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Asha Parveen SM, Kami Reddy KR, Ummanni R. Dimethylarginine Dimethylaminohydrolase - 1 expression is increased under tBHP-induced oxidative stress regulates nitric oxide production in PCa cells attenuates mitochondrial ROS-mediated apoptosis. Nitric Oxide 2023; 138-139:70-84. [PMID: 37423418 DOI: 10.1016/j.niox.2023.07.002] [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: 04/21/2023] [Revised: 07/03/2023] [Accepted: 07/07/2023] [Indexed: 07/11/2023]
Abstract
Dimethylarginine dimethylaminohydrolase-1 (DDAH1) expression is frequently elevated in different cancers including prostate cancer (PCa) and enhances nitric oxide (NO) production in tumor cells by metabolising endogenous nitric oxide synthase (NOS) inhibitors. DDAH1 protects the PCa cells from cell death and promotes survival. In this study, we have investigated the cytoprotective role of DDAH1 and determined the mechanism of DDAH1 in protecting the cells in tumor microenvironment. Proteomic analysis of PCa cells with stable overexpression of DDAH1 has identified that oxidative stress-related activity is altered. Oxidative stress promotes cancer cell proliferation, survival and causes chemoresistance. A known inducer of oxidative stress, tert-Butyl Hydroperoxide (tBHP) treatment to PCa cells led to elevated DDAH1 level that is actively involved in protecting the PCa cells from oxidative stress induced cell damage. In PC3-DDAH1- cells, tBHP treatment led to higher mROS levels indicating that the loss of DDAH1 increases the oxidative stress and eventually leads to cell death. Under oxidative stress, nuclear Nrf2 controlled by SIRT1 positively regulates DDAH1 expression in PC3 cells. In PC3-DDAH1+ cells, tBHP induced DNA damage is well tolerated compared to wild-type cells while PC3-DDAH1- became sensitive to tBHP. In PC3 cells, tBHPexposure has increased the production of NO and GSH which may be acting as an antioxidant defence to overcome oxidative stress. Furthermore, in tBHP treated PCa cells, DDAH1 is controlling the expression of Bcl2, active PARP and caspase 3. Taken together, these results confirm that DDAH1 is involved in the antioxidant defence system and promotes cell survival.
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Affiliation(s)
- Sakkarai Mohamed Asha Parveen
- Department of Applied Biology, CSIR-Indian Institute of Chemical Technology (CSIR-IICT), Hyderabad, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Karthik Reddy Kami Reddy
- Department of Applied Biology, CSIR-Indian Institute of Chemical Technology (CSIR-IICT), Hyderabad, India
| | - Ramesh Ummanni
- Department of Applied Biology, CSIR-Indian Institute of Chemical Technology (CSIR-IICT), Hyderabad, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
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2
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Narita S, Hatakeyama S, Sakamoto S, Kato T, Inokuchi J, Matsui Y, Kitamura H, Nishiyama H, Habuchi T. Management of prostate cancer in older patients. Jpn J Clin Oncol 2022; 52:513-525. [PMID: 35217872 DOI: 10.1093/jjco/hyac016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 01/31/2022] [Indexed: 01/22/2023] Open
Abstract
The incidence of prostate cancer among older men has increased in many countries, including Asian countries. However, older patients are ineligible for inclusion in large randomized trials, and the existing guidelines for the management of patients with prostate cancer do not provide specific treatment recommendations for older men. Therefore, generation of evidence for older patients with prostate cancer is a key imperative. The International Society of Geriatric Oncology has produced and updated several guidelines for management of prostate cancer in older men since 2010. Regarding localized prostate cancer, both surgery and radiotherapy are considered as feasible treatment options for intermediate- and high-risk prostate cancer even in older men, whereas watchful waiting and active surveillance are useful options for a proportion of these patients. With regard to advanced disease, androgen-receptor axis targets and taxane chemotherapy are standard treatment modalities, although dose modification and prevention of adverse events need to be considered. Management strategy for older patients with prostate cancer should take cognizance of not only the chronological age but also psychological and physical condition, socio-economic status and patient preferences. Geriatric assessment and patient-reported health-related quality of life are important tools for assessing health status of older patients with prostate cancer; however, there is a paucity of evidence of the impact of these tools on the clinical outcomes. Personalized management according to the patient's health status and tumour characteristics as well as socio-economic condition may be necessary for treatment of older patients with prostate cancer.
