Proportion of biochemically-recurrent prostate cancer patients with durable undetectable PSA after short-course androgen deprivation therapy.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 207-207
Author(s):  
Daniel M. Lim ◽  
Roman Gulati ◽  
Serge Aleshin-Guendel ◽  
Heather H. Cheng ◽  
Agnes M. Gawne ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Specific Antigen ◽  
Initial Therapy ◽  
Androgen Deprivation ◽  
Clinical Value ◽  
Short Course ◽  
Increased Risk ◽  
The University ◽  
Trial Endpoint

207 Background: Optimal utilization of novel therapies for advanced prostate cancer is challenging without a validated surrogate efficacy endpoint. Ongoing trials are using durable undetectable prostate specific antigen (PSA) levels as a marker of efficacy. The proportion of patients and clinical relevance of those with a prolonged undetectable PSA after a short course of androgen deprivation therapy (ADT) is uncertain. Methods: The University of Washington Caisis database was queried for radical prostatectomy patients who received 6–12 months of ADT after biochemical recurrence (BCR), defined as PSA ≥ 0.2 ng/mL and no radiographically detectable metastasis. Proportions of patients with undetectable PSA 12 and 24 months after ending ADT were compared to a hypothesized 5% rate using exact binomial tests. Associations with patient and tumor characteristics were examined using logistic regression, and associations with risk of subsequent metastasis and death from any cause were evaluated by log-rank tests. Results: After ineligibility exclusions, data were abstracted from 93 patients. Proportions of patients with undetectable PSA 12 and 24 months after ending ADT were n=23/93 (24.7%; 95% CI 16.4–34.8%; P<0.001) and n=14/93 (15.1%; 95% CI 8.5–24.0%; P<0.001), respectively. Proportions of patients with undetectable PSA 12 and 24 months after testosterone recovery ≥ 50 ng/dL were n=16/65 (24.6%; 95% CI 14.8-36.9%) and n=10/65 (15.4%; 95% CI 7.6-26.5%), respectively. Being 1 year older at diagnosis was associated with an 11.5% (95% CI 3.1–21.9%; P=0.01) increase in the odds of having a detectable PSA after controlling for PSA at diagnosis, Gleason sum and time from initial therapy to BCR. Detectable PSA was associated with increased risk of metastasis (P=0.006) with marginal evidence of association with death from any cause (P=0.07). Conclusions: This single-institution retrospective analysis shows that it is not uncommon to have undetectable PSA 12 or 24 months after a short course of ADT. Additional analysis is needed to demonstrate the clinical value of this measure as a surrogate for prostate cancer outcomes and for consideration as a trial endpoint.

The risk of death from prostate cancer in men with Gleason Score 3+4 prostate cancer treated using brachytherapy with or without a short course of androgen deprivation therapy.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 330-330
Author(s):  
David Dewei Yang ◽  
Ming-Hui Chen ◽  
Michelle H. Braccioforte ◽  
Brian Joseph Moran ◽  
Anthony Victor D'Amico
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Gleason Score ◽  
Specific Antigen ◽  
Androgen Deprivation ◽  
Risk Of Death ◽  
Short Course ◽  
Increased Risk ◽  
Adenocarcinoma Of The Prostate ◽  
Biopsy Gleason Score

330 Background: We evaluated whether the intermediate-risk factors of percentage of positive biopsies (PPB), clinical tumor category, and prostate-specific antigen (PSA) level, in addition to age, were associated with the risk of prostate cancer-specific mortality (PCSM) among men with Gleason 3+4 prostate cancer treated with brachytherapy (BT) alone or BT and a short course of androgen deprivation therapy (ADT). Methods: We conducted a prospective cohort study of 1920 consecutively treated men with Gleason 3+4 adenocarcinoma of the prostate who received BT or BT and a median of 4 months of ADT between 10/14/1997 and 5/28/2013. Separate multivariable Fine and Gray competing risks regression models among men treated with BT or BT and ADT were used to assess whether PPB, cT2b-T2c, and PSA of 10.1-20.0 ng/ml, in addition to age greater than the median of 70 years, were associated with the risk of PCSM after adjustment for comorbidity. Results: After a median follow-up of 7.8 years (interquartile range 5.2-10.4 years), 284 men (14.8%) had died, including 31 (10.9% of deaths) from PC of which 18 (58.1%) and 13 (41.9%) occurred in men treated with BT or BT and ADT, respectively. For men treated with BT alone, increasing PPB, PSA of 10.1-20.0 vs 4.0-10.0 ng/mL, and age >70 vs ≤70 years were significantly associated with an increased risk of PCSM (adjusted hazard ratio [AHR] 1.015 95% confidence interval [CI] 1.000-1.031, P=0.048; AHR 5.55, 95% CI 2.01-15.29, P<0.001; and AHR 3.66, 95% CI 1.16-11.56, P=0.03, respectively). The respective results for men treated with BT and ADT were AHR 1.009, 95% CI 0.987-1.031, P=0.44; AHR 4.17, 95% CI 1.29-13.50, P=0.02; and AHR 3.74, 95% CI 0.87-16.05, P=0.08. The clinical tumor category was not significantly associated with the risk of PCSM. Conclusions: Among men with biopsy Gleason score 3+4 PC, both age >70 years and PSA of 10.1-20.0 ng/ml were significantly associated with an increased risk of PCSM following BT, and adding 4 months of ADT may not be sufficient to mitigate this risk. Advanced imaging and targeted biopsy of suspicious areas should be considered to personalize treatment in order to minimize the risk of PCSM in these men.

