scholarly journals Androgen deprivation and immunotherapy for the treatment of prostate cancer

2017 ◽  
Vol 24 (12) ◽  
pp. T297-T310 ◽  
Author(s):  
Melissa Gamat ◽  
Douglas G McNeel
Keyword(s):  
Prostate Cancer ◽  
Immune System ◽  
Metastatic Prostate Cancer ◽  
The United States ◽  
Primary Treatment ◽  
Androgen Deprivation ◽  
Newly Diagnosed ◽  
Recurrent Prostate Cancer ◽  
System A ◽  
Different Types

Prostate cancer is the most common newly diagnosed malignancy in men, and the second most common cause of cancer-related death in the United States. The primary treatment for recurrent prostate cancer is androgen deprivation, and this therapy is typically continued lifelong for patients with metastatic prostate cancer. Androgens and androgen deprivation have profound effects on the immune system, a finding that has become more appreciated in an era where immune-based treatments for cancer are being increasingly explored. Preclinical studies suggest that androgen deprivation could potentially positively or negatively affect the use of approved immunotherapies, or those that are being developed for the treatment of prostate cancer. In this review, we provide a brief overview of the different types of androgen deprivation treatments used in the management of prostate cancer, discuss their effects on prostate tumors and the immune system and how they are being explored in combination with immunotherapy. Finally, we address some of the critical questions in the field that must be answered to identify the best approaches to combine androgen deprivation with immunotherapy for the treatment of prostate cancer.

Management of Metastatic Castrate-sensitive Prostate Cancer

2018 ◽  
Author(s):  
Derya Tilki ◽  
Marc A Dall’era ◽  
Christopher P Evans
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Survival Benefit ◽  
Metastatic Prostate Cancer ◽  
Oncologic Outcome ◽  
Standard Of Care ◽  
Abiraterone Acetate ◽  
Androgen Deprivation ◽  
Newly Diagnosed ◽  
Treatment Paradigm

Oncologic outcome of patients with newly diagnosed metastatic prostate cancer (mPCa) is poor. The treatment paradigm for newly diagnosed mPCa has changed. The standard of care for men with metastatic hormone-naive prostate cancer has been systemic androgen deprivation therapy (ADT). Previous randomized studies demonstrated an overall survival benefit by the addition of early chemotherapy with six cycles of docetaxel. More recently, results from randomized trials also demonstrated a survival benefit by the addition of abiraterone acetate to the ADT in men with metastatic disease. The aim of this review is to summarize the results from most recent studies, including men with newly diagnosed metastatic hormone-naive prostate cancer, focusing on chemotherapy and ADT. This review contains 1 figure, 2 tables, and 47 references.  Key Words: abiraterone acetate, androgen deprivation therapy, androgen deprivation, castrate sensitive, chemotherapy, continuous androgen deprivation, docetaxel, hormone-naive, intermittent androgen deprivation, metastatic prostate cancer

Androgen-deprivation therapy plus docetaxel-based chemotherapy in metastatic hormone-sensitive prostate cancer. A meta-analysis of randomized clinical trials.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 188-188 ◽  
Author(s):  
Allan Ramos-Esquivel ◽  
Joao M. Baptista ◽  
Luis Corrales-Rodriguez ◽  
Ileana Gonzðlez ◽  
Melissa Juarez Villegal ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Trials ◽  
Androgen Deprivation Therapy ◽  
Metastatic Prostate Cancer ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Androgen Deprivation ◽  
Cochrane Central Register ◽  
Newly Diagnosed ◽  
Hormone Sensitive

188 Background: Androgen-deprivation therapy (ADT) is the standard of treatment for patients with newly diagnosed metastatic prostatic cancer. Nevertheless, recent trials have suggested a role for chemotherapy in these patients. We performed a systematic review and meta-analysis to assess the efficacy and safety of docetaxel-based chemotherapy in combination with ADT for patients with hormone-sensitive metastatic prostate cancer. Methods: Randomized clinical trials (RCT) were identified after systematic searching of electronic databases (MEDLINE, OVID and The Cochrane Central Register of Controlled Trials), as well as ASCO conference proceedings from 2010 to 2015. We included only RCT comparing ADT versus the combination of ADT plus docetaxel-based chemotherapy in patients with newly diagnosed metastatic prostate cancer. A random-effect model was used to determine the pooled hazard ratio (HR) for the efficacy outcomes: overall survival (OS) and clinical progression-free survival (PFS), according to the inverse-variance method. Heterogeneity was measured using the Q and I2statistics. Results: Three RCT (n = 2 262), were included in our meta-analysis (E3805, GETUG-AFU 15 and the M1 subgroup from STAMPEDE Trial). Docetaxel-based chemotherapy plus ADT was associated with improved OS (HR: 0.74; 95% CI: 0.60-0.90; p = 0.003). The heterogeneity of these trials was moderate (Tau2: 0.02; I2: 51%; p = 0.13). Clinical PFS was also significantly better in patients receiving docetaxel-based chemotherapy (HR: 0.67; 95% CI 0.55-0.82; p = 0.0001), with moderate between-study heterogeneity detected (Tau2: 0.01; I2: 42%; p = 0.19). Different subset of patients in these trials can explain the aforementioned heterogeneity. Regarding adverse drug reactions grade 3 or higher, neutropenia was reported in a range from 36% in the GETUG-AFU 15 Trial to 12% in the STAMPEDE trial and febrile neutropenia was reported from 6.1% in the E3805 Trial to 12% in the STAMPEDE Trial. Conclusions: The addition of docetaxel-based chemotherapy to ADT improves OS and clinical PFS. New trials are needed to determine which patients benefit the most from this intervention.

