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Mahalingam D, Hanni S, Serritella AV, Fountzilas C, Michalek J, Hernandez B, Sarantopoulos J, Datta P, Romero O, Pillai SMA, Kuhn J, Pollak M, Thompson IM. Utilizing metformin to prevent metabolic syndrome due to androgen deprivation therapy (ADT): a randomized phase II study of metformin in non-diabetic men initiating ADT for advanced prostate cancer. Oncotarget 2023; 14:622-636. [PMID: 37335291 DOI: 10.18632/oncotarget.28458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Androgen deprivation therapy (ADT) can lead to metabolic syndrome (MS) and is implicated in ADT-resistance. Metformin showed antineoplastic activity through mTOR inhibition secondary AMPK-activation. MATERIALS AND METHODS To investigate whether metformin mitigated ADT-related MS, we conducted a randomized double-blind phase II trial of metformin 500 mg TID or placebo in non-diabetic patients with biochemically-relapsed or advanced PC due for ADT. Fasting serum glucose, insulin, PSA, metformin, weight and waist circumference (WC) were measured at baseline, week 12 and 28. The primary endpoint was a group of MS metrics. Secondary endpoints include PSA response, safety, serum metformin concentrations and analysis of downstream an mTOR target, phospho-S6-kinase. RESULTS 36 men were randomized to either metformin or placebo. Mean age was 68.4. Mean weight, WC and insulin levels increased in both arms. At week 12 and 28, no statistical differences in weight, WC or insulin were observed in either arm. No significant difference in percentage of patients with PSA <0.2 at week 28 between metformin (45.5%) vs. placebo (46.7%). Analysis in the metformin-arm showed variable down-regulation of phospho-S6 kinase. CONCLUSIONS In our small study, metformin added to ADT did not show a reduced risk of ADT-related MS or differences in PSA response.
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Affiliation(s)
- Devalingam Mahalingam
- Division of Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX 77030, USA
- Robert H Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA
| | - Salih Hanni
- Division of Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX 77030, USA
| | - Anthony V Serritella
- Robert H Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA
| | - Christos Fountzilas
- Division of Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX 77030, USA
- Roswell Park Cancer Institute, Buffalo, NY 14263, USA
| | - Joel Michalek
- Division of Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX 77030, USA
| | - Brian Hernandez
- Division of Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX 77030, USA
| | - John Sarantopoulos
- Institute for Drug Development, Mays Cancer Center at University of Texas Health, San Antonio, TX 78229, USA
| | | | - Ofelia Romero
- Division of Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX 77030, USA
| | | | - John Kuhn
- Division of Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX 77030, USA
| | - Michael Pollak
- Division of Experimental Medicine, Lady Davis Institute of Medical Research, Jewish General Hospital, McGill University, Montreal, Canada
| | - Ian M Thompson
- Division of Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX 77030, USA
- Christus Health, San Antonio, TX 78229, USA
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2
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Schwentner C. [Recent developments in the treatment of metastatic hormone-sensitive prostate cancer (mHSPC)]. Aktuelle Urol 2022; 53:31-36. [PMID: 34005823 DOI: 10.1055/a-1399-7718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Despite major developments in the therapy of advanced prostate cancer over the past decade, there was still an unmet medical need for efficacious and safe therapies suitable for a wide patient population of patients with metastatic hormone-sensitive disease.Since its label extension for the treatment of metastatic hormone-sensitive prostate cancer (mHSPC) at the beginning of 2020, apalutamide in combination with androgen deprivation therapy (ADT) has filled this gap 1. The novel androgen receptor inhibitor showed good efficacy and safety in comparison with placebo in the pivotal study TITAN while maintaining quality of life - the study included patients irrespective of risk, disease volume, or time of diagnosis 2.
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Smith KER, Brown JT, Wan L, Liu Y, Russler G, Yantorni L, Caulfield S, Lafollette J, Moore M, Kucuk O, Carthon B, Nazha B, Bilen MA. Clinical Outcomes and Racial Disparities in Metastatic Hormone-Sensitive Prostate Cancer in the Era of Novel Treatment Options. Oncologist 2021; 26:956-964. [PMID: 34096667 DOI: 10.1002/onco.13848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/21/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Docetaxel (DOC) and abiraterone (ABI) in the upfront setting have separately improved clinical outcomes for metastatic hormone-sensitive prostate cancer (mHSPC), but there are no studies comparing drug efficacies or the influence of racial disparities. MATERIALS AND METHODS We performed a retrospective multicenter review from Winship Cancer Institute at Emory University and Georgia Cancer Center for Excellence at Grady Memorial Hospital (2014-2020) for patients with mHSPC treated with either upfront DOC or ABI. Outcomes evaluated were overall survival (OS), progression-free survival (PFS), and prostate-specific antigen complete response (PSA CR). RESULTS A total of 168 patients were included, consisting of 92 (54.8%) Black patients and 76 (45.2%) non-Black patients (69 White and 7 Asian or Hispanic). Ninety-four (56%) received DOC and 74 (44%) received ABI. Median follow-up time was 22.8 months with data last reviewed June 2020. For OS, there was no significant difference between ABI versus DOC and Black versus non-Black patients. For PFS, DOC was associated with hazard ratio (HR) 1.7 compared with ABI for all patients based on univariate association and HR 2.27 compared with ABI for Black patients on multivariable analysis. For PSA CR, Black patients were less likely to have a CR (odds ratio [OR] = 0.27). CONCLUSION ABI and DOC have similar OS with a trend toward better PFS for ABI in a cohort composed of 54% Black patients. Racial disparities were observed as prolonged PFS for Black patients treated with ABI, more so compared with all patients, and less PSA CR for Black patients. A prospective trial comparing available upfront therapies in a diverse racial population is needed to help guide clinical decision-making in the era of novel treatment options. IMPLICATIONS FOR PRACTICE Overall survival is similar for abiraterone and docetaxel when used as upfront therapy in metastatic hormone-sensitive prostate cancer in a cohort composed of 54% Black patients. There is a trend towards improved progression-free survival for abiraterone in all patients and Black patients. Non-Black patients were more likely to achieve prostate-specific antigen (PSA) complete response regardless of upfront therapy.
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Affiliation(s)
| | - Jacqueline Theresa Brown
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute of Emory University, Atlanta, Georgia, USA
| | - Limeng Wan
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
| | - Yuan Liu
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
| | - Greta Russler
- Winship Cancer Institute of Emory University, Atlanta, Georgia, USA
| | - Lauren Yantorni
- Winship Cancer Institute of Emory University, Atlanta, Georgia, USA
| | - Sarah Caulfield
- Winship Cancer Institute of Emory University, Atlanta, Georgia, USA
| | - Jennifer Lafollette
- Grady Cancer Center for Excellence, Grady Memorial Hospital, Atlanta, Georgia, USA
| | - Melvin Moore
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.,Grady Cancer Center for Excellence, Grady Memorial Hospital, Atlanta, Georgia, USA
| | - Omer Kucuk
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.,Grady Cancer Center for Excellence, Grady Memorial Hospital, Atlanta, Georgia, USA
| | - Bradley Carthon
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.,Grady Cancer Center for Excellence, Grady Memorial Hospital, Atlanta, Georgia, USA
| | - Bassel Nazha
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.,Grady Cancer Center for Excellence, Grady Memorial Hospital, Atlanta, Georgia, USA
| | - Mehmet Asim Bilen
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.,Grady Cancer Center for Excellence, Grady Memorial Hospital, Atlanta, Georgia, USA
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4
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Sanli Y, Simsek DH, Sanli O, Subramaniam RM, Kendi AT. 177Lu-PSMA Therapy in Metastatic Castration-Resistant Prostate Cancer. Biomedicines 2021; 9:biomedicines9040430. [PMID: 33921146 PMCID: PMC8071500 DOI: 10.3390/biomedicines9040430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 12/25/2022] Open
Abstract
The aim of this narrative review is to evaluate the current status of 177Lu-PSMA (prostate specific membrane antigen) therapy for metastatic castration-resistant prostate cancer (mCRPC) in the light of the current literature. We also addressed patient preparation, therapy administration and side effect profiles. 177Lu-PSMA therapy efficacy was assessed by using prospective trials, meta-analyses and major retrospective trials. Predictors of efficacy were also mentioned. Although there are some different approaches regarding the use of 177Lu-PSMA therapy in different countries, this type of therapy is generally safe, with a low toxicity profile. From the oncological point of view, a PSA (prostate specific antigen) decline of ≥50% was seen in 10.6-69% of patients with mCRPC; whereas progression-free survival (PFS) was reported to be 3-13.7 months in different studies. Consequently, 177Lu-PSMA therapy is a promising treatment in patients with mCRPC, with good clinical efficacy, even in heavily pretreated patients with multiple lines of systemic therapy. Currently, there are ongoing clinical trials in the United States, including a phase III multicenter FDA registration trial.
