematic Review of Systemic Therapies and Therapeutic Combinations with Local Treatments for High-risk Localized Prostate Cancer

et al. 2019

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Context: Systemic therapies, combinedwith local treatment for high-risk prostate cancer, are recommended by the international guidelines for specific subgroups of patients; however, for many of the clinical scenarios, it remains a research field. Objective: To perform a systematic review, and describe current evidence and perspectives about the multimodal treatment of high-risk prostate cancer. Evidence acquisition: We performed a systematic review of PubMED, Embase, Cochrane Library, European Society of Medical Oncology/American Society of Clinical Oncology Annual proceedings, and clinicalTrial.gov between January 2010 and February 2018 following the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. Evidence synthesis: Seventy-seven prospective trials were identified. According to multiple randomized trials, combining androgen deprivation therapy (ADT) with external-beam radiotherapy (EBRT) outperforms EBRT alone for both relapse-free and overall survival. Neoadjuvant ADT did not show significant improvement compared with prostatectomy alone. The role of adjuvant ADT after prostatectomy in patients with high-risk disease is still debated, with lack of data from phase 3 trials in pNO patients. Novel androgen pathway inhibitors have been tested only in early-phase trials in addition to primary treatment. GETUG 12, RTOG 0521, and nonmetastatic subgroup of the STAMPEDE trial showed improved relapse-free survival for docetaxel in patients treated with EBRT plus ADT, although mature metastasis-free survival data are still pending. Both the SPCG-12 and the VACSP#553 trial showed no improvement in relapse free survival for adjuvant docetaxel after prostatectomy. Conclusions: In contrast to the clearly demonstrated survival benefits of long-term adjuvant ADT when used with EBRT, its role after prostatectomy remains unclear especially in pNO patients. Adding docetaxel to EBRT-ADT improves relapse-free survival, with immature results on overall survival. Novel androgen receptor pathway inhibitors are currently being tested in the neoadjuvant and adjuvant setting. Patient summary: Treatment of high-risk prostate cancer is based on a multimodality approach that includes systemic treatments. The best treatment or therapy combination remains to be defined.

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“…Hyperactive AR remains a key determinant in prostate cancer carcinogenesis and resistance to current therapies. Prostate cancer cells rely uniquely on androgens for proliferation [ 43 ], and blocking the AR pathway with androgen deprivation therapy invariably induces tumor regression [ 44 , 45 ]. However, in later stages, almost all prostate cancer cases inevitably progress to recurrent castration-resistant prostate cancer (CRPC), becoming androgen-independent and acquiring the ability to metastasize [ 46 ].…”

Section: Long Noncoding Rnas As Potential Therapeutic Targets In Pmentioning

confidence: 99%

Circulating Long Noncoding RNA as a Potential Target for Prostate Cancer

Huang

et al. 2015

IJMS

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Prostate cancer is considered the second most common visceral malignancy in men in Western countries. Its emergence is largely due to the coordination of a malignant network, and long noncoding RNA has been recently demonstrated to play a critical role in prostate carcinogenesis. The aberrant expression of long noncoding RNA in prostate cancer patients is strongly associated with diagnosis, risk stratification and carcinogenesis, information that provides new insight into the complicated intracellular milieu of prostate cancer. This review focuses mainly on literature evidence for the role of long noncoding RNA in prostate cancer, which may suggest novel strategies for its prognosis, diagnosis and clinical treatment.

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Survival benefit of early androgen receptor inhibitor therapy in locally advanced prostate cancer: Long-term follow-up of the SPCG-6 study

Cited by 18 publications

References 31 publications

Prediction of metastatic prostate cancer by prostate-specific antigen in combination with T stage and Gleason Grade: Nationwide, population-based register study

Prediction of metastatic prostate cancer by prostate-specific antigen in combination with T stage and Gleason Grade: Nationwide, population-based register study

Systematic Review of Systemic Therapies and Therapeutic Combinations with Local Treatments for High-risk Localized Prostate Cancer

Circulating Long Noncoding RNA as a Potential Target for Prostate Cancer

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