scholarly journals American trends in expectant management utilization for prostate cancer from 2000 to 2009

2014 ◽  
Vol 8 (11-12) ◽  
pp. 775 ◽  
Author(s):  
Matthew J. Maurice ◽  
Robert Abouassaly ◽  
Hui Zhu
Keyword(s):  
Prostate Cancer ◽  
Expectant Management ◽  
Patient Characteristics ◽  
Veterans Affairs ◽  
Health Concern ◽  
Teaching Hospitals ◽  
Limited Life ◽  
Appreciable Increase ◽  
Low Volume

Introduction: The overtreatment of early prostate cancer has become a major public health concern. Expectant management (EM) is a strategy to minimize overtreatment, but little is known about its pattern of use. We sought to examine national EM utilization over the preceding decade.Methods: We examined prostate cancer treatment utilization from 2000 to 2009 using the National Cancer Database. EM use was analyzed in relation to other treatments and by cancer stage, age group, Charlson score, and hospital practice setting.Results: Overall, 109 997 (8.2%) men were managed initially with EM. EM usage remained stable at 7.6% to 9.5% from 2000 to 2009 with no appreciable increase for low-stage cancers. Usage was only slightly higher in elderly patients and in patients with multiple comorbidities. Veterans Affairs and low-volume hospitals had a much higher and increasing EM rate (range: 18.8%-29.8% and 15.1%-24.2%, respectively), compared to community hospitals, comprehensive cancer centres, and teaching hospitals, which showed no increased adoption. On further analysis, EM use remained high for low-stage cancers at Veterans Affairs and low-volume hospitals (24.0% and 19.1%, respectively), regardless of age or comorbidity, a pattern not shared by other practice settings.Conclusions: EM utilization remained low and stable last decade, regardless of disease or patient characteristics. Conversely, Veterans Affairs and low-volume hospitals led the trend in national EM adoption, particularly in men with low-stage cancers and limited life expectancies. The limitations of this dataset preclude any determination of the appropriateness of EM utilization. Nonetheless, further study is needed to identify factors influencing EM adoption to ensure its proper use in the future.

Influence of CHAARTED, STAMPEDE, and LATITUDE eligibility criteria on utilization of abiraterone (A) and docetaxel (D).

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 301-301
Author(s):  
Shruti Parshad ◽  
Urban Emmenegger
Keyword(s):  
Prostate Cancer ◽  
Treatment Duration ◽  
Medical Oncology ◽  
High Volume ◽  
Patient Characteristics ◽  
Phase Iii ◽  
Eligibility Criteria ◽  
Drug Access ◽  
Low Volume ◽  
Phase Iii Studies

301 Background: A and D improve the survival of men with high-risk localized or metastatic hormone-naïve prostate cancer (HNPC) when combined with androgen deprivation therapy (ADT). However, the two drugs differ regarding side effects, treatment duration, and associated costs. Furthermore, different eligibility criteria were used in the seminal phase III studies. Since the latter may impact on drug access in many constituencies, we decided to study how applying the eligibility criteria of CHAARTED, STAMPEDE and LATITUDE for drug funding purposes might influence the utilization of A versus D. Methods: 102 men with HNPC were referred from 06/2014 to 09/2017 to the medical oncology service at Odette Cancer Centre (Toronto/ON, Canada) for consideration of additional systemic therapy secondary to ADT. After extraction of baseline patient characteristics, we applied the eligibility criteria of CHAARTED (both high-volume [HV] and low-volume [LV] definition), STAMPEDE, and LATITUDE to determine the rate of men qualifying for treatment with A, D, or either of the two agents. Results: 98.0, 69.6, 28.4, and 47.1 percent of all 102 men fulfilled the STAMPEDE, CHAARTED-HV, CHAARTED-LV, and LATITUDE criteria, respectively. Considering that A funding for HNPC therapy is pending in Ontario, and that D funding is limited to men with CHAARTED-HV disease, the rate of D therapy was 62.0, 69.0, and 77.1 percent of patients conforming to STAMPEDE, CHAARTED-HV, and LATITUDE, respectively. 42 of 48 men (87.5%) conforming to LATITUDE would also be candidates for D, whereas 42 of 71 CHAARTED-HV patients (59.2%) would be eligible for A as alternative treatment. Hence, while all men fulfilling the STAMPEDE criteria (100 of 102, 98%) could be considered for either A or D, only 42 of 102 patients (41.2%) would be candidates for both of the drugs if the CHAARTED-HV and LATITUDE criteria were applied. Conclusions: In our patient population, applying the more restrictive CHAARTED-HV and LATITUDE criteria - as opposed to STAMPEDE - would result in around 30% or 50% fewer men offered D or A secondary to ADT, respectively. In addition, only around 40% of men would conform to both CHAARTED-HV and LATITUDE, and thus be candidates for both drugs.

475: Clinically Insignificant Prostate Cancer - Can we Reliable Predict Low Volume and Low Grade Prostate Cancer Preoperatively?

2006 ◽  
Vol 175 (4S) ◽  
pp. 154-154
Author(s):  
Michael Alschibaja ◽  
Joerg Massmann ◽  
Armin Funk ◽  
Heiner Van Randenborgh ◽  
Rudolf Hartung ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Low Grade ◽  
Low Volume ◽  
Insignificant Prostate Cancer

Role of Cytochrome P450 in Prostate Cancer and its Therapy

2020 ◽  
Vol 16 (1) ◽  
pp. 63-73 ◽  
Author(s):  
Rishabh Kaushik ◽  
Sheeza Khan ◽  
Meesha Sharma ◽  
Srinivasan Hemalatha ◽  
Zeba Mueed ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cytochrome P450 ◽  
Drug Discovery ◽  
Cholesterol Metabolism ◽  
Molecular Targets ◽  
Health Concern ◽  
Metabolic Functions ◽  
Novel Drugs ◽  
Genes Encoding ◽  
Causes Of Mortality

Prostate cancer has become a global health concern as it is one of the leading causes of mortality in males. With the emerging drug resistance to conventional therapies, it is imperative to unravel new molecular targets for disease prevention. Cytochrome P450 (P450s or CYPs) represents a unique class of mixed-function oxidases which catalyses a wide array of biosynthetic and metabolic functions including steroidogenesis and cholesterol metabolism. Several studies have reported the overexpression of the genes encoding CYPs in prostate cancer cells and how they can be used as molecular targets for drug discovery. But due to functional redundancy and overlapping expression of CYPs in several other metabolic pathways there are several impediments in the clinical efficacy of the novel drugs reported till now. Here we review the most crucial P450 enzymes which are involved in prostate cancer and how they can be used as molecular targets for drug discovery along with the clinical limitations of the currently existing CYP inhibitors.

Determination of Sarcosine Based on Magnetic Cross-linked Enzyme Aggregates for Diagnosis of Prostate Cancer

2021 ◽  
pp. 108039
Author(s):  
Qianqian Hu ◽  
Guoning Chen ◽  
Jili Han ◽  
Lu Wang ◽  
Xia Cui ◽  
...  
Keyword(s):  
Prostate Cancer

scholarly journals Development and Validation of a GMP-Compliant High-Pressure Liquid Chromatography Method for the Determination of the Chemical and Radiochemical Purity of [18F]PSMA-1007, a PET Tracer for the Imaging of Prostate Cancer

2021 ◽  
Vol 14 (3) ◽  
pp. 188
Author(s):  
Ines Katzschmann ◽  
Heike Marx ◽  
Klaus Kopka ◽  
Ute Hennrich
Keyword(s):  
Prostate Cancer ◽  
Quality Control ◽  
Radiochemical Purity ◽  
Control Method ◽  
Solid Phase ◽  
Hplc Method ◽  
Attractive Alternative ◽  
Chromatography Method ◽  
Pet Tracer

For the PET imaging of prostate cancer, radiotracers targeting the prostate-specific membrane antigen (PSMA) are nowadays used in clinical practice. [18F]PSMA-1007, a radiopharmaceutical labeled with fluorine-18, has excellent properties for the detection of prostate cancer. Essential for the human use of a radiotracer is its production and quality control under GMP-compliance. For this purpose, all analytical methods have to be validated. [18F]PSMA-1007 is easily radiosynthesized in a one-step procedure and isolated using solid phase extraction (SPE) cartridges followed by formulation of a buffered injection solution and for the determination of its chemical and radiochemical purity a robust, fast and reliable quality control method using radio-HPLC is necessary. After development and optimizations overcoming problems in reproducibility, the here described radio-HPLC method fulfills all acceptance criteria—for e.g., specificity, linearity, and accuracy—and is therefore well suited for the routine quality control of [18F]PSMA-1007 before release of the radiopharmaceutical. Recently a European Pharmacopeia monograph for [18F]PSMA-1007 was published suggesting a different radio-HPLC method for the determination of its chemical and radiochemical purity. Since the here described method has certain advantages, not least of all easier technical implementation, it can be an attractive alternative to the monograph method. The here described method was successfully validated on several radio-HPLC systems in our lab and used for the analysis of more than 60 batches of [18F]PSMA-1007. Using this method, the chemical and radiochemical purity of [18F]PSMA-1007 can routinely be evaluated assuring patient safety.

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