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Affiliation(s)
- Yasemin Sanli
- Department of Nuclear Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (Y.S.); (D.H.S.)
| | - Duygu Has Simsek
- Department of Nuclear Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (Y.S.); (D.H.S.)
| | - Oner Sanli
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey;
| | - Rathan M. Subramaniam
- Dean’s Office, Otago Medical School, University of Otago, Dunedin 9054, New Zealand;
| | - Ayse Tuba Kendi
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
- Correspondence:
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Has Simsek D, Kuyumcu S, Karadogan S, Oflas M, Isik EG, Ozkan ZG, Paksoy N, Ekmekcioglu O, Ekenel M, Sanli Y. Can PSMA-based tumor burden predict response to docetaxel treatment in metastatic castration-resistant prostate cancer? Ann Nucl Med 2021; 35:680-90. [PMID: 33783752 DOI: 10.1007/s12149-021-01610-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/16/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE We investigated the role of PSMA-derived tumor burden in predicting docetaxel (DTX) therapy response in metastatic castration-resistant prostate cancer (mCRPC). METHODS Fifty-two mCRPC patients who received at least six cycles of DTX as the first-line treatment following 68Ga-PSMA PET/CT were enrolled in this retrospective study. Total PSMA-derived tumor volume (TV-PSMA) and total lesion PSMA activity (TL-PSMA) were derived from metastatic lesions. A ≥ 50% decline in PSA was defined as a response; a ≥ 25% increase in PSA was defined as progression. Univariate/multivariate logistic and cox regression analyses were performed to predict PSA response, OS, and TTP. RESULTS Twelve (23%) patients had PSA progression after chemotherapy, while 40 patients (77%) achieved a PSA response. On univariate analysis, a significant association was found between TV-PSMA (p = 0.001), TL-PSMA (p = 0.001), pre-PSA (p = 0.012), LDH (p = 0.003), Hg (p = 0.035), and PSA response to DTX. High TV-PSMA (> 107 cm3) (p = 0.04) and high LDH (> 234 U/L) (p = 0.017) were 8.2 times and 12.2 times more likely for DTX failure in multivariate regression analyses. The median TTP was 16 months, and the median OS was not reached. Patients with high TV-PSMA (p = 0.017), high TL-PSMA (> 1013 cm3) (p = 0.042), high age (> 70 years) (p = 0.016), and high LDH (p ≤ 0.001) had significantly shorter OS, while only high TV-PSMA (p = 0.038) and high age (p = 0.006) were significantly related with shorter TTP. High TV-PSMA (p = 0.017) and high age (p = 0.01) were significant predictors for shorter OS, while only high age (p = 0.006) was a significant predictor for shorter TTP in multivariate analysis. CONCLUSION Patients with high TV-PSMA had a significantly higher risk for DTX failure. PSMA-based tumor burden prior to DTX therapy seems to be a reliable predictive tool for survival in mCRPC patients.
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6
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Assi T, Ibrahim N, K Abboud RM, Kattan C, Rassy E, Nemr E, Kattan J. The management of patients with metastatic prostate cancer during the COVID-19 pandemic. Future Oncol 2020; 16:1455-1461. [PMID: 32412310 PMCID: PMC7426764 DOI: 10.2217/fon-2020-0361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
During the ongoing global pandemic of coronavirus disease 2019 (COVID-19), the benefit of treating patients with cancer must be weighed against the COVID-19 infection risks to patients, staff and society. Prostate cancer is one of the most common cancers among men and raises particular interest during the pandemic as recent reports show that the TMPRSS2 (and other serine proteases), which facilitate the entry, replication and budding of the virion from a cell, can be inhibited using androgen deprivation therapy. Nevertheless, patients with metastatic prostate cancer commonly receive chemotherapy which may compromise their immune system. This paper aims to address the current status of the COVID-19 in patients with cancer overall and suggests an optimal approach to patients with metastatic prostate cancer.
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Affiliation(s)
- Tarek Assi
- Department of Hematology-Oncology, Faculty of Medicine, Saint-Joseph University, Beirut, BP 17-5208, Lebanon
| | - Nathalie Ibrahim
- Department of Hematology-Oncology, Faculty of Medicine, Saint-Joseph University, Beirut, BP 17-5208, Lebanon
| | - Rita-Maria K Abboud
- Department of Hematology-Oncology, Faculty of Medicine, Saint-Joseph University, Beirut, BP 17-5208, Lebanon
| | - Clarisse Kattan
- Department of Hematology-Oncology, Faculty of Medicine, Saint-Joseph University, Beirut, BP 17-5208, Lebanon
| | - Elie Rassy
- Department of Hematology-Oncology, Faculty of Medicine, Saint-Joseph University, Beirut, BP 17-5208, Lebanon
| | - Elie Nemr
- Department of Urology, Faculty of Medicine, Saint-Joseph University, Beirut, BP 17-5208, Lebanon
| | - Joseph Kattan
- Department of Hematology-Oncology, Faculty of Medicine, Saint-Joseph University, Beirut, BP 17-5208, Lebanon
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7
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Assi T, Rassy E, Farhat F, Kattan C, Kattan J. Docetaxel Rechallenge in Patients with Metastatic Prostate Cancer: A Comprehensive Review. Oncol Res Treat 2020; 43:299-306. [PMID: 32380503 DOI: 10.1159/000506693] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 02/19/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Recent years have witnessed a huge shift in the management and prognosis of metastatic prostate cancer with the advent of new-generation anti-hormonal treatments. Docetaxel, which was initially approved in the castrate-resistant prostate cancer setting, has been approved in the earlier course of the disease as it is still castrate sensitive. SUMMARY Apart from cabazitaxel and in the absence of other effective chemotherapies, docetaxel rechallenge (DR) in patients with proved sensitivity to docetaxel in the earlier stage of the disease remains a possible option. Unfortunately, the pivotal trials rarely reported on the outcomes of docetaxel retreatment which seems a plausible option in patients initially responding to docetaxel and maintaining a minimum progression-free interval of 3-6 months. In this review, a summary of the clinical evidence and potential concerns for the use of DR in patients with metastatic prostate cancer will be presented. Key Messages: Pivotal trials of docetaxel in metastatic castrate-sensitive prostate cancer as well as metastatic castrate-resistant prostate cancer have not reported on the outcomes of DR except in the GETUG-AFU 15 trial where the outcomes were disappointing. Based on the published retrospective data, DR may be effective in patients who initially responded to docetaxel and maintained a progression-free interval exceeding 6 months.
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Affiliation(s)
- Tarek Assi
- Department of Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon, .,Oncology Department, Hammoud Hospital UMC, Saida, Lebanon,
| | - Elie Rassy
- Department of Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Fadi Farhat
- Department of Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.,Oncology Department, Hammoud Hospital UMC, Saida, Lebanon
| | - Clarisse Kattan
- Department of Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Joseph Kattan
- Department of Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
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Abstract
BACKGROUND Androgen deprivation therapy (ADT) alone has long been the standard of care in the treatment of metastatic prostate cancer (mCSPC). A paradigm shift in the treatment of patients with mCSPC has now been initiated by the results of three major phase 3 clinical trials (CHAARTED, STAMPEDE, LATITUDE): They demonstrated a significant advantage of ADT in combination with docetaxel or abiraterone/prednisone over ADT alone. OBJECTIVES This review presents the current evidence for the use of docetaxel or abiraterone/prednisone in combination with ADT and discusses-in the absence of directly comparing studies-which patients may have an advantage of ADT plus abiraterone/prednisone over ADT plus docetaxel or vice versa. METHODS A systematic review based on bibliographic literature search was conducted. RESULTS Both the combinations of ADT with docetaxel and with abiraterone/prednisone represent a major advance in the treatment of patients with mCSPC, in particular of patients with multiple metastases. Compared to chemotherapy, the use of abiraterone in addition to ADT avoids (rare) neutropenic complications and treatment-associated deaths. Long-term oral treatment with abiraterone/prednisone as a complementary therapy to ADT replaces short-term intravenous treatment (docetaxel). CONCLUSION In patients with mCSPC, ADT plus docetaxel or ADT plus abiraterone/prednisone is recommended. In particular in patients with pre-existing cardiovascular disease, ADT should be considered with a GnRH (gonadotropin-releasing hormone) antagonist to reduce the risk of cardiotoxic side effects.
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Affiliation(s)
- P Hammerer
- Klinik für Urologie und Uroonkologie, Städtisches Klinikum Braunschweig gGmbH, Salzdahlumer Str. 90, 38126, Braunschweig, Deutschland
| | - L Manka
- Klinik für Urologie und Uroonkologie, Städtisches Klinikum Braunschweig gGmbH, Salzdahlumer Str. 90, 38126, Braunschweig, Deutschland.
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9
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Tierney JF, Vale CL, Parelukar WR, Rydzewska L, Halabi S. Evidence Synthesis to Accelerate and Improve the Evaluation of Therapies for Metastatic Hormone-sensitive Prostate Cancer. Eur Urol Focus 2019; 5:137-43. [PMID: 30713089 DOI: 10.1016/j.euf.2019.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 12/21/2018] [Accepted: 01/07/2019] [Indexed: 12/23/2022]
Abstract
There are many ongoing randomised trials of promising therapies for metastatic hormone-sensitive prostate cancer (mHSPC), but standard systematic reviews may not synthesise these in a timely or reliable way. We demonstrate how a novel approach to evidence synthesis is being used to speed up and improve treatment evaluations for mHSPC. This more prospective, dynamic, and collaborative approach to systematic reviews of both trial results and individual participant data (IPD) is helping in establishing quickly and reliably which treatments are most effective and for which men. However, mHSPC is a complex disease and trials can be lengthy. Thus, parallel efforts will synthesise further IPD to identify early surrogate endpoints for overall survival and prognostic factors, to reduce the duration and improve the design of future trials. The STOPCAP M1 repository of IPD will be made available to other researchers for tackling new questions that might arise. The associated global, collaborative forum will aid strategic and harmonised development of the next generation of mHSPC trials (STOPCAP M1; http://www.stopcapm1.org). PATIENT SUMMARY: We report how a worldwide research effort will review results and anonymised data from advanced prostate cancer trials in new and different ways. We will work out, as quickly as possible, which advanced prostate cancer treatments are best and for which men. We will also find which measures of prostate cancer control and which cancer and patient characteristics can be used to shorten and improve trials of newer treatments. Finally, we describe how the data will help answer new questions about advanced prostate cancer and its treatments.
