Treatment Landscape of Nonmetastatic Castration-Resistant Prostate Cancer: A Window of Opportunity

López-Campos, Fernando; Conde-Moreno, Antonio J.; Arcos, Marta Barrado Los; Gómez-Caamaño, Antonio; García-Gómez, Raquel; Morón, A. Hervás

doi:10.3390/jpm11111190

Cited by 7 publications

(4 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the treatment of metastatic CRPC, some studies have demonstrated better oncological outcomes following MDRT for oligo-progressive metastasis in patients with long PSADT [21]. This may be explained as follows: rst, as such lesions identi ed under castration resistance are deemed refractory to current systemic therapy, one of the subsequent treatment options can be radiotherapy; second, accumulating evidence of PSADT as an alternative marker for the progression of PCa was also established in non-metastatic CRPC, with an example of an association between PSADT < 8 months and a rapid increase in the risk of bone metastasis [22]. This hypothesis supports the favorable outcomes observed in the present CRPC setting with respect to the median PFS and achievement rates of PSA50 and PSA90 in L-PSADT.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of the Prostate-Specific Antigen Doubling Time for the Effectiveness of Metastasis-Directed Radiotherapy in Patients with Oligometastases after Radical Treatment for Non-metastatic Prostate Cancer: A Single Institution Retrospective Study

Koguchi,

Tabata,

Hirano

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: Data on metastasis-directed radiotherapy (MDRT) are limited, particularly regarding its association with the prostate-specific antigen (PSA) doubling time (PSADT). The present study aims to evaluate the oncological outcomes of MDRT on the basis of the PSADT in patients who developed oligometastases after radical treatment for non-metastatic prostate cancer. Methods: We retrospectively reviewed the clinical data of 35 MDRTs for 29 patients targeting oligometastatic prostate cancer developed after radical prostatectomy or radiotherapy for non-metastatic prostate cancer. Thirty-five MDRTs were classified into the PSADT > 3 months (n = 25) or PSADT ≤ 3 months group (n = 10). Statistical analyses were performed to compare associations between the two PSADT groups and the oncological outcomes such as progression-free survival (PFS) and PSA response after MDRT. Results: There were no significant differences between the groups in terms of age, PSA level, Gleason score, or TNM stage. Kaplan–Meier analysis showed that PFS was significantly better in the PSADT > 3 months group than in the PSADT ≤ 3 months group (median: 13.3 versus [vs.] 2.6 months, P = 0.046). Regarding castration sensitivity, the predictive role of PSADT > 3 months was maintained in 21 patients who received MDRT without prior salvage hormone therapy (median PFS: 12.7 vs. 2.6 months, P = 0.024). In the castration-resistant setting (n = 14), the frequency of a decrease in serum PSA levels after MDRT by 90% was 54.5% (median PFS: 23.1 months). Conclusions: MDRT can provide benefit especially for patients with PSADT ≥ 3 months who had oligo-recurrence after the radical treatment for non-metastatic prostate cancer.

show abstract

Section: Discussionmentioning

confidence: 99%

Predictive Value of the Prostate-Specific Antigen Doubling Time for the Effectiveness of Metastasis-Directed Radiotherapy in Patients with Oligometastases after Radical Treatment for Non-metastatic Prostate Cancer: A Single Institution Retrospective Study

Koguchi,

Tabata,

Hirano

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…The interest toward nmCRPC is growing, due to the advancements in treatment and in diagnosis, with the approval of next-generation androgen inhibitors and new imaging modalities respectively ( 14 , 15 ). However, there are still many concerns regarding the management of patients with nmCRPC ( 35 ).…”

Section: Discussionmentioning

confidence: 99%

“…Variations in the management of the disease in clinical practice may significantly impact on metastases onset, affecting patients’ survival and health-related quality of life (HRQoL) ( 12 , 13 ). However, at present clinical management of nmCRPC patients is patchy and not well documented ( 14 , 15 ). Moreover, although several studies have revealed that metastases onset is associated with higher DWs ( 16 , 17 ), there is no empirical evidence within the CRPC setting.…”

Section: Introductionmentioning

confidence: 99%

Disability weights for castration-resistant prostate cancer: an empirical investigation

