Impact of testosterone replacement therapy after radiation therapy on prostate cancer outcomes.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 99-99
Author(s):  
Reith Sarkar ◽  
J Kellogg Parsons ◽  
John Paul Einck ◽  
Arno James Mundt ◽  
A. Karim Kader ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Biochemical Recurrence ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Treatment Groups

99 Background: Currently there is little data to guide the use of testosterone replacement therapy in prostate cancer patients who have received radiation therapy (RT). We sought to evaluate the impact of post-RT testosterone replacement on prostate cancer outcomes in a large national cohort. Methods: We conducted a population-based cohort study using the Veterans Affairs Informatics and Computing Infrastructure. We identified node-negative and non-metastatic prostate cancer patients diagnosed between 2001-2015 treated with RT. We excluded patients for missing covariate and follow-up data. Receipt of testosterone was coded as a time-dependent covariate. Other covariates included: age, Charlson Comorbidity index, diagnosis year, body mass index, race, PSA, clinical T/N/M stage, Gleason score, and receipt of hormone therapy. We evaluated prostate cancer-specific survival, overall survival, and biochemical recurrence free survival using multivariable Cox regression. Results: Our cohort included 41,544 patients, of whom 544 (1.3%) received testosterone replacement after RT. There were no differences in Charlson comorbidity, clinical T stage, median pre-treatment PSA or Gleason score between treatment groups. Testosterone patients were more likely to be of younger age, non-black, have a lower median post-treatment PSA nadir (0.1 vs. 0.2; p < 0.001), have higher BMI, and have used hormone therapy (46.7% vs 40.3%; p = 0.003). Median duration of ADT usage was equivalent between treatment groups (testosterone: 185 days vs. non-testosterone: 186 days, p = 0.77). The median time from RT to TRT was 3.52 years. After controlling for differences in covariates between treatment groups, we found no difference in prostate cancer specific mortality (HR 1.02; 95% CI 0.62-1.67; p = 0.95), overall survival (HR 1.02; 95% CI 0.84-1.24; p = 0.86), non-cancer mortality (HR 1.02; 95% CI 0.82-1.27; p = 0.86) biochemical recurrence free survival (HR 1.07; 95% CI 0.90-1.28; p = 0.45). Conclusions: Our results suggest that testosterone replacement is safe in prostate cancer patients who have received RT. Prospective data are required to confirm the safety of post-RT testosterone replacement.

Impact of testosterone replacement therapy after radical prostatectomy on prostate cancer outcomes.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 100-100
Author(s):  
Reith Sarkar ◽  
J Kellogg Parsons ◽  
John Paul Einck ◽  
Arno James Mundt ◽  
A. Karim Kader ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Radical Prostatectomy ◽  
Cancer Patients ◽  
Biochemical Recurrence ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy ◽  
Recurrence Free Survival ◽  
Free Survival

100 Background: Currently there is little data to guide the use of post-radical prostatectomy (RP) testosterone replacement therapy in prostate cancer. We sought to evaluate the impact of post-RP testosterone replacement on prostate cancer outcomes in a large national cohort. Methods: We conducted a population-based cohort study using the Veterans Affairs Informatics and Computing Infrastructure. We identified node-negative and non-metastatic prostate cancer patients diagnosed between 2001-2015 treated with RP. We excluded patients for missing covariate and follow-up data. We then coded receipt of testosterone replacement after RP as a time-dependent covariate. Other covariates included: age, Charlson Comorbidity index, diagnosis year, body mass index, race, PSA, clinical T/N/M stage, Gleason score, and receipt of hormone therapy. Biochemical recurrence was defined as a post-RP PSA≥0.2. We evaluated prostate cancer-specific survival, overall survival, and biochemical recurrence free survival using multivariable Cox regression. Results: Our cohort included 28,651 patients, of whom 469 (1.6%) received testosterone replacement after RP. Median follow up was 7.4 years. There were no differences in clinical T stage, median post-RP PSA (testosterone: 0 non-testosterone: 0; p = 0.18), or hormone therapy use between treatment groups. Testosterone patients were more likely to be of younger age, have higher comorbidity, non-black, have a lower median pre-treatment PSA (5.0 vs 5.8; p < 0.001), and have higher BMI. The median time from RP to TRT was 3.0 years. After controlling for potential confounders, we found no difference in prostate cancer specific mortality (HR 0.73; 95% CI 0.32-1.62; p = 0.43), overall survival (HR 1.11; 95% CI 0.86-1.44; p = 0.43), non-cancer mortality (HR 1.17; 95% CI 0.89-1.55; p = 0.26) biochemical recurrence free survival (HR 1.07; 95% CI 0.84-1.36; p = 0.59) between testosterone users and non-users. Conclusions: Our results suggest that testosterone replacement is safe in prostate cancer patients who have undergone RP, though prospective data is necessary to confirm this finding.

scholarly journals Prediction of Biochemical Recurrence-Free Survival of Prostate Cancer Patients Leveraging Multiple Gene Expression Profiles in Tumor Microenvironment

