1
|
Rodler S, Danninger D, Eismann L, Kazmierczak PM, Jokisch F, Li M, Becker A, Kretschmer A, Stief C, Westhofen T. Health-related quality of life following salvage radical prostatectomy for recurrent prostate cancer after radiotherapy or focal therapy. World J Urol 2024; 42:242. [PMID: 38635030 PMCID: PMC11026200 DOI: 10.1007/s00345-024-04945-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/17/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Salvage radical prostatectomy (sRP) is an important treatment option for patients with recurrent prostate cancer (PCa) after radiotherapy (RT) or focal therapy (FT). However, health-related quality of life (HRQOL) after sRP depending on the primary treatment is understudied. METHODS Patients who underwent Salvage RP for recurrent PCa were analyzed. The primary outcome of this study was HRQOL assessed by the quality-of-life questionnaire (QLQ)-C30 and its prostate specific QLQ-PR25 add-on. Secondary outcomes were functional outcome parameters (erectile function, continence) and biochemical recurrence-free survival (BRFS). Statistical analyses employed the chi-square test, Mann-Whitney U test, and Kaplan-Meier method, with a p value < 0.05 denoting significance. RESULTS 37 patients with RT as primary treatment (RT-sRP) and 22 patients with focal therapy prior sRP (FT-sRP) were analyzed. Mean global health score was not significantly different preoperatively (71.9 vs. 67.3, p = 0.89) as well as after a median of 32 months follow-up (54.9 vs. 50.6, p = 0.63) with impaired HRQOL after sRP in both groups. Baseline erectile dysfunction was more prevalent in the RT-sRP group (mean IIEF-5: 5.0) than in the FT-sRP group (mean IIEF-5: 8.5, p = 0.037). No differences were observed at follow-up for erectile function (IIEF-5-Score: 0.5 vs 2.5, p = 0.199) and continence (continence rate: 48.4% vs 52.9% (p = 0.763) between the RT-sRP and FT-sRP group. 5-year-BRFS was 60% (RT-sRP) and 68% (FT-sRP, p = 0.849). CONCLUSIONS sRP impacts HRQOL in patients with PCa after RT and FT with no significant differences. Comparison with HRQOL and BRFS of treatment alternatives is paramount to counsel patients for appropriate treatments.
Collapse
Affiliation(s)
- Severin Rodler
- Department of Urology, LMU University Hospital, Marchioninistr. 15, 81377, Munich, Germany.
| | - Dina Danninger
- Department of Urology, LMU University Hospital, Marchioninistr. 15, 81377, Munich, Germany
| | - Lennert Eismann
- Department of Urology, LMU University Hospital, Marchioninistr. 15, 81377, Munich, Germany
| | | | - Friedrich Jokisch
- Department of Urology, LMU University Hospital, Marchioninistr. 15, 81377, Munich, Germany
| | - Minglun Li
- Department of Radiotherapy, Klinikum Lüneburg, Lüneburg, Germany
| | - Armin Becker
- Department of Urology, LMU University Hospital, Marchioninistr. 15, 81377, Munich, Germany
| | - Alexander Kretschmer
- Department of Urology, LMU University Hospital, Marchioninistr. 15, 81377, Munich, Germany
| | - Christian Stief
- Department of Urology, LMU University Hospital, Marchioninistr. 15, 81377, Munich, Germany
| | - Thilo Westhofen
- Department of Urology, LMU University Hospital, Marchioninistr. 15, 81377, Munich, Germany
| |
Collapse
|
2
|
Zheng Z, Shi KS, Kamal A, Howard DH, Horný M, Richards TB, Ekwueme DU, Yabroff KR. Health-related quality of life among prostate cancer survivors with metastatic disease and non-metastatic disease and men without a cancer history in the USA. J Cancer Surviv 2023:10.1007/s11764-023-01509-8. [PMID: 38102521 PMCID: PMC11180215 DOI: 10.1007/s11764-023-01509-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Few studies have comprehensively compared health-related quality of life (HRQoL) between metastatic prostate cancer survivors, survivors with non-metastatic disease, and men without a cancer history. METHODS We used the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey (SEER-MHOS) data linkage to identify men aged ≥ 65 years enrolled in Medicare Advantage (MA) plans. Prostate cancer survivors were diagnosed between 1988 and 2017 and completed MHOS surveys between 1998 and 2019. We analyzed data from 752 metastatic prostate cancer survivors (1040 survey records), 19,583 localized or regional prostate cancer survivors (non-metastatic; 30,121 survey records), and 784,305 men aged ≥ 65 years without a cancer history in the same SEER regions (1.15 million survey records). We used clustered linear regressions to compare HRQoL measures at the person-level using the Veterans RAND 12 Item Health Survey (VR-12) T-scores for general health and physical and mental component summaries. RESULTS Compared to men without a cancer history, prostate cancer survivors were older, more likely to be married, and had higher socioeconomic status. Compared to men without a cancer history, metastatic prostate cancer survivors reported lower general health (T-score differences [95% confidence interval]: - 6.26, [- 7.14, - 5.38], p < .001), physical health (- 4.33, [- 5.18, - 3.48], p < .001), and mental health (- 2.64, [- 3.40, - 1.88], p < .001) component summaries. Results were similar for other VR-12 T-scores. In contrast, non-metastatic prostate cancer survivors reported similar VR-12 T-scores as men without a cancer history. Further analyses comparing metastatic and non-metastatic prostate cancer survivors support these findings. CONCLUSION Interventions to improve health-related quality of life for men diagnosed with metastatic prostate cancer merit additional investigation. IMPLICATIONS FOR CANCER SURVIVORS Interventions to improve health-related quality of life for metastatic prostate cancer survivors merit additional investigation.