Borsoi

Ciani

Vivo³

et al. 2022

Grhta

View full text Add to dashboard Cite

Introduction: Health state valuation and diagnostic-therapeutic pathways at the junction between non-metastatic and metastatic castration-resistant prostate cancer (CRPC) are not well documented. We aimed at: (i) estimating the disability weights (DWs) for health states across a continuum of disease from asymptomatic non-metastatic (nmCRPC) to symptomatic metastatic state (mCRPC); (ii) mapping the diagnostic-therapeutic pathway of nmCRPC in Italy. Methods: Structured qualitative interviews were performed with clinical experts to gather information on nmCRPC clinical pathway. An online survey was administered to clinical experts to estimate DWs for four CRPC health states defined from interviews and literature review (i.e., nmCRPC, asymptomatic mCRPC, symptomatic mCRPC, mCRPC in progression during or after chemotherapy). Clinicians’ preferences for health states were elicited using the Person-Trade-Off (PTO) and Visual Analogue Scale (VAS) methods. DWs associated with each health state, from 0 (best imaginable health state) and 1 (worst imaginable health state), were estimated. Results: We found that the management of nmCRPC is heterogeneous across Italian regions and hospitals, especially with respect to diagnostic imaging techniques. DWs for PTO ranged from 0.415 (95% confidence interval [CI] 0.208-0.623) in nmCRPC to 0.740 (95% CI 0.560-0.920) in mCRPC, in progression during or after chemotherapy. DWs for VAS ranged between 0.246 (95% CI 0.131-0.361) in nmCRPC to 0.689 (95% CI 0.583-0.795) in mCRPC, in progression during or after chemotherapy. Conclusions: Estimated DWs suggest that delaying transition to a metastatic state might ease the disease burden at both patient and societal levels.

show abstract

“…Therefore, in case of progression, it is necessary to adopt therapeutic interventions (4), and notably, patients with nmCRPC are often asymptomatic (5). Therefore, both delaying metastatic progression and reducing treatment-related adverse events (AEs) are significant therapeutic goals for patients with nmCRPC (6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Physician preferences for nonmetastatic castration-resistant prostate cancer treatment in China

Fan,

Guo,

Campobasso

et al. 2024

Front. Oncol.

View full text Add to dashboard Cite

IntroductionThe treatment preferences of Chinese physicians who treat nonmetastatic castration-resistant prostate cancer (nmCRPC) and how they weigh the benefits and risks of nmCRPC treatment are still unknown. This study aimed to evaluate Chinese physicians’ benefit–risk treatment preferences for nmCRPC and assist in setting nmCRPC treatment goals.MethodsA paper-based discrete choice experiment (DCE) survey was administered to 80 nmCRPC-treating physicians. DCE responses were analyzed to produce the preference weight and the relative importance score for each attribute level. The marginal rate of substitution (MRS) was used to quantify the amount of overall survival (OS) physicians were willing to trade for a reduction in treatment-related adverse events (AEs). We further conducted the exploratory analysis, stratifying physicians from 5 perspectives into different subgroups and examining the treatment preferences and OS trade-off in each subgroup.ResultsIn terms of efficacy attributes, physicians placed greater emphasis on OS than time to pain progression. With regard to safety attributes, serious fracture was perceived as the most important AE by physicians, followed by serious fall, cognitive problems, skin rash, and fatigue. In the exploratory analysis, we found generally that physicians with less clinical practice experience and those from more economically developed regions placed more emphasis on AEs and were willing to give up more of their patients’ OS to reduce the risk of AEs.ConclusionPhysicians from mainland China value the importance of minimizing treatment-related AEs when considering different treatment options for patients with nmCRPC, and they are willing to trade a substantial amount of OS to avoid AEs.

show abstract

Treatment Landscape of Nonmetastatic Castration-Resistant Prostate Cancer: A Window of Opportunity

Cited by 7 publications

References 45 publications

Predictive Value of the Prostate-Specific Antigen Doubling Time for the Effectiveness of Metastasis-Directed Radiotherapy in Patients with Oligometastases after Radical Treatment for Non-metastatic Prostate Cancer: A Single Institution Retrospective Study

Predictive Value of the Prostate-Specific Antigen Doubling Time for the Effectiveness of Metastasis-Directed Radiotherapy in Patients with Oligometastases after Radical Treatment for Non-metastatic Prostate Cancer: A Single Institution Retrospective Study

Disability weights for castration-resistant prostate cancer: an empirical investigation

Physician preferences for nonmetastatic castration-resistant prostate cancer treatment in China

Contact Info

Product

Resources

About