Abstract:
BACKGROUND:Among men with high-risk non-metastatic castrate-resistant prostate cancer (nmCRPC), we used network meta-analysis to compare non-steroidal anti-androgens (NSAAs) and stratified class-level meta-analysis to identify subgroups with particular benefit from NSAAs with androgen deprivation therapy versus androgen deprivation therapy alone. MATERIALS AND METHODS:We performed a systematic review of phase III parallel-group randomized controlled trials in adult men with nmCRPC. Primary outcome was metastasis-free survival (MFS). Secondary outcomes included overall survival (OS), prostate-specific antigen (PSA) progression-free survival (PFS), and rates of grade 3 to 4 adverse events (AEs). We assessed class-level effects using random effects models; effect modification owing to subgroup effects using random-effects models to pool study-level differences; and comparative outcomes between agents using fixed-effect network models in a Bayesian framework. RESULTS:Three randomized controlled trials were identified. Pooled MFS, PSA-PFS, and OS were significantly greater with NSAA versus placebo (hazard ratio [HR], 0.32; 95% confidence interval [CI], 0.25-0.41; HR, 0.08; 95% CI, 0.05-0.13; and HR, 0.74; 95% CI, 0.61-0.90, respectively). Subgroup analysis demonstrated a greater benefit with NSAAs in men with Eastern Cooperative Oncology Group performance status 0 (HR, 0.30; 95% CI, 0.24-0.38) versus 1 (HR, 0.45; 95% CI, 0.36-0.56; P = .005), but no difference owing to PSA doubling time (P = .43) or use of osteoclast targeting therapy (P = .77). Bayesian analysis showed apalutamide and enzalutamide had a 56% and 44% likelihood of maximizing MFS, respectively, with subgroup analysis demonstrating these agents were preferred regardless of PSA doubling time and performance status. There was a 44%, 41%, and 15% likelihood that apalutamide, darolutamide and enzalutamide offered the greatest OS benefit, respectively. Grade 3 to 4 AEs were more common with NSAAs (odds ratio [OR], 1.47; 95% CI, 1.27-1.71) and there was a 61% chance that darolutamide was preferred. CONCLUSIONS:NSAAs improve survival in high-risk nmCRPC. Apalutamide and enzalutamide may result in improved oncologic outcomes. Darolutamide may result in fewer AEs. Phase IV data are needed to validate these findings.
journal_name
Clin Genitourin Cancerjournal_title
Clinical genitourinary cancerauthors
Hird AE,Magee DE,Bhindi B,Ye XY,Chandrasekar T,Goldberg H,Klotz L,Fleshner N,Satkunasivam R,Klaassen Z,Wallis CJDdoi
10.1016/j.clgc.2020.02.005subject
Has Abstractpub_date
2020-10-01 00:00:00pages
343-350issue
5eissn
1558-7673issn
1938-0682pii
S1558-7673(20)30039-2journal_volume
18pub_type
杂志文章,评审abstract::Effective options are lacking for progressive castration-refractory prostate cancer (CRPC) after conventional chemotherapy. Sunitinib is an orally administered multitargeted tyrosine kinase inhibitor that is approved multinationally for renal cell carcinoma and gastrointestinal stromal tumors. A phase II trial was con...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.3816/CGC.2008.n.023
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Upper urinary tract urothelial carcinoma (UUTUC) is one of the uncommon malignancies lacking of prognostic indicators. Lactate dehydrogenase (LDH) has been demonstrated to correlate with clinical outcomes in human cancers. In this study, we aimed to evaluate the prognostic implication of the preoperative LDH...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2016.01.003
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Abiraterone acetate has been approved for metastatic castration-resistant prostate cancer (mCRPC). Coadministration with prednisone has been recommended to prevent the toxicity from secondary mineralocorticoid excess, such as hypertension, hypokalemia, and edema. However, the use of prednisone is often not d...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2016.12.008
更新日期:2017-08-01 00:00:00
abstract:INTRODUCTION:In the first-line (1L) setting, pazopanib (PAZ) has been recommended by the National Comprehensive Cancer Network for the treatment of advanced renal cell carcinoma (aRCC). In 2018, immuno-oncology (IO) therapy became a commonly used 1L treatment option for aRCC. We report the real-world clinical outcomes ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clgc.2019.10.010
更新日期:2020-02-01 00:00:00
abstract::The discovery and elucidation of prostaglandin (PG) pathways, particularly the molecular and clinical role of cyclooxygenase-2 (COX-2) function, has been found to have an important role in neoplasia. Current understanding of the role of COX-2 activity and therefore the potential clinical usefulness of COX-2-specific i...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.3816/CGC.2005.n.034
更新日期:2005-12-01 00:00:00
abstract:PURPOSE:To quantify the prognostic effect of the location of prostate cancer (PCa) metastases on cancer-specific mortality (CSM) and the rate of other-cause mortality (OCM) in contemporary newly diagnosed metastatic PCa (mPCa) patients. PATIENTS AND METHODS:Within the Surveillance Epidemiology and End Results database...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2018.05.016
更新日期:2018-10-01 00:00:00