Collapse
Affiliation(s)
| | | | - Arif Kamal
- American Cancer Society, Atlanta, GA, USA
| | - David H Howard
- Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Michal Horný
- Emory University Rollins School of Public Health, Atlanta, GA, USA
- Emory University School of Medicine, Atlanta, GA, USA
| | | | | | | |
Collapse
|
3
|
Yang X, Tan YG, Gatsinga R, Chen W, Huang HH, Loong JTK, Chua MLK, Rajasekaran T, Kanesvaran R, Tay KJ, Chen K, Yuen JSP. Far from the truth: Real-world treatment patterns among newly diagnosed metastatic prostate cancer in the era of treatment intensification. Int J Urol 2023; 30:991-999. [PMID: 37431969 DOI: 10.1111/iju.15243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/27/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVES Real-world uptake of treatment intensification (TI) with novel hormonal agents (NHA) or chemotherapy as treatment of metastatic prostate cancer remains low outside of trial settings. We aim to report the prescription patterns and treatment outcomes of de novo metastatic hormone-sensitive prostate cancer (mHSPC) in a tertiary institution. METHODS This is a retrospective cohort study using real-world data from a prospectively maintained prostate cancer registry. We selected patients newly diagnosed with mHSPC from January 2016 to December 2020. Clinicopathological parameters were recorded to determine their impact on prescription patterns. RESULTS In total, 585 patients with metastatic prostate cancer were identified. Prescription of NHA increased from 10.5% (2016) to 50.4% (2020), but that of chemotherapy declined. Factors associated with TI were (1) baseline health status: Charlson Comorbidity Index 0-2, ECOG 0-1, age ≤ 65, (2) disease burden: PSA (>400, CHAARTED high volume disease, p = 0.004), development of systemic complications and (3) physician factor: primary physician being uro-oncologist and medical oncologist versus general urologist. Patients with TI had a longer mean time to castration-resistant prostate cancer (45.0 vs. 32.5 months, HR 0.567, 95% CI: 0.441-0.730, p < 0.001) and overall survival (55.3 vs. 46.8 months, HR 0.612, 95% CI, 0.447-0.837, p = 0.001). CONCLUSION This study demonstrated the trend of treatment prescription of mHSPC and factors contributing to the use of TI. TI improved mean time to CRPC and OS.
Collapse
Affiliation(s)
- Xinyan Yang
- Department of Urology, Singapore General Hospital, Singapore
| | - Yu Guang Tan
- Department of Urology, Singapore General Hospital, Singapore
| | - Rene Gatsinga
- Department of Urology, Singapore General Hospital, Singapore
| | - Weiren Chen
- Department of Urology, Singapore General Hospital, Singapore
| | - Hong Hong Huang
- Department of Urology, Singapore General Hospital, Singapore
| | | | | | | | | | - Kae Jack Tay
- Department of Urology, Singapore General Hospital, Singapore
| | - Kenneth Chen
- Department of Urology, Singapore General Hospital, Singapore
| | | |
Collapse
|
4
|
Leaning D, Kaur G, Morgans AK, Ghouse R, Mirante O, Chowdhury S. Treatment landscape and burden of disease in metastatic castration-resistant prostate cancer: systematic and structured literature reviews. Front Oncol 2023; 13:1240864. [PMID: 37829336 PMCID: PMC10565658 DOI: 10.3389/fonc.2023.1240864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/09/2023] [Indexed: 10/14/2023] Open
Abstract
Purpose Metastatic castration-resistant prostate cancer (mCRPC) is a lethal disease that imposes a major burden on patients and healthcare systems. Three structured literature reviews (treatment guidelines, treatment landscape, and human/clinical/patient burden) and one systematic literature review (economic burden) were conducted to better understand the disease burden and unmet needs for patients with late-stage mCRPC, for whom optimal treatment options are unclear. Methods Embase®, MEDLINE®, MEDLINE® In-Process, the CENTRAL database (structured and systematic reviews), and the Centre for Reviews and Dissemination database (systematic review only) were searched for English-language records from 2009 to 2021 to identify mCRPC treatment guidelines and studies related to the treatment landscape and the humanistic/economic burden of mCRPC in adult men (aged ≥18 years) of any ethnicity. Results In total, six records were included for the treatment patterns review, 14 records for humanistic burden, nine records for economic burden, three records (two studies) for efficacy, and eight records for safety. Real-world treatment patterns were broadly aligned with treatment guidelines and provided no optimal treatment sequencing beyond second line other than palliative care. Current post-docetaxel treatments in mCRPC are associated with adverse events that cause relatively high rates of treatment discontinuation or disruption. The humanistic and economic burdens associated with mCRPC are high. Conclusion The findings highlight a lack of treatment options with novel mechanisms of action and more tolerable safety profiles that satisfy a risk-to-benefit ratio aligned with patient needs and preferences for patients with late-stage mCRPC. Treatment approaches that improve survival and health-related quality of life are needed, ideally while simultaneously reducing costs and healthcare resource utilization.
