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Belkacemi Y, Coraggio G, Brunel A, Jouhaud A, Ingels A, Joly C, Hadhri A, Hassani W, Loganadane G, Saldana C, Ouidir N, Vega B, Debbi K, Taille ADL. Effect of Serelys Homme on the Incidence and Severity of Vasomotor Symptoms and Quality-of-Life Impairments in Patients Receiving Hormone Therapy and Radiation for Localized Prostate Cancer: Results of the ESCULAPE Phase 2 Prospective Study. Adv Radiat Oncol 2023; 8:101255. [PMID: 37408674 PMCID: PMC10318267 DOI: 10.1016/j.adro.2023.101255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 04/12/2023] [Indexed: 07/07/2023] Open
Abstract
Purpose Androgen deprivation therapy (ADT) may cause vasomotor symptoms (VMS) including hot flushes and sweats, which affect quality of life (QoL). Serelys Homme is a nonhormonal and a natural origin product that could affect VMS in men undergoing ADT. We evaluated effectiveness and tolerance of Serelys Homme administration on VMS and QoL of patients undergoing combined ADT and radiation therapy for prostate cancer. Methods and Materials Between April 2017 and July 2019, 103 patients were screened, and 53 patients refused to participate in the study. Serelys Homme therapy consisted of a daily administration of 2 tablets for 6 months. Patients were evaluated with 4 questionnaires including the adapted Modified Rankin Scale (adapted-MRS), European Quality of Life 5 Dimensions 3 Level Version (EQ 5D3L), Functional Assessment of Cancer Therapy-Prostate (FACT-P), and Hot Flash Related Daily Interference Scale (HFRDIS) at day 0, day 90 (D90), and day 180 (D180). Statistical evaluation was performed using the Wilcoxon rank sign test. A 2-sided P < .05 was considered statistically significant. Results Among the 50 patients, 4 withdrew after inclusion. All patients (n = 46) received either postoperative or definitive radiation therapy combined with a short (n = 15) or long course (n = 31) of ADT. Serelys Homme administration significantly decreased the rate of patients who had ≥7 VMS and 3 to 6 VMS per day. The number of patients presenting with moderate or severe VMS was decreased at D90 (P = .005) and at D180 (P = .005). In addition, VMS duration was reduced at D90 (P = .002) and D180 (P < .001). Finally, at D90 and D180, 11.1% and 16.0% of patients, respectively, with initial severe or moderate VMS had a complete response without further symptoms. Among QoL parameters, fatigue decreased significantly. Effectiveness evaluated by doctors was rated as moderate or good to excellent VMS control in 20% and 60% of the patients, respectively. No side effects were recorded in the whole population. Conclusions This study demonstrated effectiveness and excellent tolerance of Serelys Homme. We observed a significant reduction of the frequency, duration, and intensity of hot flushes and sweats induced by ADT. Serelys Homme increased QoL scores. These encouraging results open the prospect to further studies and Serelys Homme use in patients undergoing ADT for prostate cancer.
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Affiliation(s)
- Yazid Belkacemi
- Assistance Publique - Hôpitaux de Paris (AP-HP), Radiation Oncology Department and Henri Mondor Breast Center, Henri Mondor University Hospital, Créteil, France
- Institut national de la santé et de la recherche médicale (INSERM), Unit 955 (i-Bio), Institut Mondor de Recherche Biomédicale, University of Paris-Est Créteil (UPEC), Créteil, France
| | - Gabriele Coraggio
- Assistance Publique - Hôpitaux de Paris (AP-HP), Radiation Oncology Department and Henri Mondor Breast Center, Henri Mondor University Hospital, Créteil, France
| | | | - Annie Jouhaud
- Assistance Publique - Hôpitaux de Paris (AP-HP), Radiation Oncology Department and Henri Mondor Breast Center, Henri Mondor University Hospital, Créteil, France
| | - Alexandre Ingels
- Urology Department, Henri Mondor University Hospital, University of Paris-Est Créteil (UPEC), Créteil, France
| | - Charlotte Joly
- Medical Oncology Department, Henri Mondor University Hospital, Créteil, France
| | - Asma Hadhri
- Assistance Publique - Hôpitaux de Paris (AP-HP), Radiation Oncology Department and Henri Mondor Breast Center, Henri Mondor University Hospital, Créteil, France
| | - Wissal Hassani
- Assistance Publique - Hôpitaux de Paris (AP-HP), Radiation Oncology Department and Henri Mondor Breast Center, Henri Mondor University Hospital, Créteil, France