scholarly journals Undetectable prostate-specific antigen after short-course androgen deprivation therapy for biochemically recurrent patients correlates with metastasis-free survival and prostate cancer-specific survival

The Prostate ◽  
2018 ◽  
Vol 78 (14) ◽  
pp. 1077-1083
Author(s):  
Daniel M. Lim ◽  
Roman Gulati ◽  
Serge Aleshin-Guendel ◽  
Agnes Gawne ◽  
Jonathan T. Wingate ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Androgen Deprivation Therapy ◽  
Specific Antigen ◽  
Androgen Deprivation ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Short Course

Impact of Hypertension on Early Renal Dysfunction in Japanese Prostate Cancer Patients Treated With Androgen Deprivation Therapy

2021 ◽  
Vol 1 (3) ◽  
pp. 179-183
Author(s):  
HIROSHI MASUDA ◽  
MASAHIRO SUGIURA ◽  
KYOKUSIN HOU ◽  
KAZUHIRO ARAKI ◽  
SATOKO KOJIMA ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Renal Function ◽  
Renal Dysfunction ◽  
Cancer Patients ◽  
Androgen Deprivation Therapy ◽  
Salt Intake ◽  
Specific Antigen ◽  
Androgen Deprivation ◽  
Rate Of Change ◽  
Increased Risk

Background/Aim: Recently, it was reported that the use of androgen deprivation therapy (ADT) is significantly associated with an increased risk of acute kidney injury (AKI) in patients with newly diagnosed non-metastatic prostate cancer. This study aimed to investigate the incidence of early renal dysfunction in Japanese prostate cancer patients receiving ADT and the factors associated with it. Patients and Methods: A total of 135 patients who had been pathologically diagnosed with prostate cancer and had received ADT for at least 6 months were eligible for study inclusion. The estimated glomerular filtration rate (eGFR) before treatment, and at 1, 3, and 6 months of ADT were evaluated retrospectively. We assessed renal function using eGFR and investigated the rate of change in the eGFR (ΔeGFR) during ADT. Univariate and multivariate logistic analyses were carried out to identify clinical factors that were significantly associated with renal dysfunction after 6 months ADT. Results: A total of 110 cases were evaluated in this study. The incidence of renal dysfunction after 6 months ADT was 63% (69/110). The mean ΔeGFR after 1, 3, and 6 months of ADT were –0.6%, –3.1% and –1.7%, respectively (p<0.001). Multivariate analysis showed that renal dysfunction after 3 months of ADT and hypertension were independent risk factors for renal dysfunction after 6 months ADT. Conclusion: Renal dysfunction occurs from 1 month of ADT and hypertensive prostate cancer patients receiving ADT are at high risk of developing renal dysfunction, and that such patients should be treated very carefully. Therefore, patients that are started on ADT should undergo periodic prostate-specific antigen, renal function, and urinary salt intake examinations.

Early versus delayed initiation of salvage androgen deprivation therapy and the risk of prostate cancer-specific mortality.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 189-189
Author(s):  
Brandon Arvin Virgil Mahal ◽  
Ming-Hui Chen ◽  
Andrew A. Renshaw ◽  
Philip W. Kantoff ◽  
Anthony Victor D'Amico
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Specific Antigen ◽  
Androgen Deprivation ◽  
Early Initiation ◽  
Study Cohort ◽  
Increased Risk ◽  
Specific Mortality ◽  
Salvage Androgen Deprivation Therapy

189 Background: We sought to ascertain whether there is an association between prostate cancer (PC)-specific mortality (PCSM) and salvage androgen deprivation therapy (ADT) timing amongst men with short versus long prostate-specific antigen doubling times (PSA-DT)s. Methods: The study cohort was selected from 206 men with localized unfavorable-risk PC who were randomized to radiation therapy (RT) or RT plus 6 months of ADT between 1995 and 2001. Fifty-four men who received salvage ADT for PSA failure after a median follow up of 18.72 years following randomization defined the study cohort. Fine-Gray competing risks regression analyzed whether the timing of salvage ADT was associated with an increased risk of PCSM after adjusting for age, comorbidity, known PC prognostic factors, and previously identified interactions. Results: After a median follow-up of 5.68 years (IQR 3.05 - 9.56) following salvage ADT 49 of the 54 men (91%) died, 27 from PC (54% of deaths). Increasing PSA-DT as a continuous covariate was associated with a decreasing risk of PCSM (adjusted hazard ratio [AHR] 0.33, 95% CI 0.13, 0.82; P=0.02). Amongst men with a long PSA-DT (≥6 months), initiating salvage ADT later (PSA>12ng/mL, upper quartile) versus earlier was associated with an increased risk of PCSM (AHR 8.84, 95% CI 1.99-39.27; P=0.004); whereas for men with a short (<6 months) PSA-DT (AHR 1.16, 95% CI 0.38-3.54; P=0.79) this was not true. Conclusions: Early initiation of salvage ADT for post-RT PSA recurrence in men with a PSA-DT of 6 months or more may reduce the risk of PCSM, arguing against the unproven assumption that patients with a short PSA-DT are those most likely to benefit from early initiation of salvage ADT. Clinical trial information: NCT00116220.