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10
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Purshouse K, Protheroe AS. Abiraterone acetate in combination with prednisone in the treatment of metastatic hormone-sensitive prostate cancer: clinical evidence and experience. Ther Adv Urol 2019; 11:1756287218820804. [PMID: 30671143 PMCID: PMC6329025 DOI: 10.1177/1756287218820804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 11/19/2018] [Indexed: 11/17/2022] Open
Abstract
More than a million men worldwide are diagnosed with prostate cancer every year. After androgen deprivation therapy (ADT), chemotherapy has been the only subsequent intervention to improve survival in the metastatic setting but has limitations for patients who may not tolerate its toxicity profile or are not candidates on the basis of comorbidities. Novel anti-androgens such as abiraterone acetate have shown promise for such patients. This review draws on clinical evidence and experience to identify abiraterone as a well-tolerated, effective alternative to docetaxel. In the castration-resistant setting, studies demonstrated a survival benefit over placebo, prompting further trials in the hormone-naïve population. More recently the STAMPEDE and LATITUDE studies suggest abiraterone has comparable survival outcomes to docetaxel in the castration-sensitive setting, with evidence in favour of its quality of life profile. Available comparisons with docetaxel are limited, but those available suggest they have comparable efficacy. However, the significant cost compared with docetaxel is a major barrier in resource-rationed healthcare settings. Overall, abiraterone is an effective alternative to chemotherapy for men with castration-sensitive prostate cancer, but this should be balanced with the significantly greater cost.
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Affiliation(s)
- Karin Purshouse
- Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Headington, Oxford, OX3 7LE, UK
| | - Andrew S Protheroe
- Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, UK
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11
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Francini E, Gray KP, Xie W, Shaw GK, Valença L, Bernard B, Albiges L, Harshman LC, Kantoff PW, Taplin ME, Sweeney CJ. Time of metastatic disease presentation and volume of disease are prognostic for metastatic hormone sensitive prostate cancer (mHSPC). Prostate 2018; 78:889-895. [PMID: 29707790 PMCID: PMC6171350 DOI: 10.1002/pros.23645] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 04/06/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Currently, there is no universally accepted prognostic classification for patients (pts) with metastatic hormone sensitive prostate cancer (mHSPC) treated with androgen deprivation therapy (ADT). Subgroup analyses demonstrated that pts with low volume (LV), per CHAARTED trial definition, mHSPC, and those who relapse after prior local therapy (PLT) have longer overall survival (OS) compared to high volume (HV) and de-novo (DN), respectively. Using a hospital-based registry, we aimed to assess whether a classification based on time of metastatic disease (PLT vs DN) and disease volume (LV vs HV) are prognostic for mHSPC pts treated with ADT. METHODS A retrospective cohort of consecutive patients with mHSPC treated with ADT between 1990 and 2013 was selected from the prospectively collected Dana-Farber Cancer Institute database and categorized as DN or PLT and HV or LV, at time of ADT start. Primary and secondary endpoints were OS and time to castration-resistant prostate cancer (CRPC), respectively, which were measured from date of ADT start using Kaplan-Meier method. Multivariable Cox proportional hazards models using known prognostic factors was used. RESULTS The analytical cohort consisted of 436 patients. The median OS and time to CRPC for PLT/LV were 92.4 (95%CI: 80.4-127.2) and 25.6 (95%CI: 21-35.7) months and 43.2 (95%CI: 37.2-56.4) and 12.2 (95%CI: 9.8-14.8) months for DN/HV, respectively, whereas intermediate values were observed for PLT/HV and DN/LV. A robust gradient for both outcomes was observed (Trend test P < 0.0001) in the four groups. In a multivariable analysis, DN presentation, HV, and cancer-related pain were independent prognostic factors. CONCLUSIONS In our hospital-based registry, time of metastatic presentation and disease volume were prognostic for mHSPC pts treated with ADT. This simple prognostic classification system can aid patient counseling and future trial design.
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Affiliation(s)
- Edoardo Francini
- Dana-Farber Cancer Institute, Lank Center for Genitourinary Oncology, Boston, Massachusetts
- Sapienza University of Rome, Rome, Italy
| | - Kathryn P Gray
- Dana-Farber Cancer Institute, Lank Center for Genitourinary Oncology, Boston, Massachusetts
| | - Wanling Xie
- Dana-Farber Cancer Institute, Lank Center for Genitourinary Oncology, Boston, Massachusetts
| | - Grace K Shaw
- Dana-Farber Cancer Institute, Lank Center for Genitourinary Oncology, Boston, Massachusetts
| | | | | | | | - Lauren C Harshman
- Dana-Farber Cancer Institute, Lank Center for Genitourinary Oncology, Boston, Massachusetts
| | | | - Mary-Ellen Taplin
- Dana-Farber Cancer Institute, Lank Center for Genitourinary Oncology, Boston, Massachusetts
| | - Cristopher J Sweeney
- Dana-Farber Cancer Institute, Lank Center for Genitourinary Oncology, Boston, Massachusetts
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Hadaschik B, Panic A. Neue Therapieoption – Apalutamid beim nicht fernmetastasierten kastrationsresistenten Prostatakarzinom. Urologe A 2018; 57:729-730. [DOI: 10.1007/s00120-018-0669-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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13
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Hahn AW, Higano CS, Taplin ME, Ryan CJ, Agarwal N. Metastatic Castration-Sensitive Prostate Cancer: Optimizing Patient Selection and Treatment. Am Soc Clin Oncol Educ Book 2018; 38:363-371. [PMID: 30231388 DOI: 10.1200/edbk_200967] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The treatment landscape for metastatic castration-sensitive prostate cancer (mCSPC) has rapidly evolved over the past 5 years. Although androgen-deprivation therapy (ADT) is still the backbone of treatment, the addition of docetaxel or abiraterone acetate has improved outcomes for patients with mCSPC and become standard of care. With multiple treatment options available for patients with mCSPC, treatment selection to optimize patient outcomes has become increasingly difficult. Here, we review the clinical trials involving ADT plus docetaxel or abiraterone and provide clinicians with guidelines for treatment. Although surgery and/or radiation are standard of care for localized, intermediate- and high-risk prostate cancer, these treatments are not routinely used as part of initial treatment plans for patients with de novo mCSPC. Recent clinical data are challenging that dogma, and we review the literature on the addition of surgery and radiation to systemic therapy for mCSPC. Finally, the standard of care for oligometastatic prostate cancer (a subset of mCSPC with limited metastases) has not been established compared with that for some other cancers. We discuss the recent studies on metastasis-directed therapy for treatment of oligometastatic prostate cancer.
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Affiliation(s)
- Andrew W Hahn
- From the Division of Oncology, University of Utah/Huntsman Cancer Institute, Salt Lake City, UT; Division of Oncology, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA; Division of Hematology/Oncology, University of California-San Francisco, Helen Diller Comprehensive Cancer Center, San Francisco, CA
| | - Celestia S Higano
- From the Division of Oncology, University of Utah/Huntsman Cancer Institute, Salt Lake City, UT; Division of Oncology, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA; Division of Hematology/Oncology, University of California-San Francisco, Helen Diller Comprehensive Cancer Center, San Francisco, CA
| | - Mary-Ellen Taplin
- From the Division of Oncology, University of Utah/Huntsman Cancer Institute, Salt Lake City, UT; Division of Oncology, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA; Division of Hematology/Oncology, University of California-San Francisco, Helen Diller Comprehensive Cancer Center, San Francisco, CA
| | - Charles J Ryan
- From the Division of Oncology, University of Utah/Huntsman Cancer Institute, Salt Lake City, UT; Division of Oncology, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA; Division of Hematology/Oncology, University of California-San Francisco, Helen Diller Comprehensive Cancer Center, San Francisco, CA
| | - Neeraj Agarwal
- From the Division of Oncology, University of Utah/Huntsman Cancer Institute, Salt Lake City, UT; Division of Oncology, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA; Division of Hematology/Oncology, University of California-San Francisco, Helen Diller Comprehensive Cancer Center, San Francisco, CA
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Morris MJ, Rumble RB, Basch E, Hotte SJ, Loblaw A, Rathkopf D, Celano P, Bangs R, Milowsky MI. Optimizing Anticancer Therapy in Metastatic Non-Castrate Prostate Cancer: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol 2018; 36:1521-1539. [DOI: 10.1200/jco.2018.78.0619] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose This clinical practice guideline addresses abiraterone or docetaxel with androgen-deprivation therapy (ADT) for metastatic prostate cancer that has not been treated (or has been minimally treated) with testosterone-lowering agents. Methods Standard therapy for newly diagnosed metastatic prostate cancer has been ADT alone. Three studies have compared ADT alone with ADT and docetaxel, and two studies have compared ADT alone with ADT and abiraterone. Results Three prospective randomized studies (GETUG-AFU 15, STAMPEDE, and CHAARTED) examined overall survival (OS) with adding docetaxel to ADT. STAMPEDE and CHAARTED favored docetaxel (hazard ratio [HR], 0.78; 95% CI, 0.66 to 0.93; n = 2,962 and HR, 0.73; 95% CI, 0.59 to 0.89; n = 790, respectively). GETUG-AFU 15 was negative. LATITUDE and STAMPEDE examined the impact on OS of adding abiraterone (with prednisone or prednisolone) to ADT. LATITUDE and STAMPEDE favored abiraterone (HR, 0.62; 95% CI, 0.51 to 0.76; n = 1,199 and HR, 0.63; 95% CI, 0.52 to 0.76; n = 1,917, respectively). Recommendations ADT plus docetaxel or abiraterone in newly diagnosed metastatic non-castrate prostate cancer offers a survival benefit as compared with ADT alone. The strongest evidence of benefit with docetaxel is in men with de novo high-volume (CHAARTED criteria) metastatic disease. Similar survival benefits are seen using abiraterone acetate in high-risk patients (LATITUDE criteria) and in the metastatic population in STAMPEDE. ADT plus abiraterone and ADT plus docetaxel have not been compared, and it is not known if some men benefit more from one regimen as opposed to the other. Fitness for chemotherapy, patient comorbidities, toxicity profiles, quality of life, drug availability, and cost should be considered in this decision. Additional information is available at www.asco.org/genitourinary-cancer-guidelines .