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Affiliation(s)
- Shintaro Narita
- Department of Urology, Akita University Graduate School of Medicine, Akita, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shinichi Sakamoto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Takuma Kato
- Department of Urology, Kagawa University School of Medicine, Kagawa, Japan
| | - Juichi Inokuchi
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshiyuki Matsui
- Department of Urology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroshi Kitamura
- Department of Urology, University of Toyama Faculty of Medicine, Toyama, Japan
| | - Hiroyuki Nishiyama
- Department of Urology, Tsukuba University School of Medicine, Tsukuba, Japan
| | - Tomonori Habuchi
- Department of Urology, Akita University Graduate School of Medicine, Akita, Japan
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Droupy S, Colson M, Pello‐Leprince‐Ringuet N, Perrot V, Descazeaud A. EQUINOXE study: Impact of relational cohesion and sexuality on the quality of life of patients treated with gonadotropin‐releasing hormone agonist for prostate cancer. BJUI COMPASS 2021; 3:45-54. [PMID: 35475155 PMCID: PMC8988778 DOI: 10.1002/bco2.92] [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: 02/24/2021] [Revised: 03/26/2021] [Accepted: 04/04/2021] [Indexed: 11/10/2022] Open
Abstract
Objectives To measure the effect of dyadic adjustment on changes in patients’ quality of life when initiating treatment with gonadotropin‐releasing hormone (GnRH) agonist. Patients and methods A prospective, multicenter, longitudinal, and non‐interventional study (NCT02630641) that included patients with prostate cancer starting GnRH agonist therapy, and their partners, in 157 centers in France. Data were collected at inclusion and after 6 months of treatment on quality of life (WHOQOL‐BREF), disease perception (B‐IPQ), disease symptoms (QLQ‐PR25), and perception of cohesion within the couple (dyadic adjustment, DAS‐16). Results The Full Analysis Set included 492 patients (median age [Q1;Q3]: 74 [68;80] years). An improvement of the quality of life (defined as the improvement of at least one of the four dimensions of WHOQOL‐BREF) was reported in 290/434 (67%) patients between baseline and follow‐up. Quality of life was better at baseline and follow‐up in patients with good cohesion within the couple than in those with medium or poor cohesion. Factors associated with improvement in quality of life of patients were the following: initial presence of QLQ‐PR25 hormonal treatment‐related symptoms (OR [95% CI]: 3.00 [1.46, 6.17]) suggesting testosterone deficiency symptoms at baseline and initial low level (2.04 [1.12, 3.72]) or absence of sexual activity (2.23 [1.11, 4.50]) before GnRH agonist initiation. Conclusion Men with the greatest improvement in quality of life after initiating hormone therapy were those with, at baseline, testosterone deficiency symptoms (identified by QLQ‐PR25 treatment‐related symptoms score) or no/low sexual activity. Cohesion within the couple was not confirmed as an influence on the evolution of quality of life.
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Affiliation(s)
| | - Marie‐Hélène Colson
- Department of Immunology Hematology CISIH, Ste Marguerite Hospital Marseille France
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4
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Li M, Xu H, Wang J. Optimized functional and structural design of dual-target LMRAP, a bifunctional fusion protein with a 25-amino-acid antitumor peptide and GnRH Fc fragment. Acta Pharm Sin B 2020; 10:262-275. [PMID: 32082972 PMCID: PMC7016293 DOI: 10.1016/j.apsb.2019.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 09/19/2019] [Accepted: 09/19/2019] [Indexed: 12/13/2022] Open
Abstract
To develop fusion protein of a GnRH Fc fragment and the integrin targeting AP25 antitumor peptide for GnRH receptor-expressing cancer therapy. The LMRAP fusion protein was constructed. A transwell invasion assay was performed. The gene mRNA and protein levels of GnRHR-I, α5β1, and αvβ3 in different cancer cell lines were assessed. Cell proliferation was measured using a cell counting kit-8. An antagonist assay was performed on GnRH receptors. Anti-tumor activity was evaluated with a mouse xenograft tumor model. Immunohistochemistry (IHC) was applied to detect CD31 and CD34 expressions. Pharmacokinetic characteristics were determined with an indirect competition ELISA. The developed bifunctional fusion protein LMRAP not only inhibited HUVEC invasion, but also inhibited proliferation of GnRHR-I, α5β1, and αvβ3 high expression cancer cells. The IC50 for LMRAP in the GnRH receptor was 6.235 × 10−4 mol/L. LMRAP significantly inhibited human prostate cancer cell line 22RV1 proliferation in vivo and in vitro. LMRAP significantly inhibited CD31 and CD34 expressions. The elimination half-life of the fusion protein LMRAP was 33 h in rats. The fusion protein made of a GnRH Fc fragment and the integrin targeting AP25 peptide retained the bifunctional biological activity of GnRHR blocking, angiogenesis inhibition, prolonged half-life and good tolerance.