abstract:INTRODUCTION:Oxidative stress has been found to be associated with the progression of prostate cancer (PCa); however, human studies which identify differential roles of each oxidation pathway in PCa progression are lacking. We aimed to identify which oxidative stress markers, specifically lipid and global oxidation and...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.09.014
更新日期:2020-04-01 00:00:00
abstract::Metastatic renal cell carcinoma has long been recognized as an aggressive, therapy-refractory epithelial cancer. Two decades of clinical experience with the biologic response modifiers, such as interferon and interleukin-2, have produced little in the way of clinically meaningful benefit for patients, with the notable...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,评审
doi:10.3816/cgc.2006.s.003
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:The objective of this study was to investigate positive surgical margin (PSM) rates in patients with prostate cancer treated with radical prostatectomy (RP) and assess PSM impact on cancer-specific mortality (CSM). PATIENTS AND METHODS:Within the Surveillance, Epidemiology, and End Results (SEER) database (...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2018.09.024
更新日期:2019-02-01 00:00:00
abstract:INTRODUCTION:Patients who undergo surgical treatment for malignancy often receive perioperative blood transfusion (PBT). We examined the association between PBT and mortality in patients who received surgical treatment of prostate, bladder, and kidney cancer. MATERIALS AND METHODS:Using the Surveillance, Epidemiology,...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2014.12.006
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Understanding the tumorigenesis of bilateral cancers occurring in paired organs is essential for treatment planning and follow-up strategies. To the best of our knowledge, only a few studies compared the survival outcomes in patients with unilateral and bilateral renal cell carcinoma (RCC). We aimed to evalu...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.02.008
更新日期:2019-06-01 00:00:00
abstract:INTRODUCTION:A major question concerning cancer is its cells of origin. We hypothesized that distinct cancer subtypes arise from unique cancer-initiating cells. By performing a microarray meta-analysis of seminomas and spermatogonial stem cells, we investigated a putative cell of origin for seminoma. MATERIALS AND MET...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,meta分析
doi:10.1016/j.clgc.2013.04.015
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Piritrexim is reported to have a response rate of 38% in patients with chemotherapy-naive disease and 23% for second-line therapy after chemotherapy failure. We report the results of a multiinstitutional, open-label, 2-stage, phase II study that further evaluates oral piritrexim in patients with urothelial c...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.3816/CGC.2008.n.005
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Circulating tumor DNA (ctDNA), which can be assessed by liquid biopsy, can provide valuable genomic information that may affect treatment response in prostate cancer. The aim of this study was to characterize TP53 mutations and treatment history in prostate cancer. PATIENTS AND METHODS:This study included 1...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.10.022
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:In this study we aimed to determine the relationship between prostate-specific antigen (PSA)-related information obtained from the provider and PSA test uptake. With recent focus on patient-provider communication (PC) and the guidelines recommending against PSA tests for prostate cancer (PCa), PC regarding t...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2017.05.002
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:In recent years, new-onset hypothyroidism was extensively reported in patients receiving sunitinib for malignancy. Effects of sunitinib on serum lipids are not described, however a hyperlipidemic state is commonly observed in hypothyroid patients. Here we report about the incidence and severity of hyperchole...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2014.08.009
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:We compared the short-term oncologic and functional outcomes of salvage focal cryotherapy (SFC) with those of salvage total cryotherapy (STC) for radiotherapy (RT)-persistent/recurrent prostate cancer. MATERIALS AND METHODS:We queried the Cryo On-Line Database registry for men who had undergone SFC and STC ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.11.009
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:The prognostic value of molecular markers in renal cell carcinoma has been investigated in several studies. Although their value is still not confirmed, various proteins are important. We describe the effect on long-term survival of the status of the von Hippel-Lindau (VHL) hypoxia-inducible factor 1-α (HIF1...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2017.05.016
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Hyperglycemia and hypercholesterolemia are class effects of mammalian target of rapamycin inhibitors. The purpose of this study was to characterize safety and efficacy of patients with metastatic renal cell carcinoma (mRCC) treated with everolimus in RECORD-1 (REnal Cell cancer treatment with Oral RAD001 giv...