Collapse
Affiliation(s)
- Darren Leaning
- Department of Radiology and Oncology, James Cook University Hospital, South Tees NHS Trust, Middlesbrough, United Kingdom
| | - Gagandeep Kaur
- Parexel Access Consulting, Parexel International, Mohali, Punjab, India
| | - Alicia K. Morgans
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Ray Ghouse
- Advanced Accelerator Applications, a Novartis Company, Genève, Switzerland
| | - Osvaldo Mirante
- Advanced Accelerator Applications, a Novartis Company, Genève, Switzerland
| | - Simon Chowdhury
- Department of Urological Cancer, Guy’s, King’s, and St. Thomas’ Hospitals, and Sarah Cannon Research Institute, London, United Kingdom
| |
Collapse
|
5
|
Smith MR, Sandhu S, George DJ, Chi KN, Saad F, Thiery-Vuillemin A, Stàhl O, Olmos D, Danila DC, Gafanov R, Castro E, Moon H, Joshua AM, Mason GE, Espina BM, Liu Y, Lopez-Gitlitz A, Francis P, Bevans KB, Fizazi K. Health-related quality of life in GALAHAD: A multicenter, open-label, phase 2 study of niraparib for patients with metastatic castration-resistant prostate cancer and DNA-repair gene defects. J Manag Care Spec Pharm 2023; 29:758-768. [PMID: 37404070 PMCID: PMC10387937 DOI: 10.18553/jmcp.2023.29.7.758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
BACKGROUND: Niraparib is a highly selective poly (adenosine diphosphateribose) polymerase-1 and poly (adenosine diphosphate-ribose) polymerase-2 inhibitor indicated for select patients with ovarian, fallopian tube, and primary peritoneal cancer. The phase 2 GALAHAD trial (NCT02854436) demonstrated that niraparib monotherapy is tolerable and efficacious in patients with metastatic castration-resistant prostate cancer (mCRPC) and homologous recombination repair (HRR) gene alterations, particularly those with breast cancer gene (BRCA) alterations who had progressed on prior androgen signaling inhibitor therapy and taxane-based chemotherapy. OBJECTIVE: To report the prespecified patient-reported outcomes analysis from GALAHAD. METHODS: Eligible patients with alterations to BRCA1 and/or BRCA2 (BRCA cohort) and with pathogenic alterations in other HRR genes (other HRR cohort) were enrolled and received niraparib 300 mg once daily. Patient-reported outcome instruments included the Functional Assessment of Cancer Therapy-Prostate and the Brief Pain Inventory-Short Form. Changes from baseline were compared using a mixed-effect model for repeated measures. RESULTS: On average, health-related quality of life (HRQoL) improved in the BRCA cohort by cycle 3 (mean change = 6.03; 95% CI = 2.76-9.29) and was maintained above baseline until cycle 10 (mean change = 2.84; 95% CI = -1.95 to 7.63), whereas the other HRR cohort showed no early change in HRQoL from baseline (mean change = -0.07; 95% CI = -4.69 to 4.55) and declined by cycle 10 (mean change = -5.10; 95% CI = -15.3 to 5.06). Median time to deterioration in pain intensity and pain interference could not be estimated in either cohort. CONCLUSIONS: Patients with advanced mCRPC and BRCA alterations treated with niraparib experienced more meaningful improvement in overall HRQoL, pain intensity, and pain interference compared with those with other HRR alterations. In this population of castrate, heavily pretreated patients with mCRPC and HRR alterations, stabilization, and improvement in HRQoL may be relevant to consider when making treatment decisions. DISCLOSURES: This work was supported by Janssen Research & Development, LLC (no grant number). Dr Smith has received grants and personal fees from Bayer, Amgen, Janssen, and Lilly; and has received personal fees from Astellas Pharma, Novartis, and Pfizer. Dr Sandhu has received grants from Amgen, Endocyte, and Genentech; has received grants and personal fees from AstraZeneca and Merck; and has received personal fees from Bristol Myers Squibb and Merck Serono. Dr George has received personal fees from the American Association for Cancer Research, Axess Oncology, Capio Biosciences, Constellation Pharma, EMD Serono, Flatiron, Ipsen, Merck Sharp & Dohme, Michael J. Hennessey Association, Millennium Medical Publishing, Modra Pharma, Myovant Sciences, Inc., NCI Genitourinary, Nektar Therapeutics, Physician Education Resource, Propella TX, RevHealth, LLC, and UroGPO; has received grants and personal fees from Astellas Pharma, AstraZeneca, Bristol Myers Squibb, and Pfizer; has received personal fees and nonfinancial support from Bayer and UroToday; has received grants from Calithera and Novartis; and has received grants, personal fees, and nonfinancial support from Exelixis, Inc., Sanofi, and Janssen Pharma. Dr Chi has received grants from Janssen during the conduct of the study; has received grants and personal fees from AstraZeneca, Bayer, Astellas Pharma, Novartis, Pfizer, POINT Biopharma, Roche, and Sanofi; and has received personal fees from Daiichi Sankyo, Merck, and Bristol Myers Squibb. Dr Saad has received grants, personal fees, and nonfinancial support from Janssen during the conduct of the study; and has received grants, personal fees, and nonfinancial support from AstraZeneca, Astellas Pharma, Pfizer, Bayer, Myovant, Sanofi, and Novartis. Dr Thiery-Vuillemin has received grants, personal fees, and nonfinancial support from Pfizer; has received personal fees and nonfinancial support from AstraZeneca, Janssen, Ipsen, Roche/Genentech, Merck Sharp & Dohme, and Astellas Pharma; and has received personal fees from Sanofi, Novartis, and Bristol Myers Squibb. Dr Olmos has received grants, personal fees, and nonfinancial support from AstraZeneca, Bayer, Janssen, and Pfizer; has received personal fees from Clovis, Daiichi Sankyo, and Merck Sharp & Dohme; and has received nonfinancial support from Astellas Pharma, F. Hoffman-LaRoche, Genentech, and Ipsen. Dr Danila has received research support from the US Department of Defense, the American Society of Clinical Oncology, the Prostate Cancer Foundation, Stand Up to Cancer, Janssen Research & Development, Astellas Pharma, Medivation, Agensys, Genentech, and CreaTV. Dr Gafanov has received grants from Janssen during the conduct of the study. Dr Castro has received grants from Janssen during the conduct of the study; has received grants and personal fees from Janssen, Bayer, AstraZeneca, and Pfizer; and has received personal fees from Astellas Pharma, Merck Sharp & Dohme, Roche, and Clovis. Dr Moon has received research funding from SeaGen, HuyaBio, Janssen, BMS, Aveo, Xencor, and has received personal fees from Axess Oncology, MJH, EMD Serono, and Pfizer. Dr Joshua has received nonfinancial support from Janssen; consulted or served in an advisory role for Neoleukin, Janssen Oncology, Ipsen, AstraZeneca, Sanofi, Noxopharm, IQvia, Pfizer, Novartis, Bristol Myers Squibb, Merck Serono, and Eisai; and received research funding from Bristol Myers Squibb, Janssen Oncology, Merck Sharp & Dohme, Mayne Pharma, Roche/Genentech, Bayer, MacroGenics, Lilly, Pfizer, AstraZeneca, and Corvus Pharmaceuticals. Drs Mason, Liu, Bevans, Lopez-Gitlitz, and Francis and Mr Espina are employees of Janssen Research & Development. Dr Mason owns stocks with Janssen. Dr Fizazi has participated in advisory boards and talks for Amgen, Astellas, AstraZeneca, Bayer, Clovis, Daiichi Sankyo, Janssen, MSD, Novartis/AAA, Pfizer, and Sanofi, with honoraria to his institution (Institut Gustave Roussy); has participated in advisory boards for, with personal honoraria from, Arvinas, CureVac, MacroGenics, and Orion. Study registration number: NCT02854436.