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Affiliation(s)
- Michael J. Morris
- Michael J. Morris and Dana Rathkopf, Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, New York, NY; R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Ethan Basch and Matthew I. Milowsky, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; Sebastien J. Hotte, Juravinski Cancer Centre, Hamilton; Andrew Loblaw, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada; Paul Celano, Greater Baltimore Medical Center, Towson, MD; and
| | - R. Bryan Rumble
- Michael J. Morris and Dana Rathkopf, Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, New York, NY; R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Ethan Basch and Matthew I. Milowsky, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; Sebastien J. Hotte, Juravinski Cancer Centre, Hamilton; Andrew Loblaw, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada; Paul Celano, Greater Baltimore Medical Center, Towson, MD; and
| | - Ethan Basch
- Michael J. Morris and Dana Rathkopf, Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, New York, NY; R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Ethan Basch and Matthew I. Milowsky, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; Sebastien J. Hotte, Juravinski Cancer Centre, Hamilton; Andrew Loblaw, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada; Paul Celano, Greater Baltimore Medical Center, Towson, MD; and
| | - Sebastien J. Hotte
- Michael J. Morris and Dana Rathkopf, Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, New York, NY; R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Ethan Basch and Matthew I. Milowsky, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; Sebastien J. Hotte, Juravinski Cancer Centre, Hamilton; Andrew Loblaw, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada; Paul Celano, Greater Baltimore Medical Center, Towson, MD; and
| | - Andrew Loblaw
- Michael J. Morris and Dana Rathkopf, Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, New York, NY; R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Ethan Basch and Matthew I. Milowsky, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; Sebastien J. Hotte, Juravinski Cancer Centre, Hamilton; Andrew Loblaw, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada; Paul Celano, Greater Baltimore Medical Center, Towson, MD; and
| | - Dana Rathkopf
- Michael J. Morris and Dana Rathkopf, Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, New York, NY; R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Ethan Basch and Matthew I. Milowsky, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; Sebastien J. Hotte, Juravinski Cancer Centre, Hamilton; Andrew Loblaw, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada; Paul Celano, Greater Baltimore Medical Center, Towson, MD; and
| | - Paul Celano
- Michael J. Morris and Dana Rathkopf, Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, New York, NY; R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Ethan Basch and Matthew I. Milowsky, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; Sebastien J. Hotte, Juravinski Cancer Centre, Hamilton; Andrew Loblaw, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada; Paul Celano, Greater Baltimore Medical Center, Towson, MD; and
| | - Rick Bangs
- Michael J. Morris and Dana Rathkopf, Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, New York, NY; R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Ethan Basch and Matthew I. Milowsky, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; Sebastien J. Hotte, Juravinski Cancer Centre, Hamilton; Andrew Loblaw, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada; Paul Celano, Greater Baltimore Medical Center, Towson, MD; and
| | - Matthew I. Milowsky
- Michael J. Morris and Dana Rathkopf, Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, New York, NY; R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Ethan Basch and Matthew I. Milowsky, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; Sebastien J. Hotte, Juravinski Cancer Centre, Hamilton; Andrew Loblaw, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada; Paul Celano, Greater Baltimore Medical Center, Towson, MD; and
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Abstract
PURPOSE OF REVIEW Upfront docetaxel and androgen deprivation therapy (ADT) has improved outcomes over ADT alone in men with metastatic hormone-sensitive prostate cancer (mHSPC). Here in, we review the emerging role of novel androgen axis inhibitors in the treatment of men with mHSPC. RECENT FINDINGS Recently two studies, LATITUDE and STAMPEDE arm G, showed improved survival with addition of abiraterone acetate with prednisone or prednisolone to ADT in men with hormone-naïve advanced prostate cancer. SUMMARY Upfront docetaxel in addition to ADT has been shown to improve survival outcomes in men with high-volume mHSPC. Recently, abiraterone acetate and prednisone or prednisolone and ADT have been shown to improve survival outcomes compared with ADT alone in men with mHSPC. Multiple other novel androgen axis inhibitors are being investigated in this setting, and expected to garner regulatory approval in the near future. Biomarkers predicting response to these agents are urgently needed to optimize treatment selection, not only to improve outcomes but to also minimize cost and toxicities.
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Morris MJ, Rumble RB, Milowsky MI. Optimizing Anticancer Therapy in Metastatic Non-Castrate Prostate Cancer: ASCO Clinical Practice Guideline Summary. J Oncol Pract 2018; 14:319-322. [DOI: 10.1200/jop.18.00075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Michael J. Morris
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, New York, NY; ASCO, Alexandria, VA; and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - R. Bryan Rumble
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, New York, NY; ASCO, Alexandria, VA; and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Matthew I. Milowsky
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, New York, NY; ASCO, Alexandria, VA; and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
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Lavaud P, Gravis G, Foulon S, Joly F, Oudard S, Priou F, Latorzeff I, Mourey L, Soulié M, Delva R, Krakowski I, Laguerre B, Théodore C, Ferrero JM, Beuzeboc P, Habibian M, Rolland F, Deplanque G, Pouessel D, Zanetta S, Berdah JF, Dauba J, Baciuchka M, Platini C, Linassier C, Tubiana-Mathieu N, Machiels JP, Kouri CE, Ravaud A, Suc E, Eymard JC, Hasbini A, Bousquet G, Culine S, Boher JM, Tergemina-Clain G, Legoupil C, Fizazi K. Anticancer Activity and Tolerance of Treatments Received Beyond Progression in Men Treated Upfront with Androgen Deprivation Therapy With or Without Docetaxel for Metastatic Castration-naïve Prostate Cancer in the GETUG-AFU 15 Phase 3 Trial. Eur Urol 2018; 73:696-703. [DOI: 10.1016/j.eururo.2017.09.022] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 09/19/2017] [Indexed: 12/19/2022]
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Morgans AK, Chen YH, Sweeney CJ, Jarrard DF, Plimack ER, Gartrell BA, Carducci MA, Hussain M, Garcia JA, Cella D, DiPaola RS, Patrick-Miller LJ. Quality of Life During Treatment With Chemohormonal Therapy: Analysis of E3805 Chemohormonal Androgen Ablation Randomized Trial in Prostate Cancer. J Clin Oncol 2018; 36:1088-1095. [PMID: 29522362 PMCID: PMC5891128 DOI: 10.1200/jco.2017.75.3335] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Purpose Chemohormonal therapy with docetaxel and androgen deprivation therapy (ADT+D) for metastatic hormone-sensitive prostate cancer improves overall survival as compared with androgen deprivation therapy (ADT) alone. We compared the quality of life (QOL) between patients with metastatic hormone-sensitive prostate cancer who were treated with ADT+D and those who were treated with ADT alone. Methods Men were randomly assigned to ADT+ D (six cycles) or to ADT alone. QOL was assessed by Functional Assessment of Cancer Therapy-Prostate (FACT-P), FACT-Taxane, Functional Assessment of Chronic Illness Therapy-Fatigue, and the Brief Pain Inventory at baseline and at 3, 6, 9, and 12 months. The Wilcoxon signed rank test was used to examine changes over time. Mixed-effect models compared the QOL between arms at each time point. Results Seven hundred ninety men were randomly assigned (ADT+D [n = 397] and ADT[ n = 393]) and completed FACT-P (90% at baseline, 86% at 3 months, 83% at 6 months, 78% at 9 months, and 77% at 12 months). ADT+D patients reported a statistically significant decline in FACT-P at 3 months ( P < .001) but FACT-P did not differ significantly between baseline and 12 months ( P = .38). ADT+D FACT-P scores were significantly lower at 3 months ( P = .02) but significantly higher at 12 months ( P = .04) when compared with ADT FACT-P scores. Differences did not exceed the minimal clinically important difference at any time point. ADT+D patients reported significantly lower Functional Assessment of Chronic Illness Therapy-Fatigue scores at 3 months than did ADT patients ( P < .001). Over time, both arms reported significantly poorer FACT-Taxane scores ( P < .001) when compared with baseline. Brief Pain Inventory scores were similar between arms. Conclusion Although ADT+D was associated with statistically worse QOL at 3 months, QOL was better at 12 months for ADT+D patients than for ADT patients. Both arms reported a similar minimally changed QOL over time, suggesting that ADT+D is not associated with a greater long-term negative impact on QOL.