journal_title:Clinical genitourinary cancer
pub_type: 临床试验,杂志文章
doi:10.1016/j.clgc.2016.04.011
更新日期:2016-10-01 00:00:00
abstract:INTRODUCTION:Estimation of prognosis is patients undergoing radical cystectomy is often unreliable, as occult disease remains undetected by conventional diagnostic tools. The purpose of this study was to evaluate the feasibility and the clinical significance of a polymerase chain reaction assay to detect cytokeratin 7 ...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2016.11.005
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Venous thromboembolic events (VTEs) frequently occur in cancer patients. Risk assessment models (RAMs) for cancer-associated thrombosis have been proposed. However, advanced urinary tract cancer (aUTC) was not adequately represented in these models. We studied the incidence of VTEs, the risk factors, and the...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.12.021
更新日期:2020-08-01 00:00:00
abstract:INTRODUCTION:The objective of this study was to examine the overall survival (OS) in patients diagnosed with high-grade T1 non-muscle-invasive bladder cancer treated with early radical cystectomy versus local treatment of the primary tumor, defined as endoscopic management with or without intravesical chemotherapy or i...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2020.03.013
更新日期:2020-12-01 00:00:00
abstract:PURPOSE:To determine the therapeutic value of lymph node dissection (LND) during cytoreductive nephrectomy (CN) and assess predictors of cancer-specific survival (CSS) in metastatic renal-cell carcinoma. PATIENTS AND METHODS:We identified 293 consecutive patients treated with CN at 4 academic institutions from March 2...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clgc.2017.10.004
更新日期:2018-04-01 00:00:00
abstract::We present a case of a 73-year-old female with metastatic renal cell carcinoma, clear cell histologic subtype, who developed pruritic rash after 2 weeks of 25 mg weekly infusions of temsirolimus. Rash was located on bilateral antecubital areas and posterior knees. Skin biopsy showed spongiotic dermatitis with eosinoph...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.3816/CGC.2009.n.019
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:First-line PD-inhibition in cisplatin-ineligible patients with locally advanced or metastatic urothelial cancer represents a novel clinical setting, with uncertainty concerning second-line outcomes. Specifying second-line treatment and outcomes will provide guidance in this new sequence. We performed a retro...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.10.001
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:We comprehensively tested contemporary incidence and mortality rates in patients with germ cell tumor of the testis (GCTT). MATERIALS AND METHODS:Within the Surveillance, Epidemiology, and End Results database (2004-2015), statistical analyses included estimated annual percentage changes, multivariable logi...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.06.003
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Preliminary studies suggested that selected drug-related toxicities of sunitinib may correlate with a better prognosis. PATIENTS AND METHODS:From January 2006 through December 2015, we retrospectively analyzed data of 145 patients with metastatic renal cell carcinoma treated with sunitinib as a first-line t...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clgc.2019.10.003
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate morbidity, functional, and oncological outcomes after NSS in renal tumors > 7 cm. MATERIALS AND METHODS:We retrospectively analyzed data from 168 patients with tumors > 7 cm who were treated using NSS between 1998 and 2012. RESULTS:Imperative and elective indicatio...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2013.09.004
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:We characterized clinical outcomes of patients with metastatic renal cell carcinoma (mRCC) treated with sunitinib who were long-term responders (LTRs), defined as patients having progression-free survival (PFS) > 18 months. PATIENTS AND METHODS:A retrospective analysis of data from 5714 patients with mRCC t...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2017.06.005
更新日期:2017-06-20 00:00:00
abstract:PURPOSE:To examine the California Cancer Registry (CCR) for bladder cancer survival disparities based on race, socioeconomic status (SES), and insurance in California patients. PATIENTS AND METHODS:The CCR was queried for bladder cancer cases in California from 1988 to 2012. The primary outcome was disease-specific su...
journal_title:Clinical genitourinary cancer
pub_type: 杂志文章
doi:10.1016/j.clgc.2019.05.008
更新日期:2019-10-01 00:00:00