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Affiliation(s)
- Meng Li
- Shenyang Pharmaceutical University, Shenyang 110016, China
- Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products, National Institutes for Food and Drug Control, Beijing 102629, China
| | - Hanmei Xu
- State Key Laboratory of Natural Medicines, Ministry of Education, the Engineering Research Center of Synthetic Polypeptide Drug Discovery and Evaluation of Jiangsu Province, Department of Marine Pharmacy, China Pharmaceutical University, Nanjing 211198, China
| | - Junzhi Wang
- Shenyang Pharmaceutical University, Shenyang 110016, China
- Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products, National Institutes for Food and Drug Control, Beijing 102629, China
- Corresponding author.
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5
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Lebret T, Ruffion A, Latorzeff I, Zerbib M, Moreau JL, Rossi D, Pello-Leprince-Ringuet N, Perrot V, Hennequin C. Criteria for indication and treatment modification in a cohort of patients with prostate cancer treated with hormone therapy. Ther Adv Urol 2018; 10:365-376. [PMID: 30574196 PMCID: PMC6295785 DOI: 10.1177/1756287218808496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 09/17/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND No published studies have specifically assessed whether treatment modifications to androgen deprivation therapy (ADT) for prostate cancer (PCa) are frequently carried out in routine clinical practice. The current study was conducted to determine what proportion of patients who had initiated hormone therapy with a gonadotropin-releasing hormone (GnRH) analogue then had their treatment regimen modified during the first 24 months. METHODS A prospective, noninterventional study was carried out in routine clinical practice in France. Patients with locally advanced or metastatic PCa were followed up for 2 years after treatment initiation with a GnRH analogue. The primary endpoint was the proportion of patients with a modification to their initial hormone therapy. RESULTS In total, 1301 patients were enrolled into the study by 204 physicians, and the primary endpoint could be evaluated for 891 patients. The GnRH analogue treatment was initiated for metastatic PCa (24.2%), locally advanced PCa without planned local treatment (20.6%), locally advanced PCa in association with radiotherapy (31.6%), and biochemical recurrence after local treatment (21.4%). Hormonal treatment was modified in 43.8% (390/891) of patients during the 24-month follow-up period after GnRH analogue initiation. In 61.3% of cases (239/390), the type of modification involved a change of GnRH analogue formulation or switch to another GnRH analogue. A total of five significant predictive factors for GnRH analogue treatment modification were identified: metastatic stage; physician sector; physician speciality; presence or absence of urinary symptoms; and intermittent versus continuous ADT. CONCLUSIONS This study shows that in 43.8% of the patients with advanced PCa, ADT is modified in the first 2 years after initiation in routine clinical practice. Predictive factors for alteration of ADT were metastatic stage and the choice of an intermittent schedule.
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Affiliation(s)
- Thierry Lebret
- Hôpital Foch, Université Versailles St. Quentin en Yvelines, Chef de Service Urologie et Transplantation Rénale, 40 Rue Worth, 92151 Suresnes, France
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Hachi K, Boualga K, Chettibi K, Harouni M, Ounnoughene M, Bekkat-Berkani N, Maisonobe P, Yousfi MJ. [Study of the beneficial effects of triptorelin on lower urinary tract symptoms in Algeria in patients with non-localized prostate cancer]. Prog Urol 2018; 28:450-459. [PMID: 29789236 DOI: 10.1016/j.purol.2018.03.014] [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: 12/08/2017] [Revised: 03/20/2018] [Accepted: 03/28/2018] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This study aims to assess the effectiveness of triptorelin on lower urinary tract symptoms (LUTS) in Algerian patients with non-localized prostate cancer in routine practice. MATERIALS This prospective, observational, non-interventional, multicentre study was conducted in Algeria. Included patients who had locally advanced or metastatic prostate cancer and were treated with triptorelin 11.25mg given every 12 weeks. LUTS were evaluated with the International Prostate Symptom Score (IPSS) until week 48 after treatment initiation. An IPSS>7 indicated moderate to severe LUTS. The primary objective of the study was to determine the distribution of IPSS at week 48. RESULTS This study enrolled 193 patients at 21 centres. A total of 144 participants had IPSS available at baseline and after baseline (136 patients had moderate to severe LUTS and eight had mild LUTS at baseline). At week 48, amongst the 116 patients with IPSS available and moderate to severe LUTS at baseline, 94 (81.0%) had moderate to severe LUTS and 22 (19.0%) had mild LUTS. At week 48, the eight patients with mild symptoms at baseline remained in this category. The proportion of patient with severe LUTS decreased from 53.7% at baseline to 12.1% at week 48. Adverse events were reported in 22.9% of participants. CONCLUSION A reduction of LUTS is observed in patients with locally advanced or metastatic prostate cancer treated with triptorelin in routine practice. This is in agreement with similar observational studies of triptorelin conducted in other countries. LEVEL OF PROOF 4.
