Video: Dr. Kantoff on Docetaxel Plus Androgen Deprivation Therapy in Prostate Cancer

Excerpt:

“Philip W. Kantoff, MD, chair of the Department of Medicine, Memorial Sloan Kettering Cancer Center and a 2014 Giants of Cancer Care winner for Genitourinary Cancer, discusses the combination of docetaxel (Taxotere) chemotherapy and androgen deprivation therapy (ADT) in the setting of metastatic hormone-sensitive prostate cancer.

“Considering the positive results in overall survival from the CHAARTED and STAMPEDE trials, which combined ADT with docetaxel, the next step became determining which patients would benefit from this combination.”

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ADT Use Not Linked to Dementia in Prostate Cancer

Excerpt:

“For men with prostate cancer, use of androgen deprivation therapy (ADT) seems not to be associated with dementia, according to a study published online Nov. 21 in the Journal of Clinical Oncology.

“Farzin Khosrow-Khavar, Ph.D., from McGill University in Hamilton, Canada, and colleagues examined whether use of ADT is associated with increased risk of dementia, including Alzheimer’s disease. A cohort of 30,903 men newly diagnosed with nonmetastatic prostate cancer from April 1, 1988, to April 30, 2015 were recruited and followed until April 30, 2016. To account for delays associated with dementia diagnosis and minimize reverse causality, ADT exposure was lagged by one year.”

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Prostate Radiotherapy, ADT May Extend Metastatic Prostate Cancer Survival

Excerpt:

“The addition of prostate radiotherapy to androgen deprivation may prolong survival in men with newly diagnosed metastatic prostate cancer, according to a study published in Journal of Clinical Oncology.

” ‘Prostate radiotherapy represents an attractive local treatment strategy for patients with metastatic prostate cancer, given its noninvasive administration and broad patient candidacy, advancements in delivery allowing for an increasingly favorable toxicity profile, the established role of radiotherapy in the management of locally advanced nonmetastatic prostate cancer, and recent associations between radiotherapy and improved survival for men with lymph node–positive prostate cancer,’ Chad G. Rusthoven, MD, radiation oncologist and assistant professor of radiation oncology at University of Colorado School of Medicine, and colleagues wrote.”

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Psychological Effects From ADT a Growing Challenge in Prostate Cancer

Excerpt:

“Androgen-deprivation therapy (ADT) can be associated with significant psychological effects in patients with prostate cancer.

“Additionally, these side effects—which include depression, Alzheimer disease, and coronary disease—are often underreported by patients, according to Heather Jim, MD.

“ ‘It is really important for the clinician to let [patients] know that a lot of men experience this. Let’s get them help and try to help them feel better,’ said Jim, who discussed these significant events in her lecture at the 2016 OncLive State of the Science Summit on Genitourinary Cancers.”

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ADT Decreases Survival Among Black Men With Favorable-Risk Prostate Cancer

Excerpt:

“Definitive treatment with androgen deprivation therapy increased the risk for death among black men with low- or favorable-risk prostate cancer, according to study results published in Cancer.

“ADT should be reserved for black men with high-risk disease, according to the researchers.

“ADT is frequently combined with radiation therapy for the treatment of men with intermediate- or high-risk prostate cancer. No evidence suggests that this treatment platform benefits patients with low- or favorable-risk disease.”

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African-American Men Negatively Impacted by Hormone Therapy for Treatment of Prostate Cancer

Excerpt:

“In a retrospective study analyzing patients’ medical records, researchers at Brigham and Women’s Hospital found that patients’ race significantly affected their longevity by increasing the likelihood of death after receiving androgen deprivation therapy (ADT). ADT was used to reduce the size of the prostate to make a patient eligible for prostate brachytherapy. These findings are published in the August 4, 2016 issue of Cancer.

“Konstantin Kovtun, MD, a resident at BWH, Anthony D’Amico, MD, PhD, chief of Genitourinary Radiation Oncology at BWH, and colleagues, analyzed the medical records of over 7000 men from the Chicago Prostate Cancer Center who had low or favorable-intermediate risk prostate cancer, 20 percent of whom were treated with ADT in order to reduce the size of their prostate gland to make them eligible for brachytherapy. They found that African-American men who were treated with ADT had a 77 percent higher risk of death when compared to non-African American men, the causes of which were not due to prostate cancer.”

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New Research on Triple Negative Breast Cancer Emerges at ASCO 2016


The American Society of Clinical Oncology (ASCO) meeting of 2016 is behind us, but oncologists, patients, and journalists are still analyzing the most interesting presentations made there. Below, we describe some of the more prominent results in triple negative breast cancer (TNBC), both promising and disappointing.

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Radiation Plus ADT Boosts Survival in Metastatic Prostate Ca (CME/CE)

Excerpt:

“A large contemporary analysis of men with metastatic prostate cancer has found that adding radiotherapy to androgen deprivation therapy resulted in substantially better survival than androgen deprivation alone.

“With a median follow-up of 5.1 years, giving prostate radiotherapy plus androgen deprivation was associated on univariate analysis with a longer median overall survival of 53 versus 29 months, for a hazard ratio of 0.562 (95% CI 0.498-0.635, P0.001). The effect held in multivariate, propensity score, and landmark analyses — with the last yielding improved overall survival estimates at 3, 5, and 8 years, reported Chad. G. Rusthoven, MD, of University of Colorado School of Medicine, Denver, and colleagues in the Journal of Clinical Oncology.

“The estimates were 62% versus 43% for 3 years, 49% versus 25% for 5 years, and 33% versus 13% for 8 years (HR 0.562, 95% CI 0.498-0.635, P0.001).”

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Steroid Use With Abiraterone Offers Multidimensional Benefits to Patients With mCRPC

Excerpt:

“For decades, the standard of care for men with advanced prostate cancer has been the depletion or inhibition of androgens. While androgen-deprivation therapy (ADT) often results in temporary tumor regression or symptom relief in some patients, disease progression ultimately occurs over time. For patients with metastatic disease, the median overall survival (OS), until very recently, had been less than 2 years after chemotherapy.

“While tumor progression with ADT was previously believed to be hormone-refractory or androgen-independent, a large body of evidence supports that metastatic castration-resistant prostate cancer (mCRPC) is commonly driven by elevated steroid synthesis, increased expression or splice variants of the androgen receptor (AR), or AR ligand promiscuity, indicating the ongoing need for targeted androgen therapies.”

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