scholarly journals Combined androgen blockade achieved better oncological outcome in androgen deprivation therapy for prostate cancer: Analysis of community-based multi-institutional database across Japan using propensity score matching

2018 ◽  
Vol 7 (10) ◽  
pp. 4893-4902 ◽  
Author(s):  
Mizuki Onozawa ◽  
Hideyuki Akaza ◽  
Shiro Hinotsu ◽  
Mototsugu Oya ◽  
Osamu Ogawa ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Androgen Deprivation Therapy ◽  
Oncological Outcome ◽  
Androgen Deprivation ◽  
Community Based ◽  
Combined Androgen Blockade ◽  
Androgen Blockade

scholarly journals Efficacy of Abiraterone Acetate For High-Risk Hormone-Naïve Metastatic Prostate Cancer: A Comparison With Combined Androgen Blockade Therapy With Bicalutamide And Androgen Deprivation Therapy Alone

2021 ◽  
Author(s):  
Kent Kanao ◽  
Takayuki Takahashi ◽  
Yuta Umezawa ◽  
Takashi Okabe ◽  
Gou Kaneko ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Androgen Deprivation Therapy ◽  
Treatment Efficacy ◽  
The Other ◽  
Propensity Score Matching Analysis ◽  
Combined Androgen Blockade ◽  
Androgen Blockade

Abstract Background: The treatment landscape for men with metastatic hormone-naïve prostate cancer (mHNPC) has dramatically changed with the approval of next-generation anti-androgen drugs. We compared the treatment efficacy of abiraterone with that of combined androgen blockade (CAB) therapy and androgen deprivation therapy (ADT) alone in men with high-risk mHNPC.Methods: In total, 146 Japanese men with high-risk mHNPC were retrospectively analyzed. As initial hormonal therapy, 30, 83, and 33 men were treated with ADT plus abiraterone (ABI group), ADT plus bicalutamide (CAB group), and ADT alone (ADT group), respectively. Treatment efficacy was compared using time to castration resistance (TTCR) and prostate-specific antigen (PSA) response among the groups. Propensity score matching analysis was also performed to adjust for baseline differences.Results: The median (95% confidence interval [CI]) TTCR in the ABI, CAB, and ADT groups were not reached, 10.7 (7.6–13.8) months and 11.0 (7.9–12.4) months, respectively, and it was significantly longer in the ABI group than in the other groups (p=0.0012, p=0.0008). In propensity score matching analysis, the median TTCR was also significantly longer in the ABI group than in the other groups (hazard ratio [HR], 0.47; 95% CI, 0.22–0.98; p=0.010; HR, 0.32; 95% CI, 0.12–0.85; p=0.004). The number of men who achieved PSA levels <0.2 ng/mL after propensity score matching were significantly higher in the ABI group than in the other groups.Conclusions: Our results provide important evidence regarding the superiority of abiraterone over CAB therapy and ADT alone for initial treatment for men with newly diagnosed mHNPC.

scholarly journals Clinical Outcomes in Locally Advanced Prostate Cancer Between Radical Prostatectomy and Radiotherapy With Androgen Deprivation Therapy: A Propensity Score-matched Analysis

2021 ◽  
Author(s):  
Yu-Cheng Lu ◽  
Chao-Yuan Huang ◽  
Chia-Hsien Cheng ◽  
Kuo-How Huang ◽  
Yu-Chuan Lu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Clinical Outcomes ◽  
Androgen Deprivation Therapy ◽  
Advanced Prostate Cancer ◽  
Locally Advanced ◽  
Androgen Deprivation ◽  
Locally Advanced Prostate Cancer