598: Increased Risk of Newly Diagnosed Comorbidities in Prostate Cancer Patients Treated with Androgen Deprivation Therapy

2007 ◽  
Vol 177 (4S) ◽  
pp. 200-200 ◽  
Author(s):  
Andrea Gallina ◽  
Pierre I. Karakiewicz ◽  
Jochen Walz ◽  
Claudio Jeldres ◽  
Quoc-Dien Trinh ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Newly Diagnosed ◽  
Increased Risk

The Role of Chromogranin A (CgA) in Monitoring Patients with Prostate Cancer Under Androgen Deprivation Therapy: Comparison with Prostatic Specific Antigen (PSA)

2008 ◽  
Vol 1 (2) ◽  
pp. 115-119
Author(s):  
Athanasios Bantis ◽  
Petros Sountoulides ◽  
Athanasios Zissimopoulos ◽  
Christos Kalaitzis ◽  
Stilianos Giannakopoulos ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Chromogranin A ◽  
Specific Antigen ◽  
Androgen Deprivation ◽  
Prostatic Specific Antigen

Androgen deprivation therapy and risk of SARS-CoV-2 infection in men with prostate cancer: A University of California (UC) Health System registry study.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 37-37
Author(s):  
Daniel Kwon ◽  
Rohit Vashisht ◽  
Hala Borno ◽  
Rahul Raj Aggarwal ◽  
Eric Jay Small ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Health System ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Host Cells ◽  
University Of California ◽  
Registry Study ◽  
Medical Centers ◽  
Chi Squared ◽  
The University

37 Background: SARS-CoV-2 entry into host cells is facilitated by the transmembrane protease TMPRSS2. TMPRSS2 expression can be modulated by the androgen receptor. It is unclear whether androgen deprivation therapy (ADT) may partially protect from SARS-CoV-2 infection. Methods: A retrospective registry study of adult men with prostate cancer who underwent testing for SARS-CoV-2 in the UC Health System between February 1, 2020 and October 6, 2020 was performed. The University of California Health COVID Research Data Set (UC CORDS), which includes electronic health data of all patients who underwent testing for SARS-CoV-2 at 5 UC academic medical centers (UC Davis, UC Irvine, UC Los Angeles, UC San Diego, and UC San Francisco) and 12 affiliated hospitals across California, was used. Association of SARS-CoV-2 infection and receipt of ADT (GnRH agonist or antagonist) within 90 days of COVID testing was determined using the Chi-Squared test. Analyses (Chi-Squared or Fisher’s exact tests) were also performed in race/ethnicity subgroups. Results: Overall, 2,948 men with prostate cancer who underwent SARS-CoV-2 testing were identified, of whom 59 (2.0%) tested positive. Of the 2,948 men, 2,124 (72%) were White; 219 (7%) Black or African-American; 182 (6%) Asian or Native Hawaiian/Pacific-Islander; 176 (6%) Other race; and 247 (8%) Unknown race. There were 235 (8%) Hispanic or Latino men. Among the 444 men who received ADT in the entire cohort, 7 (1.6%) tested positive, and among the 2,504 men who did not receive ADT, 52 (2.1%) tested positive (OR 0.76, 95% CI 0.34-1.67, P = 0.49). No statistically significant association between ADT and SARS-CoV-2 positivity was found within race or ethnicity subgroups. Conclusions: No association between the use of ADT and the risk of testing positive for SARS-CoV-2 was identified in this study of a diverse patient population in the University of California Health System medical centers and hospitals. In this setting of an overall low prevalence of SARS-CoV-2 infection, thus far, there is no strong evidence of a protective benefit of ADT.

Interpreting Testosterone and Concomitant Prostate Specific Antigen Values during Androgen Deprivation Therapy for Recurrent Prostate Cancer

2021 ◽  
Author(s):  
Samuel Tremblay ◽  
Lily Summers-Trasiewicz ◽  
Frédéric Pouliot ◽  
Juanita M. Crook ◽  
Keyue Ding ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Androgen Deprivation Therapy ◽  
Specific Antigen ◽  
Androgen Deprivation ◽  
Recurrent Prostate Cancer
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