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Affiliation(s)
- K Hachi
- 14, rue Faycel-Mebarek-Belcourt, Alger 16, Algérie.
| | - K Boualga
- Service de radiothérapie oncologie, établissement hospitalo-universitaire, centre de lutte contre le cancer, Blida, Algérie
| | - K Chettibi
- Service de chirurgie urologique, transplantation, CHU d'Annaba, Algérie
| | - M Harouni
- 14, rue Ghenitti-Bouchentouf (ex rue de Suffren), Hai Ibn Sina (ex Victor Hugo), Oran 31000 DZ, Algérie
| | - M Ounnoughene
- Immeuble 46, logements, Bt A1 Tizi, Ouzou 15000, Algérie
| | | | - P Maisonobe
- Ipsen Pharmaceutical, 92100 Boulogne-Billancourt, France
| | - M J Yousfi
- Service de chirurgie urologique, établissement hospitalo-universitaire 1(er) novembre 1954, Oran, Algérie
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7
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Roumeguère T, Sfeir J, El Rassy E, Albisinni S, Van Antwerpen P, Boudjeltia KZ, Farès N, Kattan J, Aoun F. Oxidative stress and prostatic diseases. Mol Clin Oncol 2017; 7:723-728. [PMID: 29181163 PMCID: PMC5700279 DOI: 10.3892/mco.2017.1413] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 08/18/2017] [Indexed: 01/01/2023] Open
Abstract
Prostatic diseases are a common health problem among males in Western countries, and include chronic prostatic diseases, which have an unclear pathogenesis and few treatment options. In vitro and in vivo studies describe oxidative stress as a major pathway involved in the occurrence of benign prostatic hyperplasia, prostatic cancer and chronic prostatitis. Thus, the oxidative stress cascade is a potential target for the treatment of prostatic diseases. This paper presents a systematic review of the available data concerning the association between oxidative stress and the most common chronic prostatic diseases, and describes the available treatment options that act upon this pathway.
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Affiliation(s)
- Thierry Roumeguère
- Department of Urology, University Clinics of Brussels, Université Libre de Bruxelles, Erasme Hôpital, 187793 Bruxelles, Belgium.,Laboratory of Experimental Medicine, Unit 222, Université Libre de Bruxelles, Le Centre Hospitalier Universitaire de Charleroi, 6042 Charleroi, Belgium
| | - Joseph Sfeir
- Department of Urology, Hôtel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut 166830, Lebanon
| | - Elie El Rassy
- Department of Oncology, Hôtel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut 166830, Lebanon
| | - Simone Albisinni
- Department of Urology, University Clinics of Brussels, Université Libre de Bruxelles, Erasme Hôpital, 187793 Bruxelles, Belgium
| | - Pierre Van Antwerpen
- Laboratory of Experimental Medicine, Unit 222, Université Libre de Bruxelles, Le Centre Hospitalier Universitaire de Charleroi, 6042 Charleroi, Belgium
| | - Karim Zouaoui Boudjeltia
- Laboratory of Experimental Medicine, Unit 222, Université Libre de Bruxelles, Le Centre Hospitalier Universitaire de Charleroi, 6042 Charleroi, Belgium
| | - Nassim Farès
- Research Laboratory of Physiology and PathoPhysiology, Faculty of Medicine, Saint Joseph University, Beirut 166830, Lebanon
| | - Joseph Kattan
- Department of Oncology, Hôtel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut 166830, Lebanon
| | - Fouad Aoun
- Department of Urology, Hôtel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut 166830, Lebanon.,Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, 1000 Bruxelles, Belgium
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8