| | - Gokoulakrichenane Loganadane
- Assistance Publique - Hôpitaux de Paris (AP-HP), Radiation Oncology Department and Henri Mondor Breast Center, Henri Mondor University Hospital, Créteil, France
| | - Carolina Saldana
- Medical Oncology Department, Henri Mondor University Hospital, Créteil, France
| | - Nabila Ouidir
- Pathology Department, Henri Mondor University Hospital, Créteil, France
| | - Barbara Vega
- Medical Department, Sérélys Pharma, Fontvieille, Monaco
| | - Kamel Debbi
- Assistance Publique - Hôpitaux de Paris (AP-HP), Radiation Oncology Department and Henri Mondor Breast Center, Henri Mondor University Hospital, Créteil, France
| | - Alexandre de La Taille
- Urology Department, Henri Mondor University Hospital, University of Paris-Est Créteil (UPEC), Créteil, France
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Managing hot flushes in men after prostate cancer--a systematic review. Maturitas 2009; 65:15-22. [PMID: 19962840 DOI: 10.1016/j.maturitas.2009.10.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2009] [Revised: 10/27/2009] [Accepted: 10/27/2009] [Indexed: 12/21/2022]
Abstract
CONTEXT AND OBJECTIVE The aim of this study was to describe hot flushes in men with prostate cancer, and their treatment methods. METHOD A systematic review was conducted of the literature indexed between 1966 and 2009 on the MEDLINE, the ISI Web of Knowledge, Cinahl and PsycINFO. Of 252 articles identified, 32 were selected for consideration of their complete texts, of which five were subject to detailed analysis. RESULTS Diethylstilbestrol, megestrol acetate and cyproterone acetate have the strongest effect, giving a 75% or larger decrease of the number of hot flushes, but they may have severe or bothersome side-effects. Gabapentin has an uncertain effect. Clonidine is not proven effective for hot flushes. Long-term effects were not evaluated in any of the studies. SSRI/SNRI and acupuncture may have a moderate effect on hot flushes but are not proven in any RCTs. CONCLUSION Hot flushes are common and bothersome symptoms in men with prostate cancer and those taking anti-androgen treatment, and reduce quality of life. Few treatments are available and some are avoided for these patients. Additional prospective treatment studies are needed, with long-term follow-up, in order to evaluate the effects and risks of treatments. Treatments with few or no severe side-effects should be prioritised in future investigations. Experimental studies are also needed to elucidate the mechanism behind hot flushes in men and to suggest routes for the development of new treatments.
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Hay DL, Poyner DR. Calcitonin gene-related peptide, adrenomedullin and flushing. Maturitas 2009; 64:104-8. [PMID: 19762180 DOI: 10.1016/j.maturitas.2009.08.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2009] [Accepted: 08/28/2009] [Indexed: 11/30/2022]
Abstract
Administration of calcitonin gene-related peptide (CGRP) or adrenomedullin (AM) can cause facial flushing, suggesting that the peptides may be important in hot flushes experienced particularly by post-menopausal women. Five studies have measured plasma CGRP concentrations in post-menopausal women who suffer from flushes; all demonstrated elevations of between 170% and 320% over control. Three of the studies showed a temporal relationship between flushes and CGRP elevation. A further study has shown that CGRP is elevated in the urine of women who suffer from flushes. Only a single study has investigated flushes in pre-menopausal women; no elevation of CGRP was observed. Flushes are also experienced by men undergoing androgen deprivation therapy. Whilst one study failed to find any increase in CGRP in the urine of these individuals, a small study has identified an increase in plasma CGRP. No studies have investigated plasma AM or the related peptide, intermedin/AM2. Overall, there is good evidence to show that flushes in post-menopausal women are accompanied by an increase in CGRP. CGRP could act centrally on the thermoregulatory centre of the hypothalamus as well as peripherally to cause vasodilation and sweating. However, it remains to be demonstrated that the elevated CGRP causes flushes. Recently developed CGRP antagonists provide an opportunity to test this hypothesis. If they are successful, they may represent a useful alternative to oestrogen replacement therapy.