Collapse
Affiliation(s)
- Matthew R Smith
- Hematology-Oncology Division, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Shahneen Sandhu
- Medical Oncology, Peter MacCallum Cancer Centre and the University of Melbourne, Australia
| | - Daniel J George
- Medical Oncology, Duke University School of Medicine, Duke Cancer Institute, Durham, NC
| | - Kim Nguyen Chi
- Division of Medical Oncology, BC Cancer, University of British Columbia, Vancouver, Canada
| | - Fred Saad
- Centre Hospitalier de L’université de Montréal, Université de Montréal, Montréal, Québec, Canada
| | - Antoine Thiery-Vuillemin
- Medical Oncology Department, Centre Hospitalier Régional Universitaire Besancon – Hôpital Jean Minjoz, Besancon, France
| | - Olaf Stàhl
- Department of Oncology, Skåne University Hospital, Lund, Sweden
| | - David Olmos
- Department of Medical Oncology, Spanish National Cancer Research Centre, Madrid, Spain
- Genitourinary Cancer Research Unit, Institute of Biomedical Research in Málaga, Spain, now with Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre, Madrid, Spain
| | - Daniel C Danila
- Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Rustem Gafanov
- Medical Oncology, Russian Scientific Center of Roentgenology and Radiology, Moscow
| | - Elena Castro
- Genitourinary Cancer Research Unit, Institute of Biomedical Research in Málaga, Spain, now with Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre, Madrid, Spain
- Medical Oncology Department, Hospital Virgen de la Victoria, Málaga, Spain
| | - Helen Moon
- Hematology-Oncology, Kaiser Permanente Southern California, Riverside
| | - Anthony M Joshua
- Medical Oncology Department, Kinghorn Cancer Centre, St. Vincent’s Hospital Sydney, Darlinghurst, Australia
| | - Gary E Mason
- Clinical Oncology, Janssen Research & Development, LLC, Spring House, PA
| | - Byron M Espina
- Clinical Oncology, Janssen Research & Development, LLC, Los Angeles, CA
| | - Yan Liu
- Janssen Global Commercial Strategy Organization, Horsham, PA, now with Genmab US, Plainsboro, NJ
| | | | | | - Katherine B Bevans
- Janssen Global Commercial Strategy Organization, Horsham, PA, now with Genmab US, Plainsboro, NJ
| | - Karim Fizazi
- Medical Oncology Department, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France
| |
Collapse
|
6
|
van der Doelen MJ, Oving IM, Wyndaele DNJ, van Basten JP, Terheggen F, van de Luijtgaarden ACM, Oyen WJG, van Schelven WD, van den Berkmortel F, Mehra N, Janssen MJR, Prins JB, Gerritsen WR, Custers JAE, van Oort IM. Health-related quality of life, psychological distress, and fatigue in metastatic castration-resistant prostate cancer patients treated with radium-223 therapy. Prostate Cancer Prostatic Dis 2023; 26:142-150. [PMID: 35804188 PMCID: PMC10023564 DOI: 10.1038/s41391-022-00569-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Radium-223 is a registered treatment option for symptomatic bone metastatic castration-resistant prostate cancer (mCRPC). Aim of this multicenter, prospective observational cohort study was to evaluate health-related quality of life (HR-QoL), psychological distress and fatigue in mCRPC patients treated with radium-223. METHODS Primary endpoint was cancer-specific and bone metastases-related HR-QoL, as measured by the EORTC QLQ-C30 and BM-22 questionnaires. Secondary endpoints were psychological distress and fatigue, evaluated by the HADS and CIS-Fatigue questionnaires. Outcomes were analyzed for the total cohort and between subgroups (1-3 versus 4-5 versus 6 radium-223 injections). A trajectory analysis was performed to explore HR-QoL patterns over time. RESULTS In total, 122 patients were included for analysis. Baseline HR-QoL, pain intensity, psychological distress and fatigue were worse in patients who did not complete radium-223 therapy. In patients who completed therapy, stabilization of HR-QoL was perceived and psychological distress and fatigue remained stable, whereas clinically meaningful and statistically significant deterioration of HR-QoL, psychological distress and fatigue over time was observed in patients who discontinued radium-223 therapy. Trajectory analysis revealed that HR-QoL deterioration over time was more likely in patients with baseline opioid use, low hemoglobin and high alkaline phosphatase levels. CONCLUSIONS Patients who discontinued radium-223 therapy showed worse HR-QoL, psychological distress and fatigue at baseline and more frequent deterioration of HR-QoL, psychological distress and fatigue over time when compared to patients who completed therapy. Specific attention with regard to HR-QoL during follow-up is indicated in patients with opioid use, low hemoglobin and high alkaline phosphatase levels before radium-223 therapy initiation. CLINICAL TRIAL REGISTRATION NUMBER NCT04995614.
Collapse
Affiliation(s)
- Maarten J van der Doelen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Irma M Oving
- Department of Medical Oncology, Ziekenhuisgroep Twente, Almelo, Netherlands
| | - Dirk N J Wyndaele
- Department of Nuclear Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | | | - Frederiek Terheggen
- Department of Medical Oncology, Bravis Hospital, Roosendaal, The Netherlands
| | - Addy C M van de Luijtgaarden
- Department of Medical Oncology, Reinier de Graaf Gasthuis and Reinier Haga Prostate Cancer Center, Delft, The Netherlands
| | - Wim J G Oyen
- Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, The Netherlands
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Nuclear Medicine, Humanitas Clinical and Research Center, Milan, Italy
| | - W Dick van Schelven
- Department of Nuclear Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | | | - Niven Mehra
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marcel J R Janssen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Winald R Gerritsen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - José A E Custers
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Inge M van Oort
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
7
|
Prognostic Impact of Nutritional Status on Overall Survival and Health-Related Quality of Life in Men with Advanced Prostate Cancer. Nutrients 2023; 15:nu15041044. [PMID: 36839402 PMCID: PMC9964768 DOI: 10.3390/nu15041044] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/12/2023] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Abstract
PURPOSE Prognostic role of nutritional status (NS) in patients with metastatic castrate-resistant prostate cancer (mCRPC) is unknown. We hypothesized that patients' NS at the presentation of mCRPC is prognostic for health-related quality of life (HRQoL) and overall survival (OS). METHODS We conducted a prospective observational study in mCRPC patients. At enrollment, we allocated each patient into one of four NS categories: (i) well-nourished (WN), (ii) nutritional risk without sarcopenia/cachexia (NR), (iii) sarcopenia, or (iv) cachexia. We sought the prognostic role of the NS for OS and HRQoL by regression models. RESULTS 141 patients were included into our study. When compared to WN patients, those with NR and cachexia had a higher chance of worse HRQoL (OR 3.45; 95% CI [1.28 to 9.09], and OR 4.17; 95% CI [1.28 to 12.5], respectively), as well as shorter OS (HR 2.04; 95% CI [1.19 to 3.39] and HR 2.9; 95% CI [1.56 to 5.41], respectively). However, when accounting for possible confounding factors, we could not prove the significant importance of NS for chosen outcomes. CONCLUSIONS Suboptimal NS might be an unfavorable prognostic factor for HRQoL and OS. Further interventional studies focusing on therapy or prevention are warranted.
