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Turco F, Di Prima L, Pisano C, Poletto S, De Filippis M, Crespi V, Farinea G, Cani M, Calabrese M, Saporita I, Di Stefano RF, Tucci M, Buttigliero C. How to Improve the Quality of Life of Patients with Prostate Cancer Treated with Hormone Therapy? Res Rep Urol 2023; 15:9-26. [PMID: 36698681 PMCID: PMC9869701 DOI: 10.2147/rru.s350793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 01/07/2023] [Indexed: 01/19/2023] Open
Abstract
Prostate cancer (PC) is a hormone-sensitive tumor. Androgen deprivation therapy (ADT) is the cornerstone of systemic therapy for patients with intermediate or high-risk localized, recurrent, and metastatic prostate cancer. Although generally well tolerated, ADT can lead to short- and long-term adverse events that can worsen the quality of life of patients with PC. In the last decade, the introduction of novel generation androgen receptor pathway inhibitors (ARPI) has resulted in an improvement in the prognosis of patients with metastatic PC when used in combination with ADT. The use of ARPI in increasingly early stages of the disease determines a longer exposure of patients to these treatments. Although ARPIs are normally well-tolerated drugs, they generally cause an increase in toxicity compared to ADT alone, being able to worsen some adverse events already induced by ADT or leading to the development of specific side effects. Although there are no specific treatments for all the adverse events induced by hormonal therapies, it is essential to know the possible toxicities induced by the different treatments and to start procedures to prevent and/or recognize and consequently treat them early in order to not compromise the quality of life of the patients with PC. The aim of this review is to describe the adverse events induced by hormonal therapies. We will first describe the side effects induced by both ADT and ARPI and then the specific adverse events of the different ARPIs. Furthermore, we will try to highlight the possible therapeutic options to prevent or mitigate the toxicity induced by hormone therapies in order to improve the quality of life of the patients with PC.
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Affiliation(s)
- Fabio Turco
- Department of Oncology, University of Turin, at Division of Medical Oncology, San Luigi Gonzaga Hospital, Turin, Italy
| | - Lavinia Di Prima
- Department of Oncology, University of Turin, at Division of Medical Oncology, San Luigi Gonzaga Hospital, Turin, Italy
| | - Chiara Pisano
- Department of Oncology, University of Turin, at Division of Medical Oncology, San Luigi Gonzaga Hospital, Turin, Italy
| | - Stefano Poletto
- Department of Oncology, University of Turin, at Division of Medical Oncology, San Luigi Gonzaga Hospital, Turin, Italy
| | - Marco De Filippis
- Department of Oncology, University of Turin, at Division of Medical Oncology, San Luigi Gonzaga Hospital, Turin, Italy
| | - Veronica Crespi
- Department of Oncology, University of Turin, at Division of Medical Oncology, San Luigi Gonzaga Hospital, Turin, Italy
| | - Giovanni Farinea
- Department of Oncology, University of Turin, at Division of Medical Oncology, San Luigi Gonzaga Hospital, Turin, Italy
| | - Massimiliano Cani
- Department of Oncology, University of Turin, at Division of Medical Oncology, San Luigi Gonzaga Hospital, Turin, Italy
| | - Mariangela Calabrese
- Department of Oncology, University of Turin, at Division of Medical Oncology, San Luigi Gonzaga Hospital, Turin, Italy
| | - Isabella Saporita
- Department of Oncology, University of Turin, at Division of Medical Oncology, San Luigi Gonzaga Hospital, Turin, Italy
| | - Rosario Francesco Di Stefano
- Department of Oncology, University of Turin, at Division of Medical Oncology, San Luigi Gonzaga Hospital, Turin, Italy
| | - Marcello Tucci
- Department of Medical Oncology, Cardinal Massaia Hospital, Asti, Italy,Correspondence: Marcello Tucci, Department of Medical Oncology, Cardinal Massaia Hospital, Corso Dante Alighieri 202, Asti, 14100, Italy, Tel +393286754734, Email
| | - Consuelo Buttigliero
- Department of Oncology, University of Turin, at Division of Medical Oncology, San Luigi Gonzaga Hospital, Turin, Italy
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Audisio M, Buttigliero C, Turco F, Delcuratolo MD, Pisano C, Parlagreco E, Di Stefano RF, Di Prima L, Crespi V, Farinea G, Cani M, Tucci M. Metastatic Urothelial Carcinoma: Have We Take the Road to the Personalized Medicine? Cells 2022; 11:1614. [PMID: 35626651 PMCID: PMC9139766 DOI: 10.3390/cells11101614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/07/2022] [Indexed: 12/10/2022] Open
Abstract
Urothelial cancer is a lethal malignancy characterized by a wide diffusion in Western countries due to a larger exposure to known risk factors, such as aromatic amines, tobacco smoke and benzene [...].
