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Evaluation of primary androgen deprivation therapy in prostate cancer patients using the J-CAPRA risk score.

Akaza H, Hinotsu S, Usami M, Ogawa O, Kitamura T, Suzuki K, Tsukamoto T, Naito S, Namiki M, Hirao Y, Murai M - Prostate Int (2013)

Bottom Line: MAB for prostate cancer patients with intermediate- or high-risk disease has a significant benefit in terms of overall survival compared with LHRH analog monotherapy or surgical castration alone.Better results may be achieved in older (≥75 years) patients.MAB therapy may provide significant survival benefits in intermediate- and high-risk patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Strategic Investigation on Comprehensive Cancer Network Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan.

ABSTRACT

Purpose: To determine the influence of maximal androgen blockade (MAB) and non-MAB hormonal therapy with an luteinizing hormone releasing hormone (LHRH) analog on overall survival of prostate cancer patients in the Japan Study Group of Prostate Cancer (J-CaP) registry according to risk, as assessed using the novel J-CAPRA risk instrument. To undertake a multivariate analysis combining J-CAPRA risk score, type of hormonal therapy and comorbidities, in order to assess their impact on overall survival.

Methods: The J-CaP database includes men in Japan diagnosed with any stage of prostate cancer between 2001 and 2003 and treated with primary androgen deprivation therapy (PADT), as monotherapy or in combination. A total of 26,272 men were enrolled and of these 19,265 were treated with PADT. This analysis was undertaken using the latest data set (30 April, 2010) including a total of 15,727 patients who received PADT and had follow-up data for periods ranging from 0 to 9.2 years.

Results: MAB for prostate cancer patients with intermediate- or high-risk disease has a significant benefit in terms of overall survival compared with LHRH analog monotherapy or surgical castration alone. Better results may be achieved in older (≥75 years) patients. Patient comorbidities are an important factor in determining overall survival, notably in older patients, and should be considered when selecting therapy.

Conclusions: Based on large-scale registry data, this report is the first to analyze the outcomes of MAB therapy in patients with prostate cancer at a wide range of disease stages. MAB therapy may provide significant survival benefits in intermediate- and high-risk patients.

No MeSH data available.


Related in: MedlinePlus

Overall survival according to J-CAPRA risk score for patients aged ≤75 years (A) and patients aged >75 years (B) who received maximal androgen blockade (MAB) or non-MAB hormonal therapy. PADT, primary androgen deprivation therapy.
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f3-pi_1-2-81-06: Overall survival according to J-CAPRA risk score for patients aged ≤75 years (A) and patients aged >75 years (B) who received maximal androgen blockade (MAB) or non-MAB hormonal therapy. PADT, primary androgen deprivation therapy.

Mentions: Overall survival according to J-CAPRA risk score for two age groups of patients (younger, ≤75 years; older, >75 years of age) who had received MAB or non-MAB hormonal therapy is shown in Fig. 3. In each age category the trend was similar with low-risk patients having a better overall survival than those with high-risk disease, regardless of type of hormonal therapy. In the younger patient subgroup (≤75 years), while there was no significant difference between MAB and non-MAB therapy in terms of overall survival for patients with low J-CAPRA risk scores, for those with intermediate and high risk scores there was a significant benefit observed in favour of MAB therapy: intermediate risk, P=0.016; high risk, P=0.0014. A similar pattern was observed for the older patient subgroup: for intermediate- and high-risk patients MAB therapy was associated with significantly better overall survival than non-MAB therapy (P=0.018 and P=0.021, respectively).


Evaluation of primary androgen deprivation therapy in prostate cancer patients using the J-CAPRA risk score.

Akaza H, Hinotsu S, Usami M, Ogawa O, Kitamura T, Suzuki K, Tsukamoto T, Naito S, Namiki M, Hirao Y, Murai M - Prostate Int (2013)

Overall survival according to J-CAPRA risk score for patients aged ≤75 years (A) and patients aged >75 years (B) who received maximal androgen blockade (MAB) or non-MAB hormonal therapy. PADT, primary androgen deprivation therapy.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3814111&req=5

f3-pi_1-2-81-06: Overall survival according to J-CAPRA risk score for patients aged ≤75 years (A) and patients aged >75 years (B) who received maximal androgen blockade (MAB) or non-MAB hormonal therapy. PADT, primary androgen deprivation therapy.
Mentions: Overall survival according to J-CAPRA risk score for two age groups of patients (younger, ≤75 years; older, >75 years of age) who had received MAB or non-MAB hormonal therapy is shown in Fig. 3. In each age category the trend was similar with low-risk patients having a better overall survival than those with high-risk disease, regardless of type of hormonal therapy. In the younger patient subgroup (≤75 years), while there was no significant difference between MAB and non-MAB therapy in terms of overall survival for patients with low J-CAPRA risk scores, for those with intermediate and high risk scores there was a significant benefit observed in favour of MAB therapy: intermediate risk, P=0.016; high risk, P=0.0014. A similar pattern was observed for the older patient subgroup: for intermediate- and high-risk patients MAB therapy was associated with significantly better overall survival than non-MAB therapy (P=0.018 and P=0.021, respectively).

Bottom Line: MAB for prostate cancer patients with intermediate- or high-risk disease has a significant benefit in terms of overall survival compared with LHRH analog monotherapy or surgical castration alone.Better results may be achieved in older (≥75 years) patients.MAB therapy may provide significant survival benefits in intermediate- and high-risk patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Strategic Investigation on Comprehensive Cancer Network Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan.

ABSTRACT

Purpose: To determine the influence of maximal androgen blockade (MAB) and non-MAB hormonal therapy with an luteinizing hormone releasing hormone (LHRH) analog on overall survival of prostate cancer patients in the Japan Study Group of Prostate Cancer (J-CaP) registry according to risk, as assessed using the novel J-CAPRA risk instrument. To undertake a multivariate analysis combining J-CAPRA risk score, type of hormonal therapy and comorbidities, in order to assess their impact on overall survival.

Methods: The J-CaP database includes men in Japan diagnosed with any stage of prostate cancer between 2001 and 2003 and treated with primary androgen deprivation therapy (PADT), as monotherapy or in combination. A total of 26,272 men were enrolled and of these 19,265 were treated with PADT. This analysis was undertaken using the latest data set (30 April, 2010) including a total of 15,727 patients who received PADT and had follow-up data for periods ranging from 0 to 9.2 years.

Results: MAB for prostate cancer patients with intermediate- or high-risk disease has a significant benefit in terms of overall survival compared with LHRH analog monotherapy or surgical castration alone. Better results may be achieved in older (≥75 years) patients. Patient comorbidities are an important factor in determining overall survival, notably in older patients, and should be considered when selecting therapy.

Conclusions: Based on large-scale registry data, this report is the first to analyze the outcomes of MAB therapy in patients with prostate cancer at a wide range of disease stages. MAB therapy may provide significant survival benefits in intermediate- and high-risk patients.

No MeSH data available.


Related in: MedlinePlus