scholarly journals AZGP1 Protein Expression in Hormone-Naïve Advanced Prostate Cancer Treated with Primary Androgen Deprivation Therapy

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 520
Author(s):  
Mads Dochedahl Winther ◽  
Gitte Kristensen ◽  
Hein Vincent Stroomberg ◽  
Kasper Drimer Berg ◽  
Birgitte Grønkær Toft ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Prediction Models ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Androgen Deprivation ◽  
Cox Regression Analysis ◽  
Primary Androgen Deprivation Therapy ◽  
Specific Mortality ◽  
Primary Androgen Deprivation

Biomarkers for predicting the risk of castration-resistant prostate cancer (CRPC) in men treated with primary androgen deprivation therapy (ADT) are lacking. We investigated whether Zinc-alpha 2 glycoprotein (AZGP1) expression in the diagnostic biopsies of men with hormone-naïve prostate cancer (PCa) undergoing primary ADT was predictive of the development of CRPC and PCa-specific mortality. The study included 191 patients who commenced ADT from 2000 to 2011. The AZGP1 expression was evaluated using immunohistochemistry and scored as high or low expression. The risks of CRPC and PCa-specific mortality were analyzed using stratified cumulative incidences and a cause-specific COX regression analysis for competing risk assessment. The median follow-up time was 9.8 (IQR: 6.1–12.7) years. In total, 94 and 97 patients presented with low and high AZGP1 expression, respectively. A low AZGP1 expression was found to be associated with a shorter time to CRPC when compared to patients with a high AZGP1 expression (HR: 1.5; 95% CI: 1.0–2.1; p = 0.03). However, the multivariable analysis demonstrated no added benefit by adding the AZGP1 expression to prediction models for CRPC. No differences for PCa-specific mortality between the AZGP1 groups were observed. In conclusion, a low AZGP1 expression was associated with a shorter time to CRPC for PCa patients treated with first-line ADT but did not add any predictive information besides well-established clinicopathological variables.

scholarly journals Effectiveness of Primary Androgen-Deprivation Therapy for Clinically Localized Prostate Cancer

2014 ◽  
Vol 32 (13) ◽  
pp. 1324-1330 ◽  
Author(s):  
Arnold L. Potosky ◽  
Reina Haque ◽  
Andrea E. Cassidy-Bushrow ◽  
Marianne Ulcickas Yood ◽  
Miao Jiang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Localized Prostate Cancer ◽  
Curative Intent ◽  
Primary Androgen Deprivation Therapy ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Primary Androgen Deprivation

Purpose Primary androgen-deprivation therapy (PADT) is often used to treat clinically localized prostate cancer, but its effects on cause-specific and overall mortality have not been established. Given the widespread use of PADT and the potential risks of serious adverse effects, accurate mortality data are needed to inform treatment decisions. Methods We conducted a retrospective cohort study using comprehensive utilization and cancer registry data from three integrated health plans. All men were newly diagnosed with clinically localized prostate cancer. Men who were diagnosed between 1995 and 2008, were not treated with curative intent therapy, and received follow-up through December 2010 were included in the study (n = 15,170). We examined all-cause and prostate cancer-specific mortality as our main outcomes. We used Cox proportional hazards models with and without propensity score analysis. Results Overall, PADT was associated with neither a risk of all-cause mortality (hazard ratio [HR], 1.04; 95% CI, 0.97 to 1.11) nor prostate-cancer–specific mortality (HR, 1.03; 95% CI, 0.89 to 1.19) after adjusting for all sociodemographic and clinical characteristics. PADT was associated with decreased risk of all-cause mortality but not prostate-cancer–specific mortality. PADT was associated with decreased risk of all-cause mortality only among the subgroup of men with a high risk of cancer progression (HR, 0.88; 95% CI, 0.78 to 0.97). Conclusion We found no mortality benefit from PADT compared with no PADT for most men with clinically localized prostate cancer who did not receive curative intent therapy. Men with higher-risk disease may derive a small clinical benefit from PADT. Our study provides the best available contemporary evidence on the lack of survival benefit from PADT for most men with clinically localized prostate cancer.