2021 ◽  
Vol 11 ◽  
Author(s):  
Rui Zhou ◽  
Yuanfa Feng ◽  
Jianheng Ye ◽  
Zhaodong Han ◽  
Yuxiang Liang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Tumor Microenvironment ◽  
Cancer Patients ◽  
Cancer Progression ◽  
Biochemical Recurrence ◽  
Expression Profiles ◽  
The Cancer Genome Atlas ◽  
Cell Contact ◽  
Recurrence Free Survival ◽  
Free Survival

Tumor-adjacent normal (TAN) tissues, which constitute tumor microenvironment and are different from healthy tissues, provide critical information at molecular levels that can be used to differentiate aggressive tumors from indolent tumors. In this study, we analyzed 52 TAN samples from the Cancer Genome Atlas (TCGA) prostate cancer patients and developed a 10-gene prognostic model that can accurately predict biochemical recurrence-free survival based on the profiles of these genes in TAN tissues. The predictive ability was validated using TAN samples from an independent cohort. These 10 prognostic genes in tumor microenvironment are different from the prognostic genes detected in tumor tissues, indicating distinct progression-related mechanisms in two tissue types. Bioinformatics analysis showed that the prognostic genes in tumor microenvironment were significantly enriched by p53 signaling pathway, which may represent the crosstalk tunnels between tumor and its microenvironment and pathways involving cell-to-cell contact and paracrine/endocrine signaling. The insight acquired by this study has advanced our knowledge of the potential role of tumor microenvironment in prostate cancer progression.

scholarly journals Positive expression of NR6A1/CT150 as a predictor of biochemical recurrence-free survival in prostate cancer patients

Oncotarget ◽  
2016 ◽  
Vol 8 (38) ◽  
pp. 64427-64439 ◽  
Author(s):  
Gong Cheng ◽  
Shangqian Wang ◽  
Xiao Li ◽  
Shuang Li ◽  
Yang Zheng ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Biochemical Recurrence ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Positive Expression

scholarly journals PD-L1promoter methylation is a prognostic biomarker for biochemical recurrence-free survival in prostate cancer patients following radical prostatectomy

Oncotarget ◽  
2016 ◽  
Vol 7 (48) ◽  
pp. 79943-79955 ◽  
Author(s):  
Heidrun Gevensleben ◽  
Emily Eva Holmes ◽  
Diane Goltz ◽  
Jörn Dietrich ◽  
Verena Sailer ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Cancer Patients ◽  
Biochemical Recurrence ◽  
Prognostic Biomarker ◽  
Recurrence Free Survival ◽  
Free Survival

Early surrogate measures for ablative therapies for intermediate-risk prostate cancer patients.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 241-241
Author(s):  
Rachel Glicksman ◽  
Amar Upadhyaya Kishan ◽  
Alan W. Katz ◽  
Constantine Anastasios Mantz ◽  
Sean P. Collins ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Cumulative Incidence ◽  
Biochemical Recurrence ◽  
Intermediate Risk ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Risk Prostate Cancer ◽  
Surrogate Measure ◽  
Surrogate Measures

241 Background: Stereotactic body radiotherapy (SBRT) is increasingly used to treat patients with intermediate-risk prostate cancer (IR-PCa), but there is a lack of early surrogate measures in this patient population treated with SBRT to guide clinicians and patients. We aim to explore the outcomes of IR-PCa patients treated with SBRT and to assess the role of PSA response at 4 years (4yPSARR) as an early surrogate measure given its encouraging results in patients treated with brachytherapy. Methods: Individual patient data from 6 institutions for 820 patients with IR-PCa treated with SBRT between 2006 and 2014 were analyzed. Cumulative incidence of biochemical recurrence (defined by Phoenix criteria) was calculated using Nelson-Aalen estimates, and metastases-free survival and overall survival were calculated using the Kaplan-Meier method. Biochemical recurrence-free survival was analyzed according to 4yPSARR with groups dichotomized based on PSA < 0.4 ng/mL or >0.4 ng/mL and compared using Log-rank test. Results: 820 patients were included, including 549 (67%) with favorable intermediate and 271 (33%) with unfavorable intermediate risk disease defined by NCCN risk group classification. Median age at time of treatment was 70 years. The most common dose, fractionation and treatment schedule was 36.25 Gy in 5 fractions prescribed to the planning target volume delivered every other day. Androgen deprivation therapy was used in combination with SBRT in 9.2% of patients for a median duration of 3 months. Median follow-up was 5.9 years. The cumulative incidence of biochemical recurrence was 7.9% at 5 years. Metastases-free survival and overall survival rates at 5 years were 99.4% and 94.6%, respectively. Median 4yPSARR (n = 504) was 0.2 ng/mL. Biochemical recurrence-free survival in patients with 4yPSARR < 0.4 ng/mL (n = 387) was 99.2%, and in patients with 4yPSARR >0.4 ng/mL (n = 117) was 81.5% at 5 years (p < 0.0001). Conclusions: Prostate SBRT is an effective treatment modality in men with IR-PCa with at least comparable rates of biochemical failure and metastases compared to other standard treatment modalities in patients with IR-PCa. 4yPSARR may represent an early surrogate measure for use in this patient population treated with SBRT and should be included for further study in prospective SBRT trials.

Sign in / Sign up

Export Citation Format

Share Document