Collapse
|
8
|
Østergaard LD, Poulsen MH, Jensen ME, Lund L, Hildebrandt MG, Nørgaard B. Health‐related
quality of life the first year after a prostate cancer diagnosis a systematic review. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2023. [DOI: 10.1111/ijun.12340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Louise Dorner Østergaard
- Department of Urology Odense University Hospital Odense Denmark
- Department of Clinical Research University of Southern Denmark Odense Denmark
| | - Mads Hvid Poulsen
- Department of Urology Odense University Hospital Odense Denmark
- Department of Clinical Research University of Southern Denmark Odense Denmark
| | - Malene Eiberg Jensen
- The Psychiatric Research Unit at Mental Health Centre North Zealand Hillerød Denmark
- Department of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Lars Lund
- Department of Urology Odense University Hospital Odense Denmark
- Department of Clinical Research University of Southern Denmark Odense Denmark
| | - Malene Grubbe Hildebrandt
- Department of Clinical Research University of Southern Denmark Odense Denmark
- Department of Nuclear Medicine Odense University Hospital Odense Denmark
| | - Birgitte Nørgaard
- Department of Public Health University of Southern Denmark Odense Denmark
| |
Collapse
|
9
|
Abstract
OBJECTIVES The aims of this systematic review were to assess the impact of neoadjuvant chemotherapy (NAC) on breast cancer (BC) patients' quality of life (QOL), to compare the different regimens of NAC on BC patients' QOL, to compare NAC versus adjuvant chemotherapy on BC patients' QOL and to identify predictors of QOL on patients with BC receiving NAC. DESIGN The design used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES Cinahl, Embase, Pubmed, Scopus, Web of Science, Cochrane library and PsycINFO were searched through 27 December 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES The inclusion criteria were included: patients with BC receiving NAC, outcome measures related to QOL and published in English. The exclusion criteria were included: duplicates or overlapping participants, not original research, data or full text not available and qualitative study. DATA EXTRACTION AND SYNTHESIS Two independent reviewers used standardised methods to search, screen and code included studies. The risk of bias in individual studies was evaluated with Cochrane collaboration's tool for assessing risk bias, Newcastle Ottawa Score or Joanna Briggs Institute Critical Appraisal tool. This systematic review performs narrative synthesis based on several different themes. RESULTS The initial search resulted in 2994 studies; 12 of these studies fulfilled inclusion criteria. There was no significant difference in the QOL of BC before and after NAC, but patients experienced adverse reactions and depression during chemotherapy. Different regimens of NAC have different effects on patients' QOL. Patients with NAC had more severe physical discomfort than those with adjuvant chemotherapy. However, BC patients' QOL can be improved by intervening on social or family support, and these predictors, including chronotype, QOL before NAC and depression. CONCLUSIONS More original research is needed in future to understand the profile and predictors of QOL in patients with BC on NAC, which will help clinicians and patients make decisions and deal with NAC-related issues.
Collapse
Affiliation(s)
- Yueqiu Zhao
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Licong Chen
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiaoqing Zheng
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yulan Shi
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| |
Collapse
|
10
|
Ventimiglia E, Bill-Axelson A, Adolfsson J, Aly M, Eklund M, Westerberg M, Stattin P, Garmo H. Modeling Disease Trajectories for Castration-resistant Prostate Cancer Using Nationwide Population-based Data. EUR UROL SUPPL 2022; 44:46-51. [PMID: 36185582 PMCID: PMC9520495 DOI: 10.1016/j.euros.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2022] [Indexed: 11/30/2022] Open
Abstract
Background Little is known about disease trajectories for men with castration-resistant prostate cancer (CRPC). Objective To create a state transition model that estimates time spent in the CRPC state and its outcomes. Design, setting, and participants The model was generated using population-based prostate-specific antigen data from 40% of the Swedish male population, which were linked to nationwide population-based databases. We compared the observed and predicted cumulative incidence of transitions to and from the CRPC state. Outcome measurements and statistical analysis We measured time spent in the CRPC state and the proportion of men who died of prostate cancer during follow-up by CRPC risk category. Results and limitations Time spent in the CRPC state varied from 1.1 yr for the highest risk category to 3.9 yr for the lowest risk category. The proportion of men who died from prostate cancer within 10 yr ranged from 93% for the highest risk category to 54% for the lowest. There was good agreement between the model estimates and observed data. Conclusions There is large variation in the time spent in the CRPC state, varying from 1 yr to 4 yr according to risk category. Patient summary It is possible to accurately estimate the disease trajectory and duration for men with castration-resistant prostate cancer.
Collapse
Affiliation(s)
- Eugenio Ventimiglia
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
- Corresponding author. Department of Surgical Sciences, Uppsala University, Akademiska sjukhuset, ingång 70, 1 tr751 85, Uppsala, Sweden.