Abstract To compare clinical outcomes between the use of robotic-assisted laparoscopic radical prostatectomy (RP) and radiotherapy (RT) with long-term androgen deprivation therapy (ADT) in locally advanced prostate cancer (PC), we enrolled 315 patients with locally advanced PC (clinical T-stage 3/4). Propensity score-matching at a 1:1 ratio was performed. The median follow-up period was 59.2 months (IQR: 39.8-87.4). There were 117 (37.1%) patients in the RP group and 198 (62.9%) patients in the RT group. RT patients were older and had higher PSA at diagnosis, higher Gleason score grade group and more advanced T-stage (all p<0.001). After propensity score-matching, there were 68 patients in each group. Among locally advanced PC patients, treatment with RP had a higher risk of biochemical recurrence compared to the RT group. In multivariate Cox regression analysis, treatment with RT plus ADT significantly decreased the risk of biochemical failure (HR: 0.162, p<0.001), but there was no significant difference in local recurrence, distant metastasis and overall survival (p=0.470, p=0.268 and p=0.509, respectively). This information may provide insight for clinicians and patients for decision-making regarding their preference for either treatment strategy.

scholarly journals Towards implementing exercise into the prostate cancer care pathway: development of a theory and evidence-based intervention to train community-based exercise professionals to support change in patient exercise behaviour (The STAMINA trial)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sophie Reale ◽  
Rebecca R. Turner ◽  
Eileen Sutton ◽  
Stephanie J. C. Taylor ◽  
Liam Bourke ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Behaviour Change ◽  
Androgen Deprivation Therapy ◽  
Cancer Care ◽  
Core Competencies ◽  
Intervention Development ◽  
Androgen Deprivation ◽  
Community Based ◽  
Training Package ◽  
Clinical Populations

Abstract Background The National Institute for Health and Care Excellence (NICE) recommend that men on androgen deprivation therapy (ADT) for prostate cancer should receive supervised exercise to manage the side-effects of treatment. However, these recommendations are rarely implemented into practice. Community-based exercise professionals (CBEPs) represent an important target group to deliver the recommendations nationally, yet their standard training does not address the core competencies required to work with clinical populations, highlighting a need for further professional training. This paper describes the development of a training package to support CBEPs to deliver NICE recommendations. Methods Development of the intervention was guided by the Medical Research Council guidance for complex interventions and the Behaviour Change Wheel. In step one, target behaviours, together with their barriers and facilitators were identified from a literature review and focus groups with CBEPs (n = 22) and men on androgen deprivation therapy (n = 26). Focus group outputs were mapped onto the Theoretical Domains Framework (TDF) to identify theoretical constructs for change. In step two, behaviour change techniques and their mode of delivery were selected based on psychological theories and evidence to inform intervention content. In step three, the intervention was refined following delivery and subsequent feedback from intervention recipients and stakeholders. Results Six modifiable CBEPs target behaviours were identified to support the delivery of the NICE recommendations. Nine domains of the TDF were identified as key determinants of change, including: improving knowledge and skills and changing beliefs about consequences. To target the domains, we included 20 BCTs across 8 training modules and took a blended learning approach to accommodate different learning styles and preferences. Following test delivery to 11 CBEPs and feedback from 28 stakeholders, the training package was refined. Conclusion Established intervention development approaches provided a structured and transparent guide to intervention development. A training package for CBEPs was developed and should increase trust amongst patients and health care professionals when implementing exercise into prostate cancer care. Furthermore, if proven effective, the development and approach taken may provide a blueprint for replication in other clinical populations where exercise has proven efficacy but is insufficiently implemented.

scholarly journals Towards Implementing Exercise into the Prostate Cancer Care Pathway: Development of a Theory and Evidence-Based Intervention to Train Community-Based Exercise Professionals to Support Change in Patient Exercise Behaviour

2021 ◽  
Author(s):  
Sophie Reale ◽  
Rebecca Turner ◽  
Eileen Sutton ◽  
Stephanie Taylor ◽  
Liam Bourke ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Behaviour Change ◽  
Androgen Deprivation Therapy ◽  
Cancer Care ◽  
Core Competencies ◽  
Intervention Development ◽  
Androgen Deprivation ◽  
Community Based ◽  
Training Package ◽  
Clinical Populations