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Affiliation(s)
- Marco Audisio
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, 10124 Turin, Italy; (C.B.); (F.T.); (M.D.D.); (C.P.); (E.P.); (R.F.D.S.); (L.D.P.); (V.C.); (G.F.); (M.C.)
| | - Consuelo Buttigliero
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, 10124 Turin, Italy; (C.B.); (F.T.); (M.D.D.); (C.P.); (E.P.); (R.F.D.S.); (L.D.P.); (V.C.); (G.F.); (M.C.)
| | - Fabio Turco
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, 10124 Turin, Italy; (C.B.); (F.T.); (M.D.D.); (C.P.); (E.P.); (R.F.D.S.); (L.D.P.); (V.C.); (G.F.); (M.C.)
| | - Marco Donatello Delcuratolo
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, 10124 Turin, Italy; (C.B.); (F.T.); (M.D.D.); (C.P.); (E.P.); (R.F.D.S.); (L.D.P.); (V.C.); (G.F.); (M.C.)
| | - Chiara Pisano
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, 10124 Turin, Italy; (C.B.); (F.T.); (M.D.D.); (C.P.); (E.P.); (R.F.D.S.); (L.D.P.); (V.C.); (G.F.); (M.C.)
| | - Elena Parlagreco
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, 10124 Turin, Italy; (C.B.); (F.T.); (M.D.D.); (C.P.); (E.P.); (R.F.D.S.); (L.D.P.); (V.C.); (G.F.); (M.C.)
| | - Rosario Francesco Di Stefano
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, 10124 Turin, Italy; (C.B.); (F.T.); (M.D.D.); (C.P.); (E.P.); (R.F.D.S.); (L.D.P.); (V.C.); (G.F.); (M.C.)
| | - Lavinia Di Prima
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, 10124 Turin, Italy; (C.B.); (F.T.); (M.D.D.); (C.P.); (E.P.); (R.F.D.S.); (L.D.P.); (V.C.); (G.F.); (M.C.)
| | - Veronica Crespi
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, 10124 Turin, Italy; (C.B.); (F.T.); (M.D.D.); (C.P.); (E.P.); (R.F.D.S.); (L.D.P.); (V.C.); (G.F.); (M.C.)
| | - Giovanni Farinea
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, 10124 Turin, Italy; (C.B.); (F.T.); (M.D.D.); (C.P.); (E.P.); (R.F.D.S.); (L.D.P.); (V.C.); (G.F.); (M.C.)
| | - Massimiliano Cani
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, 10124 Turin, Italy; (C.B.); (F.T.); (M.D.D.); (C.P.); (E.P.); (R.F.D.S.); (L.D.P.); (V.C.); (G.F.); (M.C.)
