Cognitive impairment and associations with structural brain networks, endocrine status, and risk genotypes in patients with newly diagnosed prostate cancer referred to androgen‐deprivation therapy

ObjectivesThis paper (1) sought to compare sleep, mood and physical symptom profiles of men with prostate cancer (PCa) who experienced subjective and objective cancer-related cognitive impairment (CRCI) during the first year of treatment and (2) examine if fluctuations in mood and physical symptoms are associated with change in subjective or objective CRCI.MethodsThis prospective observational cohort study examined 24 new patients with PCa receiving androgen deprivation therapy (ADT) and radiation therapy (RT) during the first 12 months of treatment. Participants completed subjective and objective assessments of cognition, sleep continuity and self-report measures of insomnia, fatigue, depression and anxiety. Independent sample t-tests, correlations and hierarchical regressions were used to compare groups, explore associations, and assess change over time. Effects are reported as corrected Cohen’s d (dc).ResultsMen with objective CRCI reported worse subjective time asleep (dc=0.47) and more depression (dc=0.55). Men with subjective CRCI reported worse insomnia (dc=0.99), hot flashes (dc=0.76), sleep quality (dc=0.54), subjective total sleep time (dc=0.41), wake after sleep onset (dc=0.71), sleep efficiency (dc=0.49), fatigue (dc=0.67) and objectively estimated sleep latency (dc=0.72) than men without subjective CRCI. Declines in perceived cognition was associated with higher anxiety (p=0.05), fatigue (p≤0.01) and symptoms of insomnia (p=0.01). Finally, subjective time awake during the night (p=0.03) and fatigue (p=0.02) were associated with subjective cognitive decline, controlling for objective change.ConclusionsSubjective concerns of CRCI appear more critical to patient experience than objective measurements in men with PCa who have received RT and ADT. Interventions to improve sleep may result in an improved perception of cognition.

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Management of Metastatic Castrate-sensitive Prostate Cancer

10.2310/uro.11097 ◽

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

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Low Serum Testosterone in Men With Newly Diagnosed Androgen-Deprivation Therapy-Naïve Prostate Cancer and Its Relationship to Cardiovascular Risk Factors—A Radical PC Substudy

The Journal of Urology ◽

10.1097/ju.0000000000002384 ◽

2022 ◽

Author(s):

Jehonathan H. Pinthus ◽

Wilhelmina C. M. Duivenvoorden ◽

Laurence Klotz ◽

Som D. Mukherjee ◽

Robert Siemens ◽

...

Keyword(s):

Prostate Cancer ◽

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Androgen Deprivation Therapy ◽

Serum Testosterone ◽

Androgen Deprivation ◽

Newly Diagnosed ◽

Low Serum

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Clinical outcomes and prognostic factors in patients with newly diagnosed metastatic prostate cancer initially treated with androgen deprivation therapy: a retrospective multicenter study in Japan

International Journal of Clinical Oncology ◽

10.1007/s10147-019-01614-8 ◽

2020 ◽

Vol 25 (5) ◽

pp. 912-920 ◽

Cited By ~ 4

Author(s):

Shintaro Narita ◽

Shingo Hatakeyama ◽

Masahiro Takahashi ◽

Toshihiko Sakurai ◽

Sadafumi Kawamura ◽

...

Keyword(s):

Prostate Cancer ◽

Prognostic Factors ◽

Clinical Outcomes ◽

Androgen Deprivation Therapy ◽

Multicenter Study ◽

Metastatic Prostate Cancer ◽

Androgen Deprivation ◽

Newly Diagnosed ◽

Retrospective Multicenter Study

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

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.2_suppl.188 ◽

2016 ◽

Vol 34 (2_suppl) ◽

pp. 188-188 ◽

Cited By ~ 1

Author(s):

Allan Ramos-Esquivel ◽

Joao M. Baptista ◽

Luis Corrales-Rodriguez ◽

Ileana GonzÃƒÂ°lez ◽

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.

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Adverse effects of androgen deprivation therapy on cognitive impairment for men with prostate cancer: A meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e16506 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e16506-e16506

Author(s):

Maxine Sun ◽

Alexander P Cole ◽

Nawar Hanna ◽

Quoc-Dien Trinh

Keyword(s):

Prostate Cancer ◽

Cognitive Impairment ◽

Androgen Deprivation Therapy ◽

Prospective Studies ◽

Meta Analysis ◽

Case Control ◽

Androgen Deprivation ◽

Cochrane Library ◽

Retrospective Data ◽

Case Control Studies

e16506 Background: Use of androgen deprivation therapy (ADT) may confer a higher risk of cognitive impairment. Published results are variable and lack consensus. Our objective was to perform meta-analysis of the risk of overall cognitive impairment in men receiving ADT for prostate cancer. Methods: Relevant studies were identified through the search of English language articles indexed in PubMed Medline, PsycINFO, Cochrane Library and Web of Knowledge/Science until December 21st2016. Articles were included if they were published in English, reported on original research with adult male subjects undergoing treatment for prostate cancer, incorporated longitudinal comparisons, and included a control group. Controlled intervention studies were required to assess an established cognitive-related endpoint that was measured by a validated instrument, and measure cognitive impairment based on the International Cognition and Cancer Task Force (ICCTF) criteria. The effect of ADT on cognitive impairment was pooled using a random-effects model for controlled intervention and case-control studies separately. Results: Of 221 abstracts, 25 were selected for full-text review, and 8 studies, with 2 controlled studies and 6 case-control studies were identified. Overall cognitive impairment was not significantly different when the results of the 2 prospective studies were pooled (OR: 1.57, 95% CI: 0.50–4.92, P= 0.44), with significant heterogeneity between estimates ( I2: 83%). In retrospective data, the odds of developing any cognitive impairment were significantly higher in men treated with ADT (HR: 1.37, 95% CI: 1.06–1.77, P= 0.02), with considerable heterogeneity ( I2: 84%). Conclusions: The relationship between overall cognitive impairment and use of ADT defined according to the ICCTF criteria in a pooled-analysis of two prospective studies was inconclusive. Although retrospective studies suggest a higher risk of overall cognitive impairment after ADT, we caution readers not to over-interpret this finding given the limitations of retrospective data. Better well-designed prospective studies are needed to assess the effect of ADT on cognitive impairment with long-term follow-up.

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