Abstract Background: The National Institute for Health and Care Excellence (NICE) recommend that men on androgen deprivation therapy (ADT) for prostate cancer should receive supervised exercise to manage the side-effects of treatment. However, these recommendations are rarely implemented in practice. Community-based exercise professionals (CBEPs) represent an important target group to deliver the recommendations nationally, yet their standard training does not address the core competencies required to work with clinical populations, highlighting a need for further professional training. This paper describes the development of a training package to support CBEPs to deliver NICE recommendations. Methods: Development of the intervention was guided by the Medical Research Council guidance for complex interventions and the Behaviour Change Wheel. In step one, target behaviours, together with their barriers and facilitators were identified from a literature review and focus groups with CBEPs (n = 22) and men on androgen deprivation therapy (n = 26). Focus group outputs were mapped onto the Theoretical Domains Framework (TDF) to identify theoretical constructs for change. In step two, behaviour change techniques and their mode of delivery were selected based on psychological theories and evidence to inform intervention content. In step three, the intervention was refined following delivery and subsequent feedback from intervention recipients and stakeholders.Results: Six modifiable CPEPs target behaviours were identified to support the delivery of the NICE recommendations. Nine domains of the TDF were identified as key determinants of change, including: improving knowledge and skills and changing beliefs about consequences. To target the domains, we included 20 BCTs across 8 training modules and took a blended learning approach to accommodate different learning styles and preferences. Following test delivery to 11 CBEPs and feedback from 28 stakeholders, the training package was refined. Conclusion: Established intervention development approaches provided a structured and transparent guide to intervention development. A training package for CBEPs was developed and should increase trust amongst patients and health care professionals when implementing exercise into prostate cancer care. Furthermore, if proven effective, the development and approach taken may provide a blueprint for replication in other clinical populations where exercise has proven efficacy but is insufficiently implemented.

UP-02.154 Duration of Androgen Deprivation Therapy with Maximum Androgen Blockade for Localized Prostate Cancer

Urology ◽  
2011 ◽  
Vol 78 (3) ◽  
pp. S313-S314
Author(s):  
N. Fujimoto ◽  
T. Kubo ◽  
H. Shinsaka ◽  
M. Matsumoto ◽  
R. Hamasuna ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Localized Prostate Cancer ◽  
Androgen Blockade

Trends and oncological outcome of testosterone recovery after androgen deprivation therapy in prostate cancer patients who received external beam radiotherapy.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 345-345
Author(s):  
Akinori Takei ◽  
Shinichi Sakamoto ◽  
Takaaki Tamura ◽  
Ken Wakai ◽  
Maihulan Maimaiti ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Multivariate Analysis ◽  
High Risk ◽  
Androgen Deprivation Therapy ◽  
External Beam Radiotherapy ◽  
Oncological Outcome ◽  
Androgen Deprivation ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation

345 Background: Although androgen deprivation therapy (ADT) combined with external beam radiation therapy (EBRT) is standard treatment for high risk prostate cancer (PC) patients, the shift of testosterone (TST) levels after ADT and the optimal duration of ADT is unclear. TST recovery and outcome were studied in PC patients who received EBRT with ADT. Methods: Eighty-two patients who underwent EBRT with ADT for PC were retrospectively analyzed. Serum TST levels after ADT terminations were studied. Cox proportional hazard models and the Kaplan-Meier method were used for statistical analysis. Results: Median age, baseline TST, nadir TST, and duration of ADT were 73 years, 456 ng/dL, 16 ng/dL, and 26 months, respectively. ADT duration of 33 months (HR 0.13; p=0.0018), nadir TST of 20 ng/dL (HR 0.35; p=0.0112), and TST >50 ng/dL at 6 months after ADT termination (HR 0.21; p=0.0075) were significantly associated with TST recovery to normal levels (200 ng/dL) on multivariate analysis. ADT duration of 33 months (HR 0.31; p=0.0023) and nadir TST of 20 ng/dL (HR 0.38; p=0.0012) were significantly associated with TST recovery to supracastrate level (50 ng/dL) on multivariate analysis. In high risk PC patients, ADT≤ 2 year group showed shorter time to TST recovery to supracastrate levels compare to those of ADT>2 year group (HR 4.21; p=0.0022) without affecting biochemical recurrence (p=0.49) and overall survival (p=0.674). Conclusions: ADT duration of 33 months and nadir TST of 20 ng/dL predicted the TST recovery to suparacastrate levels. Less than 2 year of ADT provided better TST recovery without affecting the oncological outcome in high risk patients.[Table: see text]

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