Associations between statin use and progression in men with prostate cancer treated with primary androgen deprivation therapy

2017 ◽  
Vol 51 (6) ◽  
pp. 464-469 ◽  
Author(s):  
Marta Kramer Mikkelsen ◽  
Frederik Birkebæk Thomsen ◽  
Kasper Drimer Berg ◽  
Mary Jarden ◽  
Signe Benzon Larsen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Primary Androgen Deprivation Therapy ◽  
Statin Use ◽  
Primary Androgen Deprivation

scholarly journals Trans-Pacific variation in outcomes for men treated with primary androgen-deprivation therapy (ADT) for prostate cancer

2015 ◽  
Vol 117 (1) ◽  
pp. 102-109 ◽  
Author(s):  
Matthew R. Cooperberg ◽  
Shiro Hinotsu ◽  
Mikio Namiki ◽  
Peter R. Carroll ◽  
Hideyuki Akaza
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Primary Androgen Deprivation Therapy ◽  
Primary Androgen Deprivation

Trans-Pacific variation in outcomes for men treated with primary androgen deprivation therapy for localized prostate cancer.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 92-92
Author(s):  
Matthew R. Cooperberg ◽  
Shiro Hinotsu ◽  
Mikio Namiki ◽  
Peter Carroll ◽  
Hideyuki Akaza
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
The United States ◽  
Androgen Deprivation ◽  
Localized Prostate Cancer ◽  
Primary Androgen Deprivation Therapy ◽  
The Pacific ◽  
Treatment Type ◽  
The Us ◽  
Primary Androgen Deprivation

92 Background: Primary androgen deprivation therapy (PADT) is endorsed as an option for monotherapy for localized prostate cancer by guidelines in Asia but not in the United States (US) or Europe. PADT use is common, however, in both the US and Japan. Prior studies on either side of the Pacific have reported disparate outcomes for PADT; we aimed to explore these differences in a direct comparison study. Methods: Data were drawn from the US community-based CaPSURE registry and from J-CaP, comprising men in Japan treated with PADT. 1934 men treated with PADT were included from CaPSURE, and 16,300 treated in J-CaP. Risk adjustment was based on the validated Japan Cancer of the Prostate Risk Assessment (J-CAPRA) score. Cox proportional hazards regression was used to assess prostate cancer-specific mortality (CSM), adjusting for age, J-CAPRA, year of diagnosis, and treatment type (combined androgen blockade [CAB] vs. castration (medical or surgical) monotherapy). Results: Men treated with PADT in J-CaP were older than those in CaPSURE (mean age 75.0 vs. 72.7, p<0.001), and had higher risk disease (mean J-CAPRA score 3.0 vs. 2.1, p<0.001). They were more likely to be treated with CAB: 67.1% vs. 44.5% (p<0.001). In the Cox model, the hazard ratio (HR) for PCSM was 0.31 for J-CaP compared to CaPSURE, 95% CI 0.25–0.40. In J-CaP, CAB improved survival compared to castration alone (HR 0.81, 95% CI 0.66–1.0), but this effect was not observed in CaPSURE (HR 0.96, 95% CI 0.69–1.34). For all-cause mortality, the HR for J-CaP was 0.27 (95% CI 0.24–0.30). Conclusions: Adjusting for multiple factors including disease risk and type of androgen ablation, men treated with PADT in Japan compared to the US have more than 3-fold lower CSM and 4-fold better overall survival. CAB improved outcomes compared to castration alone in J-CaP but not in CaPSURE. These findings support existing guidelines both encouraging PADT in Asia and discouraging its use in the West. The reasons for these substantial differences likely include both genetic and dietary/environmental factors, as well as potential confounding variables such as comorbidities. Such factors may explain varying biology of prostate cancer on both sides of the Pacific.

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