Network metanalysis and cost-effectiveness of abiraterone, docetaxel or placebo plus androgen deprivation therapy (ADT) for hormone-sensitive advanced prostate cancer.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. 6615-6615
Author(s):  
Pedro Nazareth Aguiar ◽  
Pui San Tan ◽  
Sarah Simko ◽  
CARMELIA MARIA NOIA BARRETO ◽  
Barbara Gutierres Aguiar ◽  
...  
2017 ◽  
Vol 11 (6) ◽  
pp. 204 ◽  
Author(s):  
Bobby Shayegan ◽  
Frédéric Pouliot ◽  
Alan So ◽  
John Fernandes ◽  
Joseph Macri

Androgen-deprivation therapy (ADT) is a standard of care in the treatment of advanced prostate cancer; however, testosterone monitoring practices for men undergoing ADT vary across Canada. Although a testosterone level of 1.7 nmol/L or lower has historically been defined as the accepted castrate level, newer assays with improved sensitivity have shown that both medical and surgical castration can suppress testosterone levels to below 0.7 nmol/L. This review explores the evidence supporting a redefinition of the castrate testosterone level as 0.7 nmol/L or lower, and presents results of a survey of testosterone monitoring practices among 153 Canadian urologists, uro-oncologists, and radiation oncologists who manage the treatment of men with hormone-sensitive prostate cancer.


2018 ◽  
Vol 14 (10) ◽  
pp. 580-587 ◽  
Author(s):  
Dipti Gupta ◽  
Katherine Lee Chuy ◽  
Ji Can Yang ◽  
Megan Bates ◽  
Marissa Lombardo ◽  
...  

Androgen-deprivation therapy (ADT) entails lowering serum testosterone levels to castrate levels and forms a cornerstone of the management of hormone-sensitive advanced prostate cancer; however, the benefit of ADT is partially offset by its detrimental metabolic and cardiovascular adverse effects. ADT decreases insulin sensitivity while promoting dyslipidemia and sarcopenic obesity, which leads to an increased risk of cardiovascular morbidity and potentially mortality. The risk seems to be highest in elderly patients who have had recent cardiovascular events before starting ADT. It is prudent to engage in an individualized risk–benefit discussion and develop a cohesive multidisciplinary management plan to medically optimize and closely observe these patients before and during treatment with ADT.


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