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Eisenhardt A, Schneider T, Scheithe K, Colling C, Heidenreich A. [Quality of life of patients with prostate cancer under androgen deprivation with GnRH analogues: Results of the noninterventional study TRIPTOSIX]. Urologe A 2016; 55:176-83. [PMID: 26518305 DOI: 10.1007/s00120-015-3989-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND In Germany, data on the quality of life (QoL) of patients with advanced prostate cancer (PCa) under therapy with gonadotropin-releasing hormone (GnRH) analogues are limited. OBJECTIVES Androgen deprivation (ADT) is a palliative therapy for patients with advanced PCa, which is given over long periods and usually continued in combination with other therapies even after progression of the disease. The present study aimed to assess prospectively (over 1 year) different aspects of patients' QoL therapy with triptorelin in daily practice. PATIENTS AND METHODS This prospective, noninterventional study at 129 centers in Germany included 608 patients with advanced PCa treated with triptorelin. Quality of life was assessed at baseline and after 6 and 12 months, using validated EORTC QLQ-C30 and QLQ-PR25 questionnaires. Predefined subgroup analyses were performed to assess the impact of demographics, anamnestic and clinical parameters on QoL. RESULTS AND DISCUSSION The majority of patients with PCa under therapy with triptorelin showed generally stable global QoL over 1 year; approximately one-quarters of the patients had a clinically relevant improvement of their global QoL. In patients without previous PCa therapy and GnRH analogue treatment, significant improvements in global QoL were seen. At the same time, these patients also reported increased treatment-related symptoms. These data indicate that the perception of global QoL is not only influenced by subjective impairment through ADT-related side effects.
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Affiliation(s)
- A Eisenhardt
- Praxisklinik Urologie Rhein Ruhr, Schulstraße 11, 45468, Mülheim an der Ruhr, Deutschland.
| | - T Schneider
- Praxisklinik Urologie Rhein Ruhr, Schulstraße 11, 45468, Mülheim an der Ruhr, Deutschland
| | - K Scheithe
- GKM Gesellschaft für Therapieforschung, München, Deutschland
| | - C Colling
- Ipsen Pharma GmbH, Ettlingen, Deutschland
| | - A Heidenreich
- Klinik für Urologie, Universitätsklinikum Aachen, Aachen, Deutschland
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9
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Merseburger AS, Hupe MC. An Update on Triptorelin: Current Thinking on Androgen Deprivation Therapy for Prostate Cancer. Adv Ther 2016; 33:1072-93. [PMID: 27246172 PMCID: PMC4939158 DOI: 10.1007/s12325-016-0351-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Indexed: 01/05/2023]
Abstract
Androgen deprivation therapy (ADT) is the mainstay palliative treatment for men with locally advanced and metastatic prostate cancer, and aims to reduce testosterone to levels obtained by surgical castration. Use of gonadotropin-releasing hormone (GnRH) agonists predominates among the ADT options. The GnRH agonist, triptorelin is a first-line hormonal therapy that has demonstrated efficacy and safety in clinical trials of patients with locally advanced non-metastatic or metastatic disease. Sustained-release 1-, 3- and 6-month formulations of triptorelin, administered intramuscularly or subcutaneously, have been developed to provide improved flexibility and convenience for the patient. Head-to-head studies of GnRH agonists are lacking in the field of prostate cancer. Despite the inevitable progression to castration-resistant prostate cancer (CRPC) in most patients receiving ADT, monitoring of testosterone levels needs to improve in routine practice and physicians should not overlook the benefits of continued ADT in their patients when introducing one of the various new treatment options for CRPC. For improved survival outcomes, there remains a need to tailor ADT treatment regimens, novel hormonal agents and chemotherapy according to the individual patient with advanced prostate cancer.
