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[PMID]:28264534
[Au] Autor:Fukui T; Nakamura K; Sakatani T; Atsuta T; Kato T; Fukumoto T; Ito M; Inoue K; Terai A
[Ad] Endereço:The Department of Urology, Kurashiki Central Hospital.
[Ti] Título:[Low-Dose Estramustine Phosphate Monotherapy in Castration-Resistant Prostate Cancer Patients].
[So] Source:Hinyokika Kiyo;63(2):57-62, 2017 Feb.
[Is] ISSN:0018-1994
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:We retrospectively evaluated the efficacy and toxicity of low-dose estramustine phosphate (EMP) monotherapy in patients with castration-resistant prostate cancer (CRPC). We administered EMP at 140 or 280 mg/day to 89 patients between January 2003 and December 2012. None of the patients were receiving concomitant dexamethasone and none had ever been treated with docetaxel. Fifty-three patients (59.6%) experienced a decline in prostate-specific antigen (PSA) levels, including 20 (22.5%) with a decline of more than 50%. The median time to PSA progression was 90 days. PSA-progression-free survival was significantly longer in patients treated with EMP 140 mg compared with patients treated with EMP 280 mg, and there was no significant difference in the incidence of adverse events between the two groups. The most frequent toxicities were nausea and anorexia. Two patients had grade 3 adverse events of pulmonary embolism and liver dysfunction. EMP treatment was discontinued in nine patients (10.1%) because of side effects (nausea and anorexia in 7, liver dysfunction and lacunar infarction in 1). Low-dose EMP monotherapy is well tolerated and can effectively reduce PSA levels.
[Mh] Termos MeSH primário: Antineoplásicos Hormonais/uso terapêutico
Estramustina/uso terapêutico
Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Antineoplásicos Hormonais/administração & dosagem
Progressão da Doença
Estramustina/administração & dosagem
Seres Humanos
Masculino
Meia-Idade
Antígeno Prostático Específico/sangue
Neoplasias de Próstata Resistentes à Castração/química
Neoplasias de Próstata Resistentes à Castração/diagnóstico
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents, Hormonal); 35LT29625A (Estramustine); EC 3.4.21.77 (Prostate-Specific Antigen)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170824
[Lr] Data última revisão:
170824
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170308
[St] Status:MEDLINE
[do] DOI:10.14989/ActaUrolJap_63_2_57


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[PMID]:27889880
[Au] Autor:Narita T; Koie T; Ookubo T; Mitsuzuka K; Narita S; Yamamoto H; Inoue T; Hatakeyama S; Kawamura S; Tochigi T; Habuchi T; Arai Y; Ohyama C
[Ad] Endereço:Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifucho, Hirosaki, 036-8562, Japan.
[Ti] Título:The impact of extended lymph node dissection versus neoadjuvant therapy with limited lymph node dissection on biochemical recurrence in high-risk prostate cancer patients treated with radical prostatectomy: a multi-institutional analysis.
[So] Source:Med Oncol;34(1):1, 2017 Jan.
[Is] ISSN:1559-131X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The optimal treatment for high-risk prostate cancer (Pca) remains to be established. The current guidelines recommend extended pelvic lymph node dissection (e-PLND) for selected intermediate- and high-risk patients treated with RP. However, the indications, optimal extent, and therapeutic benefits of e-PLND remain unclear. The aim of this study was to assess whether e-PLND confers an oncological benefit for high-risk Pca compared to neoadjuvant luteinizing hormone-releasing hormone and estramustine (LHRH + EMP). The Michinoku Urological Cancer Study Group database contained the data of 2403 consecutive Pca patients treated with RP at four institutes between March 2000 and December 2014. In the e-PLND group, we identified 238 high-risk Pca patients who underwent RP and e-PLND, with lymphatic tissue removal around the obturator and the external iliac regions, and hypogastric lymph node dissection. The neoadjuvant therapy with limited PLND (l-PLND) group included 280 high-risk Pca patients who underwent RP and removal of the obturator node chain between September 2005 and June 2014 at Hirosaki University. The outcome measure was BRFS. The 5-year biochemical recurrence-free survival rates for the neoadjuvant therapy with l-PLND group and e-PLND group were 84.9 and 54.7%, respectively (P < 0.0001). The operative time was significantly longer in the e-PLND group compared to that of the neoadjuvant therapy with l-PLND group. Grade 3/4 surgery-related complications were not identified in both groups. Although the present study was not randomized, neoadjuvant LHRH + EMP therapy followed by RP might reduce the risk of biochemical recurrence.
[Mh] Termos MeSH primário: Antibióticos Antineoplásicos/uso terapêutico
Linfonodos/cirurgia
Neoplasias da Próstata/tratamento farmacológico
Neoplasias da Próstata/cirurgia
[Mh] Termos MeSH secundário: Idoso
Quimioterapia Adjuvante
Estramustina/administração & dosagem
Hormônio Liberador de Gonadotropina/administração & dosagem
Seres Humanos
Excisão de Linfonodo
Linfonodos/patologia
Masculino
Meia-Idade
Terapia Neoadjuvante
Metástase Neoplásica
Recidiva Local de Neoplasia/patologia
Recidiva Local de Neoplasia/prevenção & controle
Neoplasias da Próstata/patologia
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Antibiotics, Antineoplastic); 33515-09-2 (Gonadotropin-Releasing Hormone); 35LT29625A (Estramustine)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161128
[St] Status:MEDLINE


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[PMID]:27270339
[Au] Autor:Mizokami A; Izumi K; Konaka H; Kitagawa Y; Kadono Y; Narimoto K; Nohara T; Bahl AK; Namiki M
[Ad] Endereço:Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi Kanazawa, 920-8640 Japan.
[Ti] Título:Understanding prostate-specific antigen dynamics in monitoring metastatic castration-resistant prostate cancer: implications for clinical practice.
[So] Source:Asian J Androl;19(2):143-148, 2017 Mar-Apr.
[Is] ISSN:1745-7262
[Cp] País de publicação:China
[La] Idioma:eng
[Ab] Resumo:Availability of novel hormonal therapies as well as docetaxel and cabazitaxel treatment for metastatic castration-resistant prostate cancer (CRPC) has changed the outlook for this group of patients with improvements in progression-free survival and overall survival. Physicians often diagnose the progression of prostate cancer using serum prostate-specific antigen (PSA). However, serum PSA is not always correlated with the clinical status in CRPC. To evaluate the PSA dynamics with greater precision, understanding of the control of PSA and of the mechanisms of development of CRPC is needed. Moreover, it is necessary to use new hormonal therapies with an appropriate timing to optimally improve the prognosis and the QOL of the patients. In the present review, we ascertain the PSA dynamics and the mechanisms of the development of CRPC to assist in optimal utilization of the new treatments for mCRPC