scholarly journals Multimodal Primary Treatment of Metastatic Prostate Cancer with Androgen Deprivation and Radiation

2016 ◽  
Vol 36 (12) ◽  
pp. 6439-6448 ◽  
Author(s):  
TIMO JOENSUU ◽  
GREETTA JOENSUU ◽  
KALEVI KAIREMO ◽  
TIMO KILJUNEN ◽  
MAIGO RIENER ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Metastatic Prostate Cancer ◽  
Primary Treatment ◽  
Androgen Deprivation

scholarly journals The prognostic value of hemoglobin change after initiating androgen-deprivation therapy for newly diagnosed metastatic prostate cancer

Cancer ◽  
2006 ◽  
Vol 107 (3) ◽  
pp. 489-496 ◽  
Author(s):  
Tomasz M. Beer ◽  
Catherine M. Tangen ◽  
Lisa B. Bland ◽  
Maha Hussain ◽  
Bryan H. Goldman ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Prognostic Value ◽  
Metastatic Prostate Cancer ◽  
Androgen Deprivation ◽  
Newly Diagnosed

scholarly journals Prostate-Specific Antigen Kinetics Effects on Outcomes of Low-Volume Metastatic Prostate Cancer Patients Receiving Androgen Deprivation Therapy

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Yen-Chi Lin ◽  
Po-Hung Lin ◽  
I-Hung Shao ◽  
Yuan-Cheng Chu ◽  
Hung-Cheng Kan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Disease Progression ◽  
Androgen Deprivation Therapy ◽  
Metastatic Prostate Cancer ◽  
Specific Antigen ◽  
Androgen Deprivation ◽  
Newly Diagnosed ◽  
Psa Kinetics ◽  
Psa Nadir ◽  
Low Volume

Background. The present study aimed to analyse factors influencing the effects of androgen deprivation therapy (ADT) in patients with newly diagnosed metastatic castration-naïve prostate cancer (mCNPC), especially in low-volume disease (LVD), according to subclassification of metastatic prostate cancer established by the CHAARTED trial. Materials and Methods. We reviewed 648 patients with newly diagnosed mCNPC receiving ADT at Chang Gung Memorial Hospital from January 2007 to December 2016. Basic characteristics and PSA kinetics profile were subsequently evaluated. Results. 48.3% of LVD patients progressed to castration-resistant prostate cancer (mCRPC). Among them, CRPC group had significantly shorter time to PSA nadir (TTN) and faster time from PSA nadir to CRPC (TFNTC) ( p  < 0.001) compared to non-CRPC group. PSA doubling time (PSADT) < 4 months tended to be associated with faster disease progression and shorter overall survival (OS). Among all patients with metastatic prostate cancer, those with shorter TTN <9 months, higher nadir PSA level ≥1 ng/mL, and shorter PSADT <3 months had increased tendency for biochemical progression. Conclusions. PSADT is an effective clinical predictor for disease progression and survival in LVD. Other PSA kinetics including TTN and TFNTC, though not the major predictors for disease progression or OS in LVD, might be the predictors for disease control status.

Improved Survival With Prostate Radiation in Addition to Androgen Deprivation Therapy for Men With Newly Diagnosed Metastatic Prostate Cancer

2016 ◽  
Vol 34 (24) ◽  
pp. 2835-2842 ◽  
Author(s):  
Chad G. Rusthoven ◽  
Bernard L. Jones ◽  
Thomas W. Flaig ◽  
E. David Crawford ◽  
Matthew Koshy ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Propensity Score ◽  
Gleason Score ◽  
Metastatic Prostate Cancer ◽  
Propensity Score Analysis ◽  
Specific Antigen ◽  
Androgen Deprivation ◽  
Time Interval ◽  
Newly Diagnosed ◽  
Comorbidity Score

Purpose There is growing interest in the role of local therapies, including external beam radiotherapy (RT), for men with metastatic prostate cancer (mPCa). We used the National Cancer Database (NCDB) to evaluate the overall survival (OS) of men with mPCa treated with androgen deprivation (ADT) with and without prostate RT. Methods The NCDB was queried for men with newly diagnosed mPCa, all treated with ADT, with complete datasets for RT, surgery, prostate-specific antigen (PSA) level, Gleason score, and Charlson-Deyo comorbidity score. OS was analyzed using the Kaplan-Meier method, log-rank test, Cox proportional hazards models, and propensity score-matched analyses. Results From 2004 to 2012, 6,382 men with mPCa were identified, including 538 (8.4%) receiving prostate RT. At a median follow-up of 5.1 years, the addition of prostate RT to ADT was associated with improved OS on univariate (P < .001) and multivariate analysis (hazard ratio, 0.624; 95% CI, 0.551 to 0.706; P < .001) adjusted for age, year, race, comorbidity score, PSA level, Gleason score, T stage, N stage, chemotherapy administration, treating facility, and insurance status. Propensity score analysis with matched baseline characteristics demonstrated superior median (55 v 37 months) and 5-year OS (49% v 33%) with prostate RT plus ADT compared with ADT alone (P < .001). Landmark analyses limited to long-term survivors of ≥1, ≥3, and ≥5 years demonstrated improved OS with prostate RT in all subsets (all P < .05). Secondary analyses comparing the survival outcomes for patients treated with therapeutic dose RT plus ADT versus prostatectomy plus ADT during the same time interval demonstrated no significant differences in OS, whereas both therapies were superior to ADT alone. Conclusion In this large contemporary analysis, men with mPCa receiving prostate RT and ADT lived substantially longer than men treated with ADT alone. Prospective trials evaluating local therapies for mPCa are warranted.

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