Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2018

Open Access 01-12-2018 | Research article

Usefulness of combined androgen blockade therapy with gonadotropin-releasing hormone antagonist for bone metastatic prostate cancer with pretreatment prostate-specific antigen level ≥ 50 ng/mL

Authors: Takeshi Kashiwabara, Sayo Suda

Published in: BMC Cancer | Issue 1/2018

Login to get access

Abstract

Background

This study was performed to examine the usefulness of combined androgen blockade (CAB) therapy with a gonadotropin-releasing hormone (GnRH) antagonist (CAB-antagonist therapy), instead of CAB therapy with GnRH agonist (CAB-agonist therapy) against very high-risk prostate cancer (Pca).

Methods

We retrospectively studied 84 Pca patients with pretreatment prostate-specific antigen (PSA) level ≥ 50 ng/mL, who were pathologically diagnosed between January 2007 and December 2016. GnRH antagonist was administered to 34 patients and GnRH agonist was administered to 50 patients. All patients received concurrent antiandrogen treatment.
The primary end point was PSA progression-free survival (PSA-PFS).

Results

PSA-PFS was significantly longer for the CAB-antagonist group compared to the CAB-agonist group (log-rank test, P <  0.01) in Pca patients with more than six bone metastases (the extent of disease [EOD] grade 2–4). On multivariate analysis, CAB-antagonist therapy was shown to be a possible prognostic factor for PSA-PFS (adjusted hazard ratio: 0.41, 95% confidence interval: 0.16–0.90, P = 0.03).