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Affiliation(s)
- Alicia K. Morgans
- Alicia K. Morgans, Maha Hussain, and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Yu-Hui Chen and Christopher J. Sweeney, Dana Farber Cancer Institute, Boston, MA; David F. Jarrard, University of Wisconsin Hospital and Clinics, Madison, WI; Elizabeth R. Plimack, Fox Chase Cancer Center, Philadelphia, PA; Elizabeth R. Plimack and Benjamin A. Gartrell, Montefiore Medical Center, Bronx, NY; Michael A. Carducci, Johns Hopkins University, Baltimore, MD; Jorge A. Garcia, Cleveland Clinic, Cleveland, OH; Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY; and Linda J. Patrick-Miller, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ.,Corresponding author: Alicia K. Morgans, MD, MPH, Department of Medicine, Division of Hematology/Oncology, Northwestern University Feinberg School of Medicine, NMH/Arkes Family Pavilion, 676 N St Clair St, Suite 850, Chicago, IL 60611; e-mail:
| | - Yu-Hui Chen
- Alicia K. Morgans, Maha Hussain, and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Yu-Hui Chen and Christopher J. Sweeney, Dana Farber Cancer Institute, Boston, MA; David F. Jarrard, University of Wisconsin Hospital and Clinics, Madison, WI; Elizabeth R. Plimack, Fox Chase Cancer Center, Philadelphia, PA; Elizabeth R. Plimack and Benjamin A. Gartrell, Montefiore Medical Center, Bronx, NY; Michael A. Carducci, Johns Hopkins University, Baltimore, MD; Jorge A. Garcia, Cleveland Clinic, Cleveland, OH; Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY; and Linda J. Patrick-Miller, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Christopher J. Sweeney
- Alicia K. Morgans, Maha Hussain, and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Yu-Hui Chen and Christopher J. Sweeney, Dana Farber Cancer Institute, Boston, MA; David F. Jarrard, University of Wisconsin Hospital and Clinics, Madison, WI; Elizabeth R. Plimack, Fox Chase Cancer Center, Philadelphia, PA; Elizabeth R. Plimack and Benjamin A. Gartrell, Montefiore Medical Center, Bronx, NY; Michael A. Carducci, Johns Hopkins University, Baltimore, MD; Jorge A. Garcia, Cleveland Clinic, Cleveland, OH; Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY; and Linda J. Patrick-Miller, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - David F. Jarrard
- Alicia K. Morgans, Maha Hussain, and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Yu-Hui Chen and Christopher J. Sweeney, Dana Farber Cancer Institute, Boston, MA; David F. Jarrard, University of Wisconsin Hospital and Clinics, Madison, WI; Elizabeth R. Plimack, Fox Chase Cancer Center, Philadelphia, PA; Elizabeth R. Plimack and Benjamin A. Gartrell, Montefiore Medical Center, Bronx, NY; Michael A. Carducci, Johns Hopkins University, Baltimore, MD; Jorge A. Garcia, Cleveland Clinic, Cleveland, OH; Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY; and Linda J. Patrick-Miller, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Elizabeth R. Plimack
- Alicia K. Morgans, Maha Hussain, and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Yu-Hui Chen and Christopher J. Sweeney, Dana Farber Cancer Institute, Boston, MA; David F. Jarrard, University of Wisconsin Hospital and Clinics, Madison, WI; Elizabeth R. Plimack, Fox Chase Cancer Center, Philadelphia, PA; Elizabeth R. Plimack and Benjamin A. Gartrell, Montefiore Medical Center, Bronx, NY; Michael A. Carducci, Johns Hopkins University, Baltimore, MD; Jorge A. Garcia, Cleveland Clinic, Cleveland, OH; Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY; and Linda J. Patrick-Miller, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Benjamin A. Gartrell
- Alicia K. Morgans, Maha Hussain, and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Yu-Hui Chen and Christopher J. Sweeney, Dana Farber Cancer Institute, Boston, MA; David F. Jarrard, University of Wisconsin Hospital and Clinics, Madison, WI; Elizabeth R. Plimack, Fox Chase Cancer Center, Philadelphia, PA; Elizabeth R. Plimack and Benjamin A. Gartrell, Montefiore Medical Center, Bronx, NY; Michael A. Carducci, Johns Hopkins University, Baltimore, MD; Jorge A. Garcia, Cleveland Clinic, Cleveland, OH; Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY; and Linda J. Patrick-Miller, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Michael A. Carducci
- Alicia K. Morgans, Maha Hussain, and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Yu-Hui Chen and Christopher J. Sweeney, Dana Farber Cancer Institute, Boston, MA; David F. Jarrard, University of Wisconsin Hospital and Clinics, Madison, WI; Elizabeth R. Plimack, Fox Chase Cancer Center, Philadelphia, PA; Elizabeth R. Plimack and Benjamin A. Gartrell, Montefiore Medical Center, Bronx, NY; Michael A. Carducci, Johns Hopkins University, Baltimore, MD; Jorge A. Garcia, Cleveland Clinic, Cleveland, OH; Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY; and Linda J. Patrick-Miller, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Maha Hussain
- Alicia K. Morgans, Maha Hussain, and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Yu-Hui Chen and Christopher J. Sweeney, Dana Farber Cancer Institute, Boston, MA; David F. Jarrard, University of Wisconsin Hospital and Clinics, Madison, WI; Elizabeth R. Plimack, Fox Chase Cancer Center, Philadelphia, PA; Elizabeth R. Plimack and Benjamin A. Gartrell, Montefiore Medical Center, Bronx, NY; Michael A. Carducci, Johns Hopkins University, Baltimore, MD; Jorge A. Garcia, Cleveland Clinic, Cleveland, OH; Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY; and Linda J. Patrick-Miller, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Jorge A. Garcia
- Alicia K. Morgans, Maha Hussain, and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Yu-Hui Chen and Christopher J. Sweeney, Dana Farber Cancer Institute, Boston, MA; David F. Jarrard, University of Wisconsin Hospital and Clinics, Madison, WI; Elizabeth R. Plimack, Fox Chase Cancer Center, Philadelphia, PA; Elizabeth R. Plimack and Benjamin A. Gartrell, Montefiore Medical Center, Bronx, NY; Michael A. Carducci, Johns Hopkins University, Baltimore, MD; Jorge A. Garcia, Cleveland Clinic, Cleveland, OH; Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY; and Linda J. Patrick-Miller, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - David Cella
- Alicia K. Morgans, Maha Hussain, and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Yu-Hui Chen and Christopher J. Sweeney, Dana Farber Cancer Institute, Boston, MA; David F. Jarrard, University of Wisconsin Hospital and Clinics, Madison, WI; Elizabeth R. Plimack, Fox Chase Cancer Center, Philadelphia, PA; Elizabeth R. Plimack and Benjamin A. Gartrell, Montefiore Medical Center, Bronx, NY; Michael A. Carducci, Johns Hopkins University, Baltimore, MD; Jorge A. Garcia, Cleveland Clinic, Cleveland, OH; Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY; and Linda J. Patrick-Miller, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Robert S. DiPaola
- Alicia K. Morgans, Maha Hussain, and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Yu-Hui Chen and Christopher J. Sweeney, Dana Farber Cancer Institute, Boston, MA; David F. Jarrard, University of Wisconsin Hospital and Clinics, Madison, WI; Elizabeth R. Plimack, Fox Chase Cancer Center, Philadelphia, PA; Elizabeth R. Plimack and Benjamin A. Gartrell, Montefiore Medical Center, Bronx, NY; Michael A. Carducci, Johns Hopkins University, Baltimore, MD; Jorge A. Garcia, Cleveland Clinic, Cleveland, OH; Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY; and Linda J. Patrick-Miller, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Linda J. Patrick-Miller
- Alicia K. Morgans, Maha Hussain, and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Yu-Hui Chen and Christopher J. Sweeney, Dana Farber Cancer Institute, Boston, MA; David F. Jarrard, University of Wisconsin Hospital and Clinics, Madison, WI; Elizabeth R. Plimack, Fox Chase Cancer Center, Philadelphia, PA; Elizabeth R. Plimack and Benjamin A. Gartrell, Montefiore Medical Center, Bronx, NY; Michael A. Carducci, Johns Hopkins University, Baltimore, MD; Jorge A. Garcia, Cleveland Clinic, Cleveland, OH; Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY; and Linda J. Patrick-Miller, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
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Francini E, Yip S, Ahmed S, Li H, Ardolino L, Evan CP, Kaymakcalan M, Shaw GK, Kantoff PW, Taplin ME, Alimohamed NS, Joshua AM, Heng DYC, Sweeney CJ. Clinical Outcomes of First-line Abiraterone Acetate or Enzalutamide for Metastatic Castration-resistant Prostate Cancer After Androgen Deprivation Therapy + Docetaxel or ADT Alone for Metastatic Hormone-sensitive Prostate Cancer. Clin Genitourin Cancer 2018; 16:130-134. [PMID: 29331381 PMCID: PMC5986287 DOI: 10.1016/j.clgc.2017.12.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 12/17/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND The CHAARTED (ChemoHormonal Therapy Versus Androgen Ablation Randomized Trial for Extensive Disease in Prostate Cancer) and STAMPEDE (Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy) trials showed that the addition of docetaxel (D) to androgen deprivation therapy (ADT) prolonged longevity of men with metastatic hormone-sensitive prostate cancer (mHSPC). However, the impact of upfront D on subsequent therapies is still unexplored. As abiraterone acetate (AA) and enzalutamide (E) are the most commonly used first-line treatment for metastatic castration-resistant prostate cancer (mCRPC), we aimed to assess whether they maintained their efficacy after ADT+D versus ADT alone. PATIENTS AND METHODS A cohort of patients with mCRPC treated between 2014 and 2017 with first-line AA or E for mCRPC was identified from 3 hospitals' institutional review board-approved databases. Patients were classified by use of D for mHSPC. This time frame was chosen as ADT+D became a valid therapeutic option for mHSPC in 2014, and it inherently entailed a short follow-up time on AA/E. The endpoints included overall survival from ADT start, overall survival from AA/E start, and time to AA/E start from ADT start. Differences between groups were assessed using the log-rank test. RESULTS Of the 102 patients with mCRPC identified, 50 (49%) had previously received ADT alone, while 52 (51%) had ADT+D. No statistically significant difference in any of the evaluated outcomes was observed between the 2 cohorts. Yet, deaths in the ADT+D group were 12 versus 21 in the ADT alone, after a median follow-up of 24.4 and 29.8 months, respectively. CONCLUSION In a cohort of ADT/ADT+D-treated patients with mCRPC with short times to first-line AA/E and follow-up, the efficacy of AA/E is similar regardless of previous use of D.
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Affiliation(s)
- Edoardo Francini
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Sapienza Università di Roma, Rome, Italy
| | - Steven Yip
- Tom Baker Cancer Centre, Calgary, AB, Canada
| | | | - Haocheng Li
- Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | | | - Carolyn P Evan
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | | | - Grace K Shaw
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
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Komura K, Sweeney CJ, Inamoto T, Ibuki N, Azuma H, Kantoff PW. Current treatment strategies for advanced prostate cancer. Int J Urol 2018; 25:220-231. [PMID: 29266472 PMCID: PMC6053280 DOI: 10.1111/iju.13512] [Citation(s) in RCA: 141] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 11/09/2017] [Indexed: 12/18/2022]
Abstract
During the past decade, treatment strategies for patients with advanced prostate cancer involving stage IV (T4N0M0, N1M0 or M1) hormone-sensitive prostate cancer and recurrent prostate cancer after treatment with curative intent, as well as castration-resistant prostate cancer, have extensively evolved with the introduction and approval of several new agents including sipuleucel-T, radium-223, abiraterone, enzalutamide and cabazitaxel, all of which have shown significant improvement on overall survival. The appropriate use of these agents and the proper sequencing of these agents are still not optimized. The results of several recently reported randomized controlled trials and retrospective studies could assist in developing a treatment strategy for advanced prostate cancer. In addition, prospective studies and molecular characterization of tumors to address these issues are ongoing.
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Affiliation(s)
- Kazumasa Komura
- Department of Urology, Osaka Medical College, Takatsuki, Osaka, Japan
| | | | - Teruo Inamoto
- Department of Urology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Naokazu Ibuki
- Department of Urology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Haruhito Azuma
- Department of Urology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Philip W. Kantoff
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Harshman LC, Chen YH, Liu G, Carducci MA, Jarrard D, Dreicer R, Hahn N, Garcia JA, Hussain M, Shevrin D, Eisenberger M, Kohli M, Plimack ER, Cooney M, Vogelzang NJ, Picus J, Dipaola R, Sweeney CJ. Seven-Month Prostate-Specific Antigen Is Prognostic in Metastatic Hormone-Sensitive Prostate Cancer Treated With Androgen Deprivation With or Without Docetaxel. J Clin Oncol 2018; 36:376-382. [PMID: 29261442 PMCID: PMC5805480 DOI: 10.1200/jco.2017.75.3921] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose We evaluated the relationship between prostate-specific antigen (PSA) and overall survival in the context of a prospectively randomized clinical trial comparing androgen-deprivation therapy (ADT) plus docetaxel with ADT alone for initial metastatic hormone-sensitive prostate cancer. Methods We performed a landmark survival analysis at 7 months using the E3805 Chemohormonal Therapy Versus Androgen Ablation Randomized Trial for Extensive Disease in Prostate Cancer (CHAARTED) database ( ClinicalTrials.gov identifier: NCT00309985). Inclusion required at least 7 months of follow-up and PSA levels at 7 months from ADT initiation. We used the prognostic classifiers identified in a previously reported trial (Southwest Oncology Group 9346) of PSA ≤ 0.2, > 0.2 to 4, and > 4 ng/mL. Results Seven hundred nineteen of 790 patients were eligible for this subanalysis; 358 were treated with ADT plus docetaxel, and 361 were treated with ADT alone. Median follow-up time was 23.1 months. On multivariable analysis, achieving a 7-month PSA ≤ 0.2 ng/mL was more likely with docetaxel, low-volume disease, prior local therapy, and lower baseline PSAs (all P ≤ .01). Across all patients, median overall survival was significantly longer if 7-month PSA reached ≤ 0.2 ng/mL compared with > 4 ng/mL (median survival, 60.4 v 22.2 months, respectively; P < .001). On multivariable analysis, 7-month PSA ≤ 0.2 and low volume disease were prognostic of longer overall survival (all P < 0.01). The addition of docetaxel increased the likelihood of achieving a PSA ≤ 0.2 ng/mL at 7 months (45.3% v 28.8% of patients on ADT alone). Patients on ADT alone who achieved a 7-month PSA ≤ 0.2 ng/mL had the best survival and were more likely to have low-volume disease (56.7%). Conclusion PSA ≤ 0.2 ng/mL at 7 months is prognostic for longer overall survival with ADT for metastatic hormone-sensitive prostate cancer irrespective of docetaxel administration. Adding docetaxel increased the likelihood of a lower PSA and improved survival.
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Affiliation(s)
- Lauren C. Harshman
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Yu-Hui Chen
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Glenn Liu
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Michael A. Carducci
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - David Jarrard
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Robert Dreicer
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Noah Hahn
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Jorge A. Garcia
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Maha Hussain
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Daniel Shevrin
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Mario Eisenberger
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Manish Kohli
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Elizabeth R. Plimack
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Matthew Cooney
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Nicholas J. Vogelzang
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Joel Picus
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Robert Dipaola
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Christopher J. Sweeney
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - on behalf of the ECOG-ACRIN 3805 Investigators
- Lauren C. Harshman and Christopher J. Sweeney, Dana-Farber Cancer Institute, Harvard Medical School; Yu-Hui Chen, Dana-Farber Cancer Institute, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, Boston, MA; Glenn Liu and David Jarrard, University of Wisconsin School of Medicine and Public Health and Carbone Cancer Center, Madison, WI; Michael A. Carducci, Noah Hahn, and Mario Eisenberger, Johns Hopkins University, Baltimore, MD; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute; Matthew Cooney, University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago; Daniel Shevrin, NorthShore University Health System, Evanston, IL; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; and Robert Dipaola, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
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Abstract
In the contemporary scene, less than 5% of men with newly diagnosed prostate cancer (PC) have metastases at first presentation, compared to 20-25%, more than 20 years ago. Nonetheless, the use of androgen deprivation therapy (ADT) has increased over the years, suggesting that patients in Europe and United States may receive ADT in cases of lower disease burden, and not always according to evidence based indications. Nonetheless, PC remains the second most common cause of cancer death after lung cancer in American men. Thus, there is a need for more effective, specific and well tolerated agents which can provide a longer and good quality of life while avoiding the side effects related to disease and treatment morbidity.After mentioning the current knowledge on the endocrinology of androgens and androgen receptor, relevant to PC development, as well as the possible events occurring during PC initiation, we will compare different hormonal compounds available for the treatment of PC, both from a pharmacological standpoint, and in terms of contemporary clinical indications.
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Affiliation(s)
- Vincenzo Pagliarulo
- Department of Urology, University "Aldo Moro", Bari, Italy. .,Azienda Ospedaliero-Universitaria Policlinico, Bari, Italy.
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McNamara M, Sweeney C, Antonarakis ES, Armstrong AJ. The evolving landscape of metastatic hormone-sensitive prostate cancer: a critical review of the evidence for adding docetaxel or abiraterone to androgen deprivation. Prostate Cancer Prostatic Dis 2017; 21:306-318. [PMID: 29263421 DOI: 10.1038/s41391-017-0014-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 09/29/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND Until 2015, androgen deprivation therapy (ADT) alone was the standard-of-care for metastatic hormone-sensitive prostate cancer (mHSPC). In 2015, the CHAARTED and STAMPEDE-Docetaxel studies demonstrated marked survival benefit with the addition of docetaxel to ADT in the mHSPC setting, leading to a change in the standard-of-care for mHSPC. The recent LATITUDE and STAMPEDE-Abiraterone trials showed similar substantial improvement in survival with the addition of abiraterone plus prednisone to ADT in this space. METHODS We conducted a review of the randomized phase III studies that have investigated either the addition of docetaxel or abiraterone to ADT in patients with mHSPC. RESULTS We describe the study designs, key eligibility criteria, and key results for the CHAARTED, STAMPEDE-Docetaxel, GETUG-AFU 15, LATITUDE, and STAMPEDE-Abiraterone clinical trials. We compare the data for abiraterone/prednisone plus ADT in mHSPC with the evidence for docetaxel plus ADT in these patients. Finally, we discuss several factors that should be considered when choosing between docetaxel/ADT or abiraterone/prednisone/ADT in mHSPC. CONCLUSIONS The management of mHSPC is evolving. Abiraterone plus prednisone in addition to ADT has emerged as an alternative standard-of-care to docetaxel plus ADT, and ongoing trials should clarify whether combination vs. sequential approaches with AR-targeting agents and taxane chemotherapy are preferred for initial management in the hormone-sensitive setting.
