China
Africa
Explore chapters and articles related to this topic
Particle Therapy Clinical Trials
Published in Manjit Dosanjh, Jacques Bernier, Advances in Particle Therapy, 2018
Cai Grau, Damien Charles Weber, Johannes A. Langendijk, James D. Cox, Tadashi Kamada, Hirohiko Tsujii
Similarly, cancer of the prostate is common but less often life-threatening. Because prostate cancer was the one type of cancer treated in large numbers at the Harvard Cyclotron Lab, it has been approved by insurance carriers as part of their standard policies. Nevertheless, because so many men who are covered by Medicare refer themselves for proton treatment, it is quite difficult to mount randomised studies. One trial compares proton therapy with and without androgen suppression for intermediate-risk prostate cancer (NCT01492972). Another compares hypo-fractionated versus standard-fractionation radiation therapy with protons and photons for low-risk prostate cancer (NCT01230866). ‘Level I’ evidence is virtually impossible because of the required periods of observation.
Physical activity and prostate cancer
Published in Roy J. Shephard, Physical Activity and the Abdominal Viscera, 2017
Unfortunately, vigorous physical activity seems necessary for enhanced outcomes during ADT.[106] Relatively few prostate cancer survivors spontaneously engage in adequate volumes of physical activity.[101] This may be in part because of the symptoms associated with androgen-suppression[130] but another issue is the need to adapt programmes in the light of specific complications such as urinary incontinence and exercise-induced diarrhoea. Some investigators have found good sustained compliance with what seem fairly standard exercise programmes, albeit with some individual tailoring, but others have suggested that motivation can be boosted by novel approaches such as a recreational soccer programme[129] or the use of a personal trainer.
Pattern hair loss: Pathogenesis, clinical features, diagnosis, and management
Published in Jerry Shapiro, Nina Otberg, Hair Loss and Restoration, 2015
Spironolactone is a synthetic 17-lactone drug, which is a renal competitive aldosterone antagonist with a mild antiandrogenic effect by blocking the androgen receptor and preventing its interaction with dihydrotestosterone [176]. In the adrenal gland, the essential androgen synthesis is decreased by depleting cytochrome P450. Spironolactone is 98% protein bound and the primary metabolite, canrenone, is at least 90% protein bound, which contributes to the diuretic activities of spironolactone. Drug absorption is increased by food; spironolactone is metabolized in the liver and excreted in urine and bile [176]. The maximum androgen suppression is reached after 4–12 months; dosages of 200 mg daily are required.
Advances with androgen deprivation therapy for prostate cancer
Published in Expert Opinion on Pharmacotherapy, 2022
Eun-mi Yu, Jeanny B. Aragon-Ching
Prostate cancer is projected to occur in 248,530 men in the United States and mortality in 34,130 men in 2021 alone [1]. Androgen deprivation therapy (ADT) is the cornerstone of treatment for locally advanced and metastatic prostate cancer [2]. Recent efforts have been geared toward the most efficient and safest way of administering drugs that would lead to androgen suppression. Fortunately, progress has been made by the introduction of depot GnRH agonists and antagonists, as well as oral agents that have supplanted surgical castration, the use of diethylstilbestrol (DES) fraught with cardiovascular toxicity, and short-acting parenteral medications that are inconvenient to use [3,4] Furthermore, the emergence of castration resistance often involves addition of novel anti-androgens or androgen signaling inhibitors that have shaped the landscape of treatment in both castration-resistant prostate cancer (CRPC) and metastatic CRPC. This review focuses primarily on androgen suppression (see Table 1 for landmark trials and Table 2 for specific products) and newer agents that have recently become commercially available. The recent development and FDA approval of an oral GnRH-antagonist, relugolix, represents an advancement in the delivery and administration of ADT. Moreover, relugolix may be a safer alternative for prostate cancer patients with significant cardiovascular comorbid conditions. was approved by the FDA for routine use wherever ADT is also applicable
Real world treatment utilization patterns in patients with castration-resistant prostate cancer
Published in Scandinavian Journal of Urology, 2021
Hari T. Vigneswaran, Anna Warnqvist, Therese M. L. Andersson, Amy Leval, Martin Eklund, Tobias Nordström, Sandra Eloranta, Frida Schain, Lindsay Dearden, Johan Liwing, Maneesha Mehra, Sandhya Nair, Andreas Pettersson, Olof Akre, Markus Aly
After the CRPC cohort was defined (n = 1712), a retrospective chart review was performed starting from the date of PC diagnosis. A total of 13 patients were removed due to data quality and data linkage problems resulting in a total of 1699 men. The review was performed at the oncology sites (Södersjukhuset and Karolinska Solna) in the Stockholm region that treat PC patients with chemotherapy, non-hormonal systemic treatments and ARTs with treatment exposure data through September 2016 and OS data through October 2017. No patients from clinical trials were included. Data collection included treatment start date and treatment regimen. All patients received continued androgen suppression after CRPC diagnosis. Treatment side effects and the occurrence of palliative radiation was recorded. The oncology clinics were separated by electronic medical record on 30 September 2016 and not all follow up data were observable after this date.
Abiraterone acetate in combination with prednisone in the treatment of prostate cancer: safety and efficacy
Published in Expert Review of Anticancer Therapy, 2020
Cécile Manceau, Loic Mourey, Damien Pouessel, Guillaume Ploussard
Prostate cancer remains an important life-threatening public health issue given its prevalence and its related mortality. At a metastatic stage, the disease is not curable and androgen suppression has proven, for decades, its importance in the castration sensitivity of prostate cancer. Androgen suppression by orchiectomy or first-generation hormone treatments (LHRH agonists and antagonists, anti-androgens) was the only treatment at both CRPC and CSPC until the beginning of our century. This means that no survival benefit has been gained and no convincing research has been confirmed in patients for years. Nevertheless, the last 15 years of research including the first docetaxel studies, taxane-specific chemotherapy, and new generation hormone therapies have shown life prolongation in mCRPC and at earlier stages of mCSPC. Abiraterone acetate has been the first new-generation hormone therapy to be approved in post-chemotherapy mCRPC stage, then in pre-chemotherapy stage, and finally in mCSPC disease. It has strongly participated in the improvement of metastatic prostate cancer prognosis.