| | - Anna Bill-Axelson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Jan Adolfsson
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Markus Aly
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Martin Eklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Marcus Westerberg
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Pär Stattin
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Hans Garmo
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| |
Collapse
|
11
|
Cella D, Ganguli A, Turnbull J, Rohay J, Morlock R. US Population Reference Values for Health-Related Quality of Life Questionnaires Based on Demographics of Patients with Prostate Cancer. Adv Ther 2022; 39:3696-3710. [PMID: 35731340 PMCID: PMC9309145 DOI: 10.1007/s12325-022-02204-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/20/2022] [Indexed: 11/26/2022]
Abstract
Introduction The patient experience with prostate cancer differs throughout the disease continuum, with health-related quality of life (HRQoL) and symptoms worsening as the disease progresses. To understand the prostate cancer experience, it is important to understand the experience of same-aged men without prostate cancer as a basis for comparison. This study provides the US population reference values for six patient-reported outcome (PRO) questionnaires. Methods A cross-sectional online survey, including several PRO questionnaires, was administered in 2019 to a representative sample of US adults. The male sample (N = 876) was raked by age to have similar characteristics of men in key advanced prostate cancer trials (mean/median age: 67.5/70.0 years), with the majority being white and non-Hispanic. Results Results from six PRO questionnaires (Brief Pain Inventory; Quality of Life in Neurological Disorders 2.0 Cognitive Short Form; PRO Measurement Information System Fatigue-Short Form; Functional Assessment of Cancer Therapy-General; European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30; and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Prostate Cancer Module) indicated that the US representative sample of men have good role, physical, and emotional functioning but slightly impaired social, functional, and overall well-being. In addition, they have normal cognitive function, few financial problems, minimal pain and fatigue, minimal urinary and bowel symptoms, and limited use of incontinence aids. Conclusions The availability of the reference values for these PRO questionnaires will enable researchers to compare the HRQoL of patients with advanced prostate cancer in the US with that of the general US population and allow for a better interpretation of those scores. Registration numbers of advanced prostate cancer trials: NCT02677896, NCT02003924, NCT01212991, NCT00974311. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-022-02204-3.
Collapse
Affiliation(s)
- David Cella
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA.
| | - Arijit Ganguli
- HEOR, Oncology, Medical Affairs, Astellas Pharma Inc., Northbrook, IL, USA
| | | | - Jeffrey Rohay
- Patient Centered Endpoints, IQVIA, New York, NY, USA
| | | |
Collapse
|
12
|
Procopio G, Chiuri V, Giordano M, Alitto A, Maisano R, Bordonaro R, Cinieri S, Rossetti S, De Placido S, Airoldi M, Galli L, Gasparro D, Ludovico G, Guglielmini P, Carella C, Nova P, Aglietta M, Schips L, Beccaglia P, Sciarra A, Livi L, Santini D, Procopio G, Chiuri V, Mantini G, Roberto Bordonaro RM, Cinieri S, Rossetti S, De Placido S, Airoldi M, Galli L, Gasparro D, Ludovico GM, Guglielmini PF, Santini D, Naglieri E, Fagnani D, Aglietta M, Livi L, Schips L, Passalacqua R, Fiore M, D'Angelillo RM, Ceresoli GL, Magrini S, Rondonotti D, Mirone V, Ferriero MC, Sciarra A, Acquati M, Boccardo F, Scagliotti GV, Mencoboni M, De Giorgi U, Micheletti G, Lanzetta G, Sartori D, Carlini P, Soto Parra HJ, Battaglia M, Uricchio F, Bernardo A, De Lisa A, Carrieri G, Ardizzoia A, Aieta M, Pisconti S, Marchetti P, Paiar F. Real-world experience of abiraterone acetate plus prednisone in chemotherapy-naive patients with metastatic castration-resistant prostate cancer: long-term results of the prospective ABItude study. ESMO Open 2022; 7:100431. [PMID: 35405438 PMCID: PMC9058899 DOI: 10.1016/j.esmoop.2022.100431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 01/14/2022] [Accepted: 02/07/2022] [Indexed: 12/24/2022] Open
Abstract
Background Limited real-world data exist on the effectiveness and safety of abiraterone acetate plus prednisone (abiraterone hereafter) in the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) naive to chemotherapy. Most of the few available studies had a retrospective design and included a small number of patients. In the interim analysis of the ABItude study, abiraterone showed good clinical effectiveness and safety profile in the chemotherapy-naive setting over a median follow-up of 18 months. Patients and methods We evaluated clinical and patient-reported outcomes (PROs) of chemotherapy-naive mCRPC patients treated with abiraterone as for clinical practice in the Italian, observational, prospective, multicentric ABItude study. mCRPC patients were enrolled at abiraterone start (February 2016-June 2017) and followed up for 3 years; clinical endpoints and PROs, including quality of life (QoL) and pain, were prospectively collected. Kaplan–Meier curves were estimated. Results Of the 481 patients enrolled, 454 were assessable for final study analyses. At abiraterone start, the median age was 77 years, with 58.6% elderly patients and 69% having at least one comorbidity (57.5% cardiovascular diseases). Visceral metastases were present in 8.4% of patients. Over a median follow-up of 24.8 months, median progression-free survival (any progression reported by the investigators), time to abiraterone discontinuation, and overall survival were, respectively, 17.3 months [95% confidence interval (CI) 14.1-19.4 months], 16.0 months (95% CI 13.1-18.2 months), and 37.3 months (95% CI 36.5 months-not estimable); 64.2% of patients achieved ≥50% reduction in prostate-specific antigen. QoL assessed by Functional Assessment of Cancer Therapy—Prostate, the European Quality of Life 5 Dimensions 3 Level, and European Quality of Life Visual Analog Scale remained stable during treatment. Median time to pain progression according to Brief Pain Inventory data was 31.1 months (95% CI 24.8 months-not estimable). Sixty-two patients (13.1%) had at least one adverse drug reaction (ADR) and 8 (1.7%) one serious ADR. Conclusion With longer follow-up, abiraterone therapy remains safe, well tolerated, and active in a large unselected population. A prospective real-life study of abiraterone acetate in mCRPC patients. In 481 chemotherapy-naive mCRPC patients (median follow-up: 25 months), abiraterone plus prednisone was effective and safe. QoL, measured with various tools, remained stable during treatment with abiraterone plus prednisone. The median time to pain progression was 31.1 months.
Collapse
|
13
|
Hui D, Darke AK, Guthrie KA, Subbiah IM, Unger JM, Hershman DL, Krouse RS, Bakitas M, O'Rourke MA. Association Between Health-Related Quality of Life and Progression-Free Survival in Patients With Advanced Cancer: A Secondary Analysis of SWOG Clinical Trials. JCO Oncol Pract 2022; 18:e442-e451. [PMID: 34606328 PMCID: PMC9014467 DOI: 10.1200/op.21.00407] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Health-related quality of life (HRQOL) is an established prognostic factor for mortality; however, it is unclear if HRQOL is predictive of time to disease progression, a particularly meaningful outcome for patients. We examined the association between HRQOL and progression-free survival (PFS) in SWOG Cancer Research Network clinical trials. METHODS For this secondary analysis, we reviewed all completed SWOG clinical trials to identify those for patients with advanced cancer that incorporated Functional Assessment of Cancer Therapy (FACT) questionnaires at baseline. FACT-Trial Outcome Index (FACT-TOI) was the primary independent variable. Associations between FACT-TOI and other FACT subscores with PFS and overall survival were evaluated via log-rank test and multivariable Cox regression analysis. RESULTS Three clinical trials met our inclusion criteria: S0027 and S9509 for advanced non-small-cell lung cancer and S0421 for hormone-refractory prostate cancer. Of the 1,527 enrolled patients, 1,295 (85%) had both HRQOL and survival outcomes data available and were included in this analysis. In univariable analysis, we observed a statistically significant gradient effect in all three trials, with higher baseline FACT-TOI scores corresponding to better PFS (S0027, P < .001; S9509, P = .02; and S0421, P < .001). In multivariable analysis, FACT-TOI was significantly associated with PFS in S0027 (hazard ratio [HR] = 0.64; 95% CI, 0.42 to 1.00) but not in S9509 (HR = 0.77; 95% CI, 0.56 to 1.05) or S042 (HR = 0.86; 95% CI, 0.73 to 1.01). FACT-TOI was significantly associated with overall survival in multivariable analysis (P < .005 in all three trials). CONCLUSION The association between baseline FACT-TOI scores and survival underscores their potential as a stratification factor in clinical trials.
Collapse
Affiliation(s)
- David Hui
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX
| | - Amy K Darke
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Katherine A Guthrie
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Ishwaria M Subbiah
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX
| | - Joseph M Unger
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Robert S Krouse
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Marie Bakitas
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL
| | | |
Collapse
|
14
|
Kretschmer A, van den Bergh RCN, Martini A, Marra G, Valerio M, Tsaur I, Heidegger I, Kasivisvanathan V, Kesch C, Preisser F, Fankhauser CD, Zattoni F, Ceci F, Olivier J, Chiu P, Puche-Sanz I, Thibault C, Gandaglia G, Tilki D. Assessment of Health-Related Quality of Life in Patients with Advanced Prostate Cancer-Current State and Future Perspectives. Cancers (Basel) 2021; 14:cancers14010147. [PMID: 35008310 PMCID: PMC8749907 DOI: 10.3390/cancers14010147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/22/2021] [Accepted: 12/25/2021] [Indexed: 11/25/2022] Open
Abstract
Simple Summary In recent years, evidence regarding survival outcomes of novel therapies has increased significantly. However, less is known regarding the impact of novel therapy combinations on quality of life aspects of the treated patients. In the current comprehensive review, we discuss the importance of quality of life for patients with advanced prostate cancer, and present the most frequently used tools to evaluate quality of life in recent randomized trials. Further, we discuss the ease of use of these validated questionnaires for clinicians and try to focus on the suggested appropriate use as well as potential strategies for improvement of quality of life evaluation in these clinical scenarios of advanced prostate cancer. Abstract With the therapeutic landscape of advanced prostate cancer rapidly evolving and oncological benefits being shown for a plethora of new agents and indications, health-related quality of life (HRQOL)-associated evidence is still subpar. In the current comprehensive review, we discuss the importance of HRQOL for patients with advanced PC (metastatic hormone-sensitive prostate cancer (mHSPC), metastatic castration-resistant prostate cancer (mCRPC) and non-metastatic castration-resistant prostate cancer (nmCRPC)), and present the most frequently used tools to evaluate HRQOL in recent randomized trials. Furthermore, we discuss the ease of use of these validated questionnaires for clinicians and try to focus on the suggested appropriate use in clinical practice, as well as potential strategies for improvement of HRQOL evaluation in these clinical scenarios of advanced prostate cancer.
Collapse
Affiliation(s)
- Alexander Kretschmer
- Department of Urology, Ludwig-Maximilians University, 81377 Munich, Germany
- Correspondence: ; Tel.: +49-89440076531
| | | | - Alberto Martini
- Unit of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy; (A.M.); (G.G.)
| | - Giancarlo Marra
- Department of Urology, San Giovanni Battista Hospital, University of Torino, 10126 Torino, Italy;
| | - Massimo Valerio
- Department of Urology, CHUV Lausanne, 1011 Lausanne, Switzerland;
| | - Igor Tsaur
- Department of Urology and Pediatric Urology, Mainz University Medicine, 55131 Mainz, Germany;
| | - Isabel Heidegger
- Department of Urology, Medical University Innsbruck, 6020 Innsbruck, Austria;
| | - Veeru Kasivisvanathan
- Division of Surgery and Interventional Science, University College London, London W1W 7TY, UK;
| | - Claudia Kesch
- Department of Urology, University Hospital Essen, 45147 Essen, Germany;
| | - Felix Preisser
- Department of Urology, University Hospital Frankfurt, 60590 Frankfurt, Germany;
| | | | - Fabio Zattoni
- Department of Surgery, Oncology and Gastroenterology, University of Padua, 35128 Padua, Italy;
- Urology Unit, Academical Medical Centre Hospital, 33100 Udine, Italy
| | - Francesco Ceci
- Division of Nuclear Medicine, IEO European Institute of Oncology, 20141 Milan, Italy;
| | - Jonathan Olivier
- Department of Urology, Lille University Hospital, 59000 Lille, France;
| | - Peter Chiu
- SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China;
| | - Ignacio Puche-Sanz
- Department of Urology, Bio-Health Research Institute, Hospital Universitario Virgen de las Nieves, University of Granada, 18014 Granada, Spain;
| | - Constance Thibault
- Department of Medical Oncology, European Georges Pompidou Hospital, Assistance Publique des Hôpitaux de Paris, Paris Descartes University, 75004 Paris, France;
| | - Giorgio Gandaglia
- Unit of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy; (A.M.); (G.G.)