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Affiliation(s)
- Megan McNamara
- Duke University Medical Center and Cancer Institute, Duke Prostate and Urologic Cancer Center, Durham, NC, 27710, USA.
| | - Christopher Sweeney
- Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, 02215, USA
| | | | - Andrew J Armstrong
- Duke University Medical Center and Cancer Institute, Duke Prostate and Urologic Cancer Center, Durham, NC, 27710, USA
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Marino P, Sfumato P, Joly F, Fizazi K, Oudard S, Culine S, Habibian M, Boher JM, Gravis G. Q-TWiST analysis of patients with metastatic castrate naive prostate cancer treated by androgen deprivation therapy with or without docetaxel in the randomised phase III GETUG-AFU 15 trial. Eur J Cancer 2017; 84:27-33. [DOI: 10.1016/j.ejca.2017.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 07/10/2017] [Indexed: 10/19/2022]
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Fizazi K, Tran N, Fein L, Matsubara N, Rodriguez-Antolin A, Alekseev BY, Özgüroğlu M, Ye D, Feyerabend S, Protheroe A, De Porre P, Kheoh T, Park YC, Todd MB, Chi KN. Abiraterone plus Prednisone in Metastatic, Castration-Sensitive Prostate Cancer. N Engl J Med 2017; 377:352-360. [PMID: 28578607 DOI: 10.1056/nejmoa1704174] [Citation(s) in RCA: 1353] [Impact Index Per Article: 193.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Abiraterone acetate, a drug that blocks endogenous androgen synthesis, plus prednisone is indicated for metastatic castration-resistant prostate cancer. We evaluated the clinical benefit of abiraterone acetate plus prednisone with androgen-deprivation therapy in patients with newly diagnosed, metastatic, castration-sensitive prostate cancer. METHODS In this double-blind, placebo-controlled, phase 3 trial, we randomly assigned 1199 patients to receive either androgen-deprivation therapy plus abiraterone acetate (1000 mg daily, given once daily as four 250-mg tablets) plus prednisone (5 mg daily) (the abiraterone group) or androgen-deprivation therapy plus dual placebos (the placebo group). The two primary end points were overall survival and radiographic progression-free survival. RESULTS After a median follow-up of 30.4 months at a planned interim analysis (after 406 patients had died), the median overall survival was significantly longer in the abiraterone group than in the placebo group (not reached vs. 34.7 months) (hazard ratio for death, 0.62; 95% confidence interval [CI], 0.51 to 0.76; P<0.001). The median length of radiographic progression-free survival was 33.0 months in the abiraterone group and 14.8 months in the placebo group (hazard ratio for disease progression or death, 0.47; 95% CI, 0.39 to 0.55; P<0.001). Significantly better outcomes in all secondary end points were observed in the abiraterone group, including the time until pain progression, next subsequent therapy for prostate cancer, initiation of chemotherapy, and prostate-specific antigen progression (P<0.001 for all comparisons), along with next symptomatic skeletal events (P=0.009). These findings led to the unanimous recommendation by the independent data and safety monitoring committee that the trial be unblinded and crossover be allowed for patients in the placebo group to receive abiraterone. Rates of grade 3 hypertension and hypokalemia were higher in the abiraterone group. CONCLUSIONS The addition of abiraterone acetate and prednisone to androgen-deprivation therapy significantly increased overall survival and radiographic progression-free survival in men with newly diagnosed, metastatic, castration-sensitive prostate cancer. (Funded by Janssen Research and Development; LATITUDE ClinicalTrials.gov number, NCT01715285 .).
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Affiliation(s)
- Karim Fizazi
- From Gustave Roussy, University of Paris Sud, Villejuif, France (K.F.); Janssen Research and Development, Los Angeles (N.T.), Beerse, Belgium (P.D.P.), San Diego, CA (T.K.), and Raritan, NJ (Y.C.P.); Instituto de Oncologia de Rosário, Rosário, Argentina (L.F.); National Cancer Center Hospital East, Chiba, Japan (N.M.); 12 de Octubre University Hospital, Madrid (A.R.-A.); P.A. Hertsen Moscow Cancer Research Institute, Moscow (B.Y.A.); Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey (M.Ö.); Fudan University Shanghai Cancer Center, Shanghai, China (D.Y.); Studienpraxis Urologie, Nürtingen, Germany (S.F.); Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom (A.P.); Janssen Global Services, Raritan, NJ (M.B.T.); and BC Cancer Agency, Vancouver, Canada (K.N.C.)
| | - NamPhuong Tran
- From Gustave Roussy, University of Paris Sud, Villejuif, France (K.F.); Janssen Research and Development, Los Angeles (N.T.), Beerse, Belgium (P.D.P.), San Diego, CA (T.K.), and Raritan, NJ (Y.C.P.); Instituto de Oncologia de Rosário, Rosário, Argentina (L.F.); National Cancer Center Hospital East, Chiba, Japan (N.M.); 12 de Octubre University Hospital, Madrid (A.R.-A.); P.A. Hertsen Moscow Cancer Research Institute, Moscow (B.Y.A.); Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey (M.Ö.); Fudan University Shanghai Cancer Center, Shanghai, China (D.Y.); Studienpraxis Urologie, Nürtingen, Germany (S.F.); Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom (A.P.); Janssen Global Services, Raritan, NJ (M.B.T.); and BC Cancer Agency, Vancouver, Canada (K.N.C.)
| | - Luis Fein
- From Gustave Roussy, University of Paris Sud, Villejuif, France (K.F.); Janssen Research and Development, Los Angeles (N.T.), Beerse, Belgium (P.D.P.), San Diego, CA (T.K.), and Raritan, NJ (Y.C.P.); Instituto de Oncologia de Rosário, Rosário, Argentina (L.F.); National Cancer Center Hospital East, Chiba, Japan (N.M.); 12 de Octubre University Hospital, Madrid (A.R.-A.); P.A. Hertsen Moscow Cancer Research Institute, Moscow (B.Y.A.); Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey (M.Ö.); Fudan University Shanghai Cancer Center, Shanghai, China (D.Y.); Studienpraxis Urologie, Nürtingen, Germany (S.F.); Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom (A.P.); Janssen Global Services, Raritan, NJ (M.B.T.); and BC Cancer Agency, Vancouver, Canada (K.N.C.)
| | - Nobuaki Matsubara
- From Gustave Roussy, University of Paris Sud, Villejuif, France (K.F.); Janssen Research and Development, Los Angeles (N.T.), Beerse, Belgium (P.D.P.), San Diego, CA (T.K.), and Raritan, NJ (Y.C.P.); Instituto de Oncologia de Rosário, Rosário, Argentina (L.F.); National Cancer Center Hospital East, Chiba, Japan (N.M.); 12 de Octubre University Hospital, Madrid (A.R.-A.); P.A. Hertsen Moscow Cancer Research Institute, Moscow (B.Y.A.); Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey (M.Ö.); Fudan University Shanghai Cancer Center, Shanghai, China (D.Y.); Studienpraxis Urologie, Nürtingen, Germany (S.F.); Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom (A.P.); Janssen Global Services, Raritan, NJ (M.B.T.); and BC Cancer Agency, Vancouver, Canada (K.N.C.)
| | - Alfredo Rodriguez-Antolin
- From Gustave Roussy, University of Paris Sud, Villejuif, France (K.F.); Janssen Research and Development, Los Angeles (N.T.), Beerse, Belgium (P.D.P.), San Diego, CA (T.K.), and Raritan, NJ (Y.C.P.); Instituto de Oncologia de Rosário, Rosário, Argentina (L.F.); National Cancer Center Hospital East, Chiba, Japan (N.M.); 12 de Octubre University Hospital, Madrid (A.R.-A.); P.A. Hertsen Moscow Cancer Research Institute, Moscow (B.Y.A.); Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey (M.Ö.); Fudan University Shanghai Cancer Center, Shanghai, China (D.Y.); Studienpraxis Urologie, Nürtingen, Germany (S.F.); Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom (A.P.); Janssen Global Services, Raritan, NJ (M.B.T.); and BC Cancer Agency, Vancouver, Canada (K.N.C.)
| | - Boris Y Alekseev
- From Gustave Roussy, University of Paris Sud, Villejuif, France (K.F.); Janssen Research and Development, Los Angeles (N.T.), Beerse, Belgium (P.D.P.), San Diego, CA (T.K.), and Raritan, NJ (Y.C.P.); Instituto de Oncologia de Rosário, Rosário, Argentina (L.F.); National Cancer Center Hospital East, Chiba, Japan (N.M.); 12 de Octubre University Hospital, Madrid (A.R.-A.); P.A. Hertsen Moscow Cancer Research Institute, Moscow (B.Y.A.); Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey (M.Ö.); Fudan University Shanghai Cancer Center, Shanghai, China (D.Y.); Studienpraxis Urologie, Nürtingen, Germany (S.F.); Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom (A.P.); Janssen Global Services, Raritan, NJ (M.B.T.); and BC Cancer Agency, Vancouver, Canada (K.N.C.)