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Affiliation(s)
| | - Marie C Hupe
- University Hospital Schleswig-Holstein, Lübeck, Germany
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10
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Zhong X, Lim EA, Hershman DL, Moinpour CM, Unger J, Lee SM. Identifying Severe Adverse Event Clusters Using the National Cancer Institute's Common Terminology Criteria for Adverse Events. J Oncol Pract 2016; 12:e270-80, 245-6. [PMID: 26907453 DOI: 10.1200/jop.2015.006106] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Exploring the relationships among adverse events is important because those that arise from a common mechanism are amenable to a common intervention, which can improve symptom management, quality of life, and treatment adherence. To date, symptom cluster studies have used patient-reported data, which are not always available in clinical trials. In this study, we proposed using the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) to identify adverse event clusters because the CTCAE data are collected as standard practice and can therefore be used when patient-reported outcomes are unavailable. METHODS The CTCAE data from a randomized clinical trial conducted by SWOG that compared docetaxel plus estramustine versus mitoxantrone plus predinsone in patients with advanced prostate cancer were used to identify severe adverse event clusters. A variable based hierarchical cluster analysis was conducted using the CTCAE for the 323 patients who experienced at least one grade 3 or higher adverse event. RESULTS A total of 109 adverse event types were captured using the CTCAE. Four clusters had moderate associations: nausea, vomiting, and anorexia (n = 35, r = 0.45); joint/bone(myalgia, arthralgia, and arthritis) and muscle weakness (n = 26, r = 0.29); anemia and transfusion (n = 20, r = 0.38); and neutrophils/granulocytes, febrile neutropenia, and leukocytes/lymphopenia (n = 114, r = 0.29). Two clusters had weak associations: fatigue/malaise/lethargy and dehydration (n = 66, r = 0.12); and constipation, infection without neutropenia, and abdominal pain/cramping (n = 35, r = 0.13). CONCLUSION Several severe adverse event clusters were identified in patients with advanced prostate cancer. Identifying adverse event clusters using CTCAE data from clinical trials is feasible.
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Affiliation(s)
- Xiaobo Zhong
- Columbia University, New York, NY; and Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Emerson A Lim
- Columbia University, New York, NY; and Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Dawn L Hershman
- Columbia University, New York, NY; and Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Carol M Moinpour
- Columbia University, New York, NY; and Fred Hutchinson Cancer Research Center, Seattle, WA
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11
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McKibben MJ, Smith AB. Evaluation and Management of the Geriatric Urologic Oncology Patient. CURRENT GERIATRICS REPORTS 2015; 4:7-15. [PMID: 25678987 PMCID: PMC4321682 DOI: 10.1007/s13670-014-0106-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The geriatric population presents a unique set of challenges in urologic oncology. In addition to the known natural history of disease, providers must also consider patient factors such as functional and nutritional status, comorbidities and social support when determining the treatment plan. The development of frailty measures and biomarkers to estimate surgical risk shows promise, with several assessment tools predictive of surgical complications. Decreased dependence on chronologic age is important when assessing surgical fitness, as age cutoffs prevent appropriate treatment of many elderly patients who would benefit from surgery. Within bladder, kidney and prostate cancers, continued refinement of surgical techniques offers a broader array of options for the geriatric patient than previously available.
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Affiliation(s)
- Maxim J McKibben
- Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Angela B Smith
- Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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12
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Teoh JYC, Chiu PKF, Chan SYS, Poon DMC, Cheung HY, Hou SSM, Ng CF. Androgen deprivation therapy, diabetes and poor physical performance status increase fracture risk in Chinese men treated for prostate cancer. Aging Male 2015; 18:180-5. [PMID: 26004988 DOI: 10.3109/13685538.2015.1046043] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We investigated the fracture risk after androgen deprivation therapy (ADT) for prostate cancer in the Chinese population. All Chinese prostate cancer patients who were treated primarily by radical prostatectomy or radiotherapy, with or without further ADT, from year 2000 to 2009 were reviewed. We compared the fracture risk in patients who were given ADT (ADT group) with those who were not given any ADT (non-ADT group). Potential risk factors including age, diabetes mellitus, hypertension, hyperlipidemia, ischemic heart disease and performance status were reviewed. The fracture risk was analyzed with Kaplan-Meier and multivariate Cox regression analyses. Our cohort consisted of 200 patients in the non-ADT group and 252 patients in the ADT group. The ADT group was shown to have higher fracture risk (p = 0.036) upon Kaplan-Meier analysis. Upon multivariate Cox regression analyses, diabetes mellitus (HR 4.39, 95% CI 1.08-17.83, p = 0.039), poor performance status (HR 3.14, 95% CI 1.24-8.00, p = 0.016) and the use of ADT (HR 4.89, 95% CI 1.03-23.17, p = 0.045) were associated with increased fracture risk. In conclusion, the fracture risk should be considered while deciding on ADT in Chinese men, especially in diabetic patients with poor performance status.
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Affiliation(s)
| | | | | | - Darren Ming Chun Poon
- b Department of Clinical Oncology , Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, Hong Kong , China
| | - Ho-Yuen Cheung
- c Division of Urology, Department of Surgery , North District Hospital , Hong Kong , China , and
| | | | - Chi-Fai Ng
- a Division of Urology, Department of Surgery and
- d SH Ho Urology Centre , Department of Surgery , The Chinese University of Hong Kong , Shatin, Hong Kong , China
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