scholarly journals Emerging Therapies to Prevent Skeletal Morbidity in Men With Prostate Cancer

2011 ◽  
Vol 29 (27) ◽  
pp. 3705-3714 ◽  
Author(s):  
Philip J. Saylor ◽  
Richard J. Lee ◽  
Matthew R. Smith
Keyword(s):  
Prostate Cancer ◽  
Fracture Risk ◽  
Androgen Deprivation Therapy ◽  
Osteoporotic Fracture ◽  
Kinase Inhibitor ◽  
Fragility Fractures ◽  
Androgen Deprivation ◽  
Castration Resistant Prostate Cancer ◽  
Mineral Density ◽  
Radium 223

Skeletal morbidity is a prominent burden to men with advanced prostate cancer throughout the natural history of the disease. Bone metastases can cause pain and greatly elevate the risk for fractures and other structural complications. Distinct from the problem of metastases, treatment-related osteoporosis and associated fragility fractures are potential complications of androgen-deprivation therapy. Bone-targeted therapies for prostate cancer have therefore been the focus of considerable research and drug development efforts. The osteoclast is a validated therapeutic target in the management of prostate cancer. Osteoclast inhibition with zoledronic acid (a bisphosphonate) or with denosumab (a monoclonal antibody to RANK ligand) reduces risk for skeletal events in men with castration-resistant prostate cancer metastatic to bone. Osteoclast inhibition with any of several bisphosphonates improves bone mineral density, a surrogate for osteoporotic fracture risk. Denosumab and toremifene (a selective estrogen receptor modulator) have each been shown to reduce osteoporotic fracture risk among men receiving androgen-deprivation therapy. Beta-emitting radiopharmaceuticals reduce pain due to metastatic disease. Investigations involving alpha-emitting radium-223, endothelin-A receptor antagonists atrasentan and zibotentan, proto-oncogene tyrosine-protein kinase (SRC) inhibitor dasatinib, and tyrosine kinase inhibitor cabozantinib (XL184) are ongoing in clinical trials and are also discussed.

Contemporary analysis of bone mineral density in men initiating androgen deprivation therapy for prostate cancer.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 38-38
Author(s):  
Jason Hu ◽  
Armen G. Aprikian ◽  
Marie Vanhuyse ◽  
Alice Dragomir
Keyword(s):  
Prostate Cancer ◽  
Bone Mineral Density ◽  
Fracture Risk ◽  
Androgen Deprivation Therapy ◽  
Bone Mineral ◽  
Androgen Deprivation ◽  
Rural Residence ◽  
Mineral Density ◽  
Bmd Testing

38 Background: Androgen deprivation therapy (ADT) is a cornerstone of advanced prostate cancer (PCa) treatment, however several side-effects are associated with its long-term use. Notably, loss of bone mineral density (BMD) is accelerated which increases fracture risk. Guidelines recommend BMD testing when initiating ADT to properly assess baseline fracture risk. The objective was to examine the proportion of BMD testing in men initiating long-term ADT in Quebec. Methods: The cohort consists of men extracted from Quebec public healthcare insurance administrative databases who were diagnosed with PCa from 2001-2012 and treated by ADT for at least one continuous year. The primary study outcome was the receipt of baseline BMD testing (defined as a BMD test identified in the period from 6 months prior to and up to 12 months after ADT initiation). Multivariable generalized linear mixed with a logit link was performed to identify variables associated with baseline BMD testing accounting for physician clustering. Results: We identified 7,069 patients, of which 887 (12.6%) underwent baseline BMD testing. Baseline BMD testing varied by year of ADT initiation, from 7.7% in 2001-2003 to 12.3% in 2013-2012. Following multivariable analyses, later years of ADT initiation (2004-2006, 2007-2009, 2010-2012, 2013-2015) remained associated with higher odds of baseline BMD testing compared to the earlier years (2001-2003) (ORs ranging from 1.43-1.88; p < 0.001). Conversely, age > 80 (OR 0.73; 95% CI 0.57-0.94; p = 0.001), greater Charlson comorbidity score (OR 0.51; 95%CI 0.34-0.75; p = 0.001), and rural residence (OR 0.60; 95%CI 0.48-0.75; p < 0.001) were associated with lower odds of baseline BMD testing. Conclusions: In our study population, rates of baseline BMD testing in men initiating ADT are low, although the rates increased over the course of the study period. Potential gaps identified in baseline BMD testing include older, more comorbid patients, and rural residence. Additional efforts emphasizing the importance of BMD testing in PCa guidelines may be needed.

scholarly journals Corrigendum to “Predictors of Fracture Risk and Bone Mineral Density in Men with Prostate Cancer on Androgen Deprivation Therapy”

2017 ◽  
Vol 2017 ◽  
pp. 1-1
Author(s):  
Katherine Neubecker ◽  
Beverley Adams-Huet ◽  
Irfan M. Farukhi ◽  
Rosinda Castanon ◽  
Ugis Gruntmanis
Keyword(s):  
Prostate Cancer ◽  
Bone Mineral Density ◽  
Fracture Risk ◽  
Androgen Deprivation Therapy ◽  
Bone Mineral ◽  
Androgen Deprivation ◽  
Mineral Density

scholarly journals Contemporary Population-Based Analysis of Bone Mineral Density Testing in Men Initiating Androgen Deprivation Therapy for Prostate Cancer

2020 ◽  
Vol 18 (10) ◽  
pp. 1374-1381
Author(s):  
Jason Hu ◽  
Armen G. Aprikian ◽  
Marie Vanhuyse ◽  
Alice Dragomir
Keyword(s):  
Prostate Cancer ◽  
Bone Mineral Density ◽  
Fracture Risk ◽  
Androgen Deprivation Therapy ◽  
Bone Mineral ◽  
Androgen Deprivation ◽  
Primary Study ◽  
Mineral Density ◽  
Bone Mineral Density Testing ◽  
Bmd Testing