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany;
- Department of Urology, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany
- Department of Urology, Koc University Hospital, 34010 Istanbul, Turkey
| | | |
Collapse
|
15
|
Acceptability and Preliminary Efficacy of a Web- and Telephone-Based Personalised Exercise Intervention for Individuals with Metastatic Prostate Cancer: The ExerciseGuide Pilot Randomised Controlled Trial. Cancers (Basel) 2021; 13:cancers13235925. [PMID: 34885036 PMCID: PMC8656540 DOI: 10.3390/cancers13235925] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Previous research supports the participation in supervised exercise among individuals with metastatic prostate cancer to help lessen the physical and psychological disease burden. However, many individuals experience considerable barriers to attending face-to-face exercise services. To overcome some of these limitations, digital interventions that can be delivered remotely have been proposed. Our pilot study investigated the acceptability, safety and preliminary efficacy of an 8-week computer-tailored web-based exercise intervention. We demonstrated that a web-based exercise program with telehealth support was acceptable and could be implemented safely. Participants in the intervention group increased their participation in moderate to vigorous physical activity compared to the control group. This study provides insight into the prospect of web-based exercise prescription for individuals with metastatic prostate cancer as an alternative for individuals who cannot access supervised exercise interventions. Abstract Preliminary research has shown the effectiveness of supervised exercise-based interventions in alleviating sequela resulting from metastatic prostate cancer. However, many individuals encounter barriers that limit the uptake of face-to-face exercise. Technology-enabled interventions offer a distance-based alternative. This pilot study aimed to explore the acceptability, safety and preliminary efficacy of a web-based exercise intervention (ExerciseGuide) in individuals with metastatic prostate cancer. Forty participants (70.2 ± 8.5 years) with metastatic prostate cancer were randomised into the 8-week intervention (N = 20) or a wait-list control (N = 20). The intervention arm had access to a computer-tailored website, personalised exercise prescription and remote supervision. ExerciseGuide was deemed acceptable with a score ≥20 on the client satisfaction questionnaire; however, the usability score was just below the pre-specified score of ≥68 on the software usability scale. There were no serious adverse events reported. Moderate-to-vigorous physical activity levels between baseline and follow-ups were significantly higher (10.0 min per day; 95% CI = (1.3–18.6); p = 0.01) in the intervention group compared to wait-list control. There were also greater improvements in step count (1332; 95% CI = (159–2505); p = 0.02) and identified motivation (0.4, 95% CI = (0.0, 0.7); p = 0.04). Our findings provide preliminary evidence that ExerciseGuide is acceptable, safe and efficacious among individuals with metastatic prostate cancer.
Collapse
|
16
|
Quality of life in men with metastatic castration-resistant prostate cancer treated with enzalutamide or abiraterone: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 2021; 24:948-961. [PMID: 33820951 DOI: 10.1038/s41391-021-00359-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/01/2021] [Accepted: 03/15/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Enzalutamide and abiraterone acetate plus prednisone (AAP) have similar efficacy in metastatic castration-resistant prostate cancer (mCRPC), but different mechanisms of action. The aim was to compare patient-reported health-related quality of life (HRQoL) in men treated with enzalutamide vs AAP for mCRPC. METHODS We systematically reviewed the literature in June 2020 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Patient-reported outcomes (PROs) until the last follow-up were summarised in a narrative synthesis. Short-term changes (12 weeks) in HRQoL, measured by the Functional Assessment of Cancer Therapy-Prostate total score (FACT-P), were compared between treatment groups and were analysed for enzalutamide and AAP in separate meta-analyses. Higher FACT-P scores indicate better HRQoL. RESULTS Eight studies were included in the systematic review, four of which were randomised clinical trials (RCTs) eligible for the meta-analyses. The meta-analyses showed mean within-subject FACT-P changes from baseline to week 12 of -1.3 points (95% confidence interval [CI] -2.7; 0.1) for enzalutamide and 4.7 points (95% CI -0.1; 9.6) for AAP. One RCT and three non-randomised studies directly compared enzalutamide with AAP. The RCT showed better short-term HRQoL for AAP (6.8 FACT-P-points, 95% CI 1.7; 11.8) and better long-term HRQoL for AAP in men ≥75 years (7.35 FACT-P-points, 95% CI 2.59; 12.11). The non-randomised studies showed no difference in long-term HRQoL but had all a serious risk of bias. Limitations of the included studies include that the PRO in the included trials were inconsistently reported and that only one study defined the HRQoL measures in their published protocol. CONCLUSIONS AAP seems to be associated with better short-term HRQoL than enzalutamide. This difference was not apparent at longer follow-up, but the long-term studies had serious risks of bias.
Collapse
|
17
|
Abstract
In recent years there have been substantial changes in the therapeutic landscape for systemic treatment of advanced prostate cancer (PCa), which resulted in a multitude of novel treatment options for different stages of the disease. In the current narrative review currently available treatment options for metastatic hormone-sensitive PCa as well as nonmetastatic castration-resistant PCa are presented. In addition, current treatment sequence options and targeted treatment in the stage of metastatic castration-resistant PCa are highlighted.
Collapse
Affiliation(s)
- Alexander Kretschmer
- Urologische Klinik und Poliklinik, Klinikum der Universität München, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377, München, Deutschland.
| | - Tilman Todenhöfer
- Studienpraxis Nürtingen, Steinengrabenstraße 17, 72622, Nürtingen, Deutschland
| |
Collapse
|
18
|
Sharpley CF, Christie DRH, Bitsika V. Depression and prostate cancer: implications for urologists and oncologists. Nat Rev Urol 2020; 17:571-585. [PMID: 32733038 DOI: 10.1038/s41585-020-0354-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2020] [Indexed: 02/07/2023]
Abstract
Many patients with prostate cancer experience severe levels of depression, which can negatively affect their treatment and disease course. Some prostate cancer treatments can increase the severity of a patient's depression, for example, by increasing anhedonia and erectile dysfunction. Depression is often thought of as a unitary phenomenon, but multiple subtypes can be distinguished. This variety of manifestations challenges the successful application of universal antidepressant treatment options and argues for a multi-symptom assessment process that considers a patient's disease burden and their particular form of depression. Inclusion of screening and detailed diagnosis of depression can be argued to be part of good practice, and clinicians are urged to consider when and how this might be accomplished within their urological practice.
Collapse
Affiliation(s)
- Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.
| | - David R H Christie
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.,Genesiscare, John Flynn Private Hospital, Tugun, Queensland, Australia
| | - Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia
| |
Collapse
|