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Affiliation(s)
- Debbie L Hay
- School of Biological Sciences, University of Auckland, New Zealand
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Harding C, Harris A, Chadwick D. Auricular acupuncture: a novel treatment for vasomotor symptoms associated with luteinizing-hormone releasing hormone agonist treatment for prostate cancer. BJU Int 2008; 103:186-90. [PMID: 18710455 DOI: 10.1111/j.1464-410x.2008.07884.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the role of auricular acupuncture (AA) in men receiving luteinizing-hormone releasing hormone (LHRH) analogues for carcinoma of the prostate, as vasomotor symptoms can affect the quality of life in such men, and similar symptoms in postmenopausal women have been successfully treated with AA. PATIENTS AND METHODS In all, 60 consecutive patients with prostate cancer and on LHRH agonist treatment (median age 74 years, range 58-83) consented to weekly AA for 10 weeks. The validated 'Measure Yourself Concerns and Well-Being' questionnaire (a six-point scale to assess symptom severity) was used to assess concerns and well-being before and after treatment. RESULTS All men completed the treatment with no adverse events recorded, apart from transient exacerbation of symptoms in two men; 95% of patients reported a decrease in the severity of symptoms, from a mean 5.0 to 2.1 (Student's t-test, P < 0.01). CONCLUSIONS The symptomatic improvement was at levels comparable with that from pharmacotherapy, and cost analysis showed AA to be a viable alternative. Larger randomized studies are needed to fully evaluate AA against more conventional treatments, and these are planned.
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Yuzurihara M, Ikarashi Y, Noguchi M, Kase Y, Takeda S, Aburada M. Prevention by 17β-estradiol and progesterone of calcitonin gene-related peptide-induced elevation of skin temperature in castrated male rats. Urology 2004; 64:1042-7. [PMID: 15533515 DOI: 10.1016/j.urology.2004.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2004] [Accepted: 06/02/2004] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To clarify the relationship between calcitonin gene-related peptide (CGRP) and ovarian hormones (17beta-estradiol and progesterone) in hot flashes in men who undergo androgen deprivation therapy for prostate cancer, we studied the effects of ovarian hormones on CGRP-induced elevation of skin temperature in castrated male rats. The results were compared with those from rats treated with testosterone replacement. METHODS Adult male rats were castrated by either a single injection of gonadotropin-releasing hormone analogue (Leuplin, 1.0 mg/kg, subcutaneously) or bilateral orchiectomy. The castrated animals were subcutaneously injected daily for 14 days with ovarian hormones, testosterone, or olive oil as the vehicle. On the day after the final administration of the drug, the changes in skin temperature induced by exogenous CGRP (10 mug/kg intravenously), serum testosterone concentration, and prostate weight were measured. RESULTS The CGRP-induced elevation of skin temperature was significantly greater in the castrated rats than in the sham-treated rats. This potentiation was significantly inhibited by treatment with ovarian hormones, as well as by testosterone replacement. The testosterone replacement restored decreases in both the serum testosterone level and the prostate weight due to castration; the treatment with ovarian hormones did not affect them. CONCLUSIONS 17beta-Estradiol and progesterone, which do not confer testosterone activity on serum, may be useful for the treatment of hot flashes in patients for whom testosterone replacement therapy is contraindicated, such as those with prostate carcinoma. In addition, we suggest that CGRP is closely involved in the amelioration of hot flashes by ovarian hormones in men who undergo androgen deprivation therapy.
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SPETZ ANNACLARA, PETTERSSON BILL, VARENHORST EBERHARD, THEODORSSON ELVAR, THORELL LARSHÅKAN, HAMMAR MATS. MOMENTARY INCREASE IN PLASMA CALCITONIN GENE-RELATED PEPTIDE IS INVOLVED IN HOT FLASHES IN MEN TREATED WITH CASTRATION FOR CARCINOMA OF THE PROSTATE. J Urol 2001. [DOI: 10.1016/s0022-5347(05)65660-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- ANNA-CLARA SPETZ
- From the Divisions of Obstetrics and Gynaecology, Urology, Neurochemistry and Psychiatry, Faculty of Health Sciences, University Hospital, Linköping, Sweden
| | - BILL PETTERSSON
- From the Divisions of Obstetrics and Gynaecology, Urology, Neurochemistry and Psychiatry, Faculty of Health Sciences, University Hospital, Linköping, Sweden
| | - EBERHARD VARENHORST
- From the Divisions of Obstetrics and Gynaecology, Urology, Neurochemistry and Psychiatry, Faculty of Health Sciences, University Hospital, Linköping, Sweden
| | - ELVAR THEODORSSON
- From the Divisions of Obstetrics and Gynaecology, Urology, Neurochemistry and Psychiatry, Faculty of Health Sciences, University Hospital, Linköping, Sweden
| | - LARS-HÅKAN THORELL
- From the Divisions of Obstetrics and Gynaecology, Urology, Neurochemistry and Psychiatry, Faculty of Health Sciences, University Hospital, Linköping, Sweden
| | - MATS HAMMAR
- From the Divisions of Obstetrics and Gynaecology, Urology, Neurochemistry and Psychiatry, Faculty of Health Sciences, University Hospital, Linköping, Sweden
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