Background: Androgen deprivation therapy (ADT) is a cornerstone of treatment for advanced prostate cancer (PCa); however, it accelerates the loss of bone mineral density (BMD), which increases fracture risk. Guidelines recommend BMD testing when initiating ADT to assess baseline fracture risk properly. The objective of this study was to examine the proportion of BMD testing in men initiating ADT in Quebec and to identify factors associated with receipt of this testing. Methods: The study cohort consisted of men extracted from Quebec public healthcare insurance administrative databases who initiated continuous ADT from 2000 to 2015 for >12 months. The primary study outcome was receipt of BMD testing in the period from 6 months before through 12 months after ADT initiation. Multivariable generalized linear mixed regression modeling with a logit link was performed to identify variables associated with BMD testing. Results: We identified 22,033 patients, of whom 3,910 (17.8%) underwent BMD testing. Rates of BMD testing increased from 4.1% in 2000 to 23.4% in 2015. After multivariable analyses, prior history of osteoporosis (odds ratio [OR], 1.84; 95% CI, 1.32–2.57; P<.001), rheumatoid arthritis (OR, 1.64; 95% CI, 1.15–2.34; P=.006), use of bisphosphonates (OR, 1.47; 95% CI, 1.25–1.73; P<.001), and long-term corticosteroid use (OR, 1.63; 95% CI, 1.15–2.31; P=.006) were associated with higher odds of BMD testing. Patient age >80 years (OR, 0.67; 95% CI, 0.59–0.76; P<.001), metastases (OR, 0.79; 95% CI, 0.70–0.89; P<.001), higher Charlson comorbidity score (OR, 0.65; 95% CI, 0.51–0.81; P<.001), and rural residence (OR, 0.77; 95% CI, 0.68–0.87; P<.001) were associated with lower odds of BMD testing. Conclusions: In our study population, BMD testing rates in men initiating ADT were low, although they increased over the years especially in the years after the publication of recommendations for BMD testing in these patients. Potential gaps identified include being older, more comorbid, and rural areas. Overall, additional efforts emphasizing the importance of BMD testing in PCa guidelines may be needed.

scholarly journals Predictors of Fracture Risk and Bone Mineral Density in Men with Prostate Cancer on Androgen Deprivation Therapy

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Katherine Neubecker ◽  
Beverley Adams-Huet ◽  
Irfan M. Farukhi ◽  
Rosinda C. Delapena ◽  
Ugis Gruntmanis
Keyword(s):  
Prostate Cancer ◽  
Bone Mineral Density ◽  
Vertebral Fracture ◽  
Fracture Risk ◽  
Androgen Deprivation Therapy ◽  
Bone Mineral ◽  
Vertebral Fractures ◽  
Predictive Ability ◽  
Androgen Deprivation ◽  
Mineral Density

Decrease of bone mineral density (BMD) and fracture risk is increased in men with prostate cancer receiving androgen deprivation therapy (ADT). We looked at possible predictors of decreased BMD and increased fracture risk in men with prostate cancer; most of whom were on ADT. In a retrospective study, we analyzed serum, BMD, and clinical risk factors used in the Fracture Risk Assessment (FRAX) tool and others in 78 men with prostate cancer with reported height loss. The subjects were divided in two groups: 22 men with and 56 without vertebral fractures. 17 of the 22 men with vertebral fractures on spine X-rays did not know they had a vertebral fracture. Of those 17 men, 9 had not previously qualified for treatment based on preradiograph FRAX score calculated with BMD, and 6 based on FRAX calculated without BMD. Performing spine films increased the predictive ability of FRAX for vertebral fracture. Vertebral fracture was better predicted by FRAX for other osteoporotic fractures than FRAX for hip fractures. The inclusion of BMD in FRAX calculations did not affect the predictive ability of FRAX. The PSA level showed a positive correlation with lumbar spine BMD and accounted for about 9% of spine BMD.

Re: Toremifene to Reduce Fracture Risk in Men Receiving Androgen Deprivation Therapy for Prostate Cancer

2011 ◽  
Vol 185 (6) ◽  
pp. 2430-2432 ◽  
Author(s):  
Ruth E. Langley ◽  
Fay H. Cafferty ◽  
Philip A. Pollock ◽  
Patricia Price ◽  
Paul D. Abel
Keyword(s):  
Prostate Cancer ◽  
Fracture Risk ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Reduce Fracture Risk

scholarly journals Next-generation androgen receptor inhibitors in non-metastatic castration-resistant prostate cancer

2020 ◽  
Vol 12 ◽  
pp. 175883592097813
Author(s):  
Pernelle Lavaud ◽  
Clément Dumont ◽  
Constance Thibault ◽  
Laurence Albiges ◽  
Giulia Baciarello ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Androgen Receptor ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Next Generation ◽  
Castration Resistant Prostate Cancer ◽  
Free Survival ◽  
Castration Resistant ◽  
Recent Advances

Until recently, continuing androgen deprivation therapy (ADT) and closely monitoring patients until evolution towards metastatic castration-resistant prostate cancer (CRPC) were recommended in men with non-metastatic CRPC (nmCRPC). Because delaying the development of metastases and symptoms in these patients is a major issue, several trials have investigated next-generation androgen receptor (AR) axis inhibitors such as apalutamide, darolutamide, and enzalutamide in this setting. This review summarizes the recent advances in the management of nmCRPC, highlighting the favourable impact of next-generation AR inhibitors on metastases-free survival, overall survival and other clinically meaningful endpoints.

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