| | - Mustafa Özgüroğlu
- From Gustave Roussy, University of Paris Sud, Villejuif, France (K.F.); Janssen Research and Development, Los Angeles (N.T.), Beerse, Belgium (P.D.P.), San Diego, CA (T.K.), and Raritan, NJ (Y.C.P.); Instituto de Oncologia de Rosário, Rosário, Argentina (L.F.); National Cancer Center Hospital East, Chiba, Japan (N.M.); 12 de Octubre University Hospital, Madrid (A.R.-A.); P.A. Hertsen Moscow Cancer Research Institute, Moscow (B.Y.A.); Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey (M.Ö.); Fudan University Shanghai Cancer Center, Shanghai, China (D.Y.); Studienpraxis Urologie, Nürtingen, Germany (S.F.); Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom (A.P.); Janssen Global Services, Raritan, NJ (M.B.T.); and BC Cancer Agency, Vancouver, Canada (K.N.C.)
| | - Dingwei Ye
- From Gustave Roussy, University of Paris Sud, Villejuif, France (K.F.); Janssen Research and Development, Los Angeles (N.T.), Beerse, Belgium (P.D.P.), San Diego, CA (T.K.), and Raritan, NJ (Y.C.P.); Instituto de Oncologia de Rosário, Rosário, Argentina (L.F.); National Cancer Center Hospital East, Chiba, Japan (N.M.); 12 de Octubre University Hospital, Madrid (A.R.-A.); P.A. Hertsen Moscow Cancer Research Institute, Moscow (B.Y.A.); Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey (M.Ö.); Fudan University Shanghai Cancer Center, Shanghai, China (D.Y.); Studienpraxis Urologie, Nürtingen, Germany (S.F.); Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom (A.P.); Janssen Global Services, Raritan, NJ (M.B.T.); and BC Cancer Agency, Vancouver, Canada (K.N.C.)
| | - Susan Feyerabend
- From Gustave Roussy, University of Paris Sud, Villejuif, France (K.F.); Janssen Research and Development, Los Angeles (N.T.), Beerse, Belgium (P.D.P.), San Diego, CA (T.K.), and Raritan, NJ (Y.C.P.); Instituto de Oncologia de Rosário, Rosário, Argentina (L.F.); National Cancer Center Hospital East, Chiba, Japan (N.M.); 12 de Octubre University Hospital, Madrid (A.R.-A.); P.A. Hertsen Moscow Cancer Research Institute, Moscow (B.Y.A.); Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey (M.Ö.); Fudan University Shanghai Cancer Center, Shanghai, China (D.Y.); Studienpraxis Urologie, Nürtingen, Germany (S.F.); Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom (A.P.); Janssen Global Services, Raritan, NJ (M.B.T.); and BC Cancer Agency, Vancouver, Canada (K.N.C.)
| | - Andrew Protheroe
- From Gustave Roussy, University of Paris Sud, Villejuif, France (K.F.); Janssen Research and Development, Los Angeles (N.T.), Beerse, Belgium (P.D.P.), San Diego, CA (T.K.), and Raritan, NJ (Y.C.P.); Instituto de Oncologia de Rosário, Rosário, Argentina (L.F.); National Cancer Center Hospital East, Chiba, Japan (N.M.); 12 de Octubre University Hospital, Madrid (A.R.-A.); P.A. Hertsen Moscow Cancer Research Institute, Moscow (B.Y.A.); Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey (M.Ö.); Fudan University Shanghai Cancer Center, Shanghai, China (D.Y.); Studienpraxis Urologie, Nürtingen, Germany (S.F.); Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom (A.P.); Janssen Global Services, Raritan, NJ (M.B.T.); and BC Cancer Agency, Vancouver, Canada (K.N.C.)
| | - Peter De Porre
- From Gustave Roussy, University of Paris Sud, Villejuif, France (K.F.); Janssen Research and Development, Los Angeles (N.T.), Beerse, Belgium (P.D.P.), San Diego, CA (T.K.), and Raritan, NJ (Y.C.P.); Instituto de Oncologia de Rosário, Rosário, Argentina (L.F.); National Cancer Center Hospital East, Chiba, Japan (N.M.); 12 de Octubre University Hospital, Madrid (A.R.-A.); P.A. Hertsen Moscow Cancer Research Institute, Moscow (B.Y.A.); Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey (M.Ö.); Fudan University Shanghai Cancer Center, Shanghai, China (D.Y.); Studienpraxis Urologie, Nürtingen, Germany (S.F.); Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom (A.P.); Janssen Global Services, Raritan, NJ (M.B.T.); and BC Cancer Agency, Vancouver, Canada (K.N.C.)
| | - Thian Kheoh
- From Gustave Roussy, University of Paris Sud, Villejuif, France (K.F.); Janssen Research and Development, Los Angeles (N.T.), Beerse, Belgium (P.D.P.), San Diego, CA (T.K.), and Raritan, NJ (Y.C.P.); Instituto de Oncologia de Rosário, Rosário, Argentina (L.F.); National Cancer Center Hospital East, Chiba, Japan (N.M.); 12 de Octubre University Hospital, Madrid (A.R.-A.); P.A. Hertsen Moscow Cancer Research Institute, Moscow (B.Y.A.); Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey (M.Ö.); Fudan University Shanghai Cancer Center, Shanghai, China (D.Y.); Studienpraxis Urologie, Nürtingen, Germany (S.F.); Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom (A.P.); Janssen Global Services, Raritan, NJ (M.B.T.); and BC Cancer Agency, Vancouver, Canada (K.N.C.)
| | - Youn C Park
- From Gustave Roussy, University of Paris Sud, Villejuif, France (K.F.); Janssen Research and Development, Los Angeles (N.T.), Beerse, Belgium (P.D.P.), San Diego, CA (T.K.), and Raritan, NJ (Y.C.P.); Instituto de Oncologia de Rosário, Rosário, Argentina (L.F.); National Cancer Center Hospital East, Chiba, Japan (N.M.); 12 de Octubre University Hospital, Madrid (A.R.-A.); P.A. Hertsen Moscow Cancer Research Institute, Moscow (B.Y.A.); Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey (M.Ö.); Fudan University Shanghai Cancer Center, Shanghai, China (D.Y.); Studienpraxis Urologie, Nürtingen, Germany (S.F.); Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom (A.P.); Janssen Global Services, Raritan, NJ (M.B.T.); and BC Cancer Agency, Vancouver, Canada (K.N.C.)
| | - Mary B Todd
- From Gustave Roussy, University of Paris Sud, Villejuif, France (K.F.); Janssen Research and Development, Los Angeles (N.T.), Beerse, Belgium (P.D.P.), San Diego, CA (T.K.), and Raritan, NJ (Y.C.P.); Instituto de Oncologia de Rosário, Rosário, Argentina (L.F.); National Cancer Center Hospital East, Chiba, Japan (N.M.); 12 de Octubre University Hospital, Madrid (A.R.-A.); P.A. Hertsen Moscow Cancer Research Institute, Moscow (B.Y.A.); Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey (M.Ö.); Fudan University Shanghai Cancer Center, Shanghai, China (D.Y.); Studienpraxis Urologie, Nürtingen, Germany (S.F.); Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom (A.P.); Janssen Global Services, Raritan, NJ (M.B.T.); and BC Cancer Agency, Vancouver, Canada (K.N.C.)
| | - Kim N Chi
- From Gustave Roussy, University of Paris Sud, Villejuif, France (K.F.); Janssen Research and Development, Los Angeles (N.T.), Beerse, Belgium (P.D.P.), San Diego, CA (T.K.), and Raritan, NJ (Y.C.P.); Instituto de Oncologia de Rosário, Rosário, Argentina (L.F.); National Cancer Center Hospital East, Chiba, Japan (N.M.); 12 de Octubre University Hospital, Madrid (A.R.-A.); P.A. Hertsen Moscow Cancer Research Institute, Moscow (B.Y.A.); Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey (M.Ö.); Fudan University Shanghai Cancer Center, Shanghai, China (D.Y.); Studienpraxis Urologie, Nürtingen, Germany (S.F.); Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom (A.P.); Janssen Global Services, Raritan, NJ (M.B.T.); and BC Cancer Agency, Vancouver, Canada (K.N.C.)
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Crawford ED, Petrylak DP, Shore N, Saad F, Slovin SF, Vogelzang NJ, Keane TE, Koo PJ, Gomella LG, O'Sullivan JM, Tombal B, Concepcion RS, Sieber P, Stone NN, Finkelstein SE, Yu EY. The Role of Therapeutic Layering in Optimizing Treatment for Patients With Castration-resistant Prostate Cancer (Prostate Cancer Radiographic Assessments for Detection of Advanced Recurrence II). Urology 2017; 104:150-159. [PMID: 28302580 DOI: 10.1016/j.urology.2016.12.033] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 11/22/2016] [Accepted: 12/18/2016] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To offer recommendations on identification of disease progression, treatment management strategies, and suggestions on timing of initiating and discontinuing specific castration-resistant prostate cancer (CRPC) treatments. MATERIALS AND METHODS The Prostate Cancer Radiographic Assessments for Detection of Advanced Recurrence II Working Group convened to provide guidance on sequencing, combination, or layering of approved treatments for metastatic CRPC based on available data and clinical experience. RESULTS A consensus was developed to address important questions on management of patients with metastatic CRPC. CONCLUSION In the absence of large-scale clinical trials, the Working Group recommends that patients may best be managed with a layered approach of approved therapies with unique or complimentary mechanisms of action.
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Affiliation(s)
| | | | - Neal Shore
- Carolina Urologic Research Center, Myrtle Beach, SC
| | - Fred Saad
- Centre Hospitalier de L'Universite de Montreal, Montreal, QC, Canada
| | | | | | | | | | - Leonard G Gomella
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | | | | | | | | | | | | | - Evan Y Yu
- University of Washington, Seattle, WA
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