| | - Marcello Tucci
- Department of Medical Oncology, Cardinal Massaia Hospital, 14100 Asti, Italy;
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Audisio M, Tucci M, Di Stefano RF, Parlagreco E, Ungaro A, Turco F, Audisio A, Di Prima L, Ortega C, Di Maio M, Scagliotti GV, Buttigliero C. New emerging targets in advanced urothelial carcinoma: is it the primetime for personalized medicine? Crit Rev Oncol Hematol 2022; 174:103682. [DOI: 10.1016/j.critrevonc.2022.103682] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 12/13/2022] Open
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Audisio A, Buttigliero C, Delcuratolo MD, Parlagreco E, Audisio M, Ungaro A, Di Stefano RF, Di Prima L, Turco F, Tucci M. New Perspectives in the Medical Treatment of Non-Muscle-Invasive Bladder Cancer: Immune Checkpoint Inhibitors and Beyond. Cells 2022; 11:cells11030357. [PMID: 35159167 PMCID: PMC8834622 DOI: 10.3390/cells11030357] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 12/12/2022] Open
Abstract
Non-muscle-invasive bladder cancer (NMIBC) is characterized by a high rate of cure, but also by a non-negligible probability of recurrence and risk progression to muscle-invasive disease. NMIBC management requires a proper local resection and staging, followed by a risk-based treatment with intravesical agents. For many years, the current gold standard treatment for patients with intermediate or high-risk disease is transurethral resection of the bladder (TURB) followed by intravesical bacillus Calmette–Guérin (BCG) instillations. Unfortunately, in about half of high-risk patients, intravesical BCG treatment fails and NMIBC persists or recurs early. While radical cystectomy remains the gold standard for these patients, new therapeutic targets are being individuated and studied. Radical cystectomy in fact can provide an excellent long-term disease control, but can deeply interfere with quality of life. In particular, the enhanced immune checkpoints expression shown in BCG-unresponsive patients and the activity of immune checkpoints inhibitors (ICIs) in advanced bladder cancer provided the rationale for testing ICIs in NMIBC. Recently, pembrolizumab has shown promising activity in BCG-unresponsive NMIBC patients, obtaining FDA approval. Meanwhile multiple novel drugs with alternative mechanisms of action have proven to be safe and effective in NMIBC treatment and others are under investigation. The aim of this review is to analyse and describe the clinical activity of new emerging drugs in BCG-unresponsive NMIBC focusing on immunotherapy results.
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Affiliation(s)
- Alessandro Audisio
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, 10093 Turin, Italy; (A.A.); (M.D.D.); (E.P.); (M.A.); (A.U.); (R.F.D.S.); (L.D.P.); (F.T.)
| | - Consuelo Buttigliero
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, 10093 Turin, Italy; (A.A.); (M.D.D.); (E.P.); (M.A.); (A.U.); (R.F.D.S.); (L.D.P.); (F.T.)
- Correspondence:
| | - Marco Donatello Delcuratolo
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, 10093 Turin, Italy; (A.A.); (M.D.D.); (E.P.); (M.A.); (A.U.); (R.F.D.S.); (L.D.P.); (F.T.)
| | - Elena Parlagreco
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, 10093 Turin, Italy; (A.A.); (M.D.D.); (E.P.); (M.A.); (A.U.); (R.F.D.S.); (L.D.P.); (F.T.)
| | - Marco Audisio
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, 10093 Turin, Italy; (A.A.); (M.D.D.); (E.P.); (M.A.); (A.U.); (R.F.D.S.); (L.D.P.); (F.T.)
| | - Antonio Ungaro
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, 10093 Turin, Italy; (A.A.); (M.D.D.); (E.P.); (M.A.); (A.U.); (R.F.D.S.); (L.D.P.); (F.T.)
| | - Rosario Francesco Di Stefano
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, 10093 Turin, Italy; (A.A.); (M.D.D.); (E.P.); (M.A.); (A.U.); (R.F.D.S.); (L.D.P.); (F.T.)
| | - Lavinia Di Prima
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, 10093 Turin, Italy; (A.A.); (M.D.D.); (E.P.); (M.A.); (A.U.); (R.F.D.S.); (L.D.P.); (F.T.)
| | - Fabio Turco
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, 10093 Turin, Italy; (A.A.); (M.D.D.); (E.P.); (M.A.); (A.U.); (R.F.D.S.); (L.D.P.); (F.T.)
| | - Marcello Tucci
- Department of Medical Oncology, Cardinal Massaia Hospital, 14100 Asti, Italy;
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