Conclusions

CAB-antagonist therapy may be a useful option in bone metastatic Pca patients with EOD grade 2–4.
Literature
1.
Fujimoto H, Nakanishi H, Miki T, Kubota Y, Takahashi S, Suzuki K, et al. Oncological outcomes of the Pca patients registered in 2004: report from the Cancer registration committee of the JUA. Int J Urol. 2011;18:876–81.CrossRefPubMed
2.
Cooperberg MR, Hinotsu S, Namiki M, Carroll PR, Akaza H. Trans-Pacific variation in outcomes for men treated with primary androgen-deprivation therapy (ADT) for prostate cancer. BJU Int. 2016;117:102–9.CrossRefPubMed
3.
Fizazi K, Tran N, Fein L, Matsubara N, Rodriguez-Antolin A, Alekseev BY, et al. Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer. N Engl J Med. 2017;377:352–60.CrossRefPubMed
4.
James ND, de Bono JS, Spears MR, Clarke NW, Mason MD, Dearnaley DP, et al. Abiraterone for prostate cancer not previously treated with hormone therapy. N Engl J Med. 2017;377:338–51.CrossRefPubMedPubMedCentral
5.
Wiebe E, Rodrigues G, Lock M, D'Souza D, Stitt L. Outcome analysis of prostate cancer patients with pretreatment PSA greater than 50 ng/ml. Can J Urol. 2008;15:4078–83.PubMed
6.
Tombal B, Miller K, Boccon-Gibod L, Schröder F, Shore N, Crawford ED, et al. Additional analysis of the secondary end point of biochemical recurrence rate in a phase 3 trial (CS21) comparing degarelix 80 mg versus leuprolide in prostate cancer patients segmented by baseline characteristics. Eur Urol. 2010;57:836–42.CrossRefPubMed
7.
Schröder FH, Tombal B, Miller K, Boccon-Gibod L, Shore ND, Crawford ED, et al. Changes in alkaline phosphatase levels in patients with prostate cancer receiving degarelix or leuprolide: results from a 12-month, comparative, phase III study. BJU Int. 2010;106:182–7.CrossRefPubMed
8.
Iversen P, Damber JE, Malmberg A, Persson BE, Klotz L. Degarelix monotherapy compared with luteinizing hormone-releasing hormone (GnRH) agonists plus anti-androgen flare protection in advanced prostate cancer: an analysis of two randomized controlled trials. Ther Adv Urol. 2016;8:75–82.CrossRefPubMed
9.
Soloway MS, Hardeman SW, Hickey D, Raymond J, Todd B, Soloway S, et al. Stratification of patients with metastatic prostate cancer based on extent of disease on initial bone scan. Cancer. 1988;61:195–202.CrossRefPubMed
10.
Sweeney CJ, Chen YH, Carducci M, Liu G, Jarrard DF, Eisenberger M, et al. Chemohormonal therapy in metastatic hormone-sensitive prostate cancer. N Engl J Med. 2015;373:737–46.CrossRefPubMedPubMedCentral
11.
Huggins C, Hodge CV. Studies on prostate cancer. I. The effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of prostate. Cancer Res. 1941;1:293–7.
12.
Klotz L, Schellhammer P, Carroll K. A reassessment of the role of combined androgen blockade for advanced prostate cancer. BJU Int. 2004;93:1177–82.CrossRefPubMed
13.
Chen XQ, Huang Y, Li X, Zhang P, Huang R, Xia J, et al. Efficacy of maximal androgen blockade versus castration alone in the treatment of advanced prostate cancer: a retrospective clinical experience from a Chinese medical centre. Asian J Androl. 2010;12:718–27.CrossRefPubMedPubMedCentral
14.
Hinotsu S, Akaza H, Usami M, Ogawa O, Kagawa S, Kitamura T, et al. Current status of endocrine therapy for prostate cancer in Japan-analysis of primary androgen deprivation therapy on the basis of data collected by J-CaP. Jpn J Clin Oncol. 2007;37:775–81.CrossRefPubMed
15.
Akaza H, Hinotsu S, Usami M, Arai Y, Kanetake H, Naito S, et al. Combined androgen blockade with Bicalutamide for advanced prostate cancer. Long-term follow-up of a phase 3, double-blind, randomized study for survival. Cancer. 2009;115:3437–45.CrossRefPubMed
16.
Hussain M, Tangen CM, Higano C, Schelhammer PF, Faulkner J, Crawford ED, et al. Absolute prostate-specific antigen value after androgen deprivation is a strong independent predictor of survival in new metastatic prostate Cancer: data from southwest oncology group trial 9346 (INT-0162). J Clin Oncol. 2006;24:3984–90.CrossRefPubMed
17.
Halabi S, Vogelzang NJ, Ou SS, Owzar K, Archer L, Small EJ. Progression-free survival as predictor of overall survival in men with castrate-resistant prostate cancer. J Clin Oncol. 2009;27:2766–71.CrossRefPubMedPubMedCentral
18.
Klotz L, Miller K, Crawford ED, Shore N, Tombal B, Karup C, et al. Disease control outcomes from analysis of pooled individual patient data from five comparative randomized clinical trials of degarelix versus luteinizing hormone-releasing hormone agonists. Eur Urol. 2014;66:1101–8.CrossRefPubMed
19.
Thompson IM. Flare associated with GnRH-agonist therapy. Rev Urol. 2014;3(Suppl 3):10–4.
20.
Klotz L, Boccon-Gibod L, Shore ND, Andreou C, Persson BE, Cantor P, et al. The efficacy and safety of degarelix: a 12-month, comparative, randomized, open-label, parallel-group phaseIII study in patients with prostate cancer. BJU Int. 2014;102:1531–8.CrossRef
21.
Porter AT, Ben-Josef E, F.A.C.R.O. Humoral mechanisms in prostate cancer: a role for FSH. Urol Oncol. 2001;6:131–8.CrossRefPubMed
22.
Hoare D, Skinner TAA, Black A, Robert Siemens DR. Serum follicle-stimulating hormone levels predict time to development of castration-resistant prostate cancer. Can Urol Assoc J. 2015;9:122–7.PubMedPubMedCentral
23.
Akaza H, Hinotsu S, Usami M, Ogawa O, Kitamura T, Suzuki K, et al. Evaluation of primary androgen deprivation therapy in prostate cancer patients using the J-CAPRA risk score. Prostate Int. 2013;1:81–8.CrossRefPubMedPubMedCentral
24.
Chodak GW, Thisted RA, Gerber GS, Johansson JE, Adolfsson J, Jones GW, et al. Results of conservative management of clinically localized prostate cancer. N Engl J Med. 1994;330:242–8.CrossRefPubMed
25.
Kitagawa Y, Ueno S, Izumi K, Kadono Y, Mizokami A, Hinotsu S, et al. Clinical outcomes and nadir prostate-specific antigen (PSA) according to initial PSA levels in primary androgen deprivation therapy for metastatic prostate cancer. World J Urol. 2016;34:319–27.CrossRefPubMed
26.
Halabi S, Kelly WK, Ma H, Zhou H, Solomon NC, Fizazi K, et al. Meta-analysis evaluating the impact of site of metastasis on overall survival in men with castration-resistant prostate cancer. J Clin Oncol. 2016;34:1652–9.CrossRefPubMedPubMedCentral
Metadata
Title
Usefulness of combined androgen blockade therapy with gonadotropin-releasing hormone antagonist for bone metastatic prostate cancer with pretreatment prostate-specific antigen level ≥ 50 ng/mL
Authors
Takeshi Kashiwabara
Sayo Suda
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-018-4541-0

Other articles of this Issue 1/2018

BMC Cancer 1/2018 Go to the issue

Research article

Elevated platelet count is a negative predictive and prognostic marker in locally advanced rectal cancer undergoing neoadjuvant chemoradiation: a retrospective multi-institutional study on 965 patients

Research article

Chromoanasynthesis is a common mechanism that leads to ERBB2 amplifications in a cohort of early stage HER2+ breast cancer samples

Research article

The clinical implications of G1-G6 transcriptomic signature and 5-gene score in Korean patients with hepatocellular carcinoma

Research article

Preliminary qualification of a novel, hypoxic-based radiologic signature for trans-arterial chemoembolization in hepatocellular carcinoma

Correction

Correction to: Palliative external beam radiotherapy for the treatment of tumor bleeding in inoperable advanced gastric cancer

Research article

HPV-16 E7 expression up-regulates phospholipase D activity and promotes rapamycin resistance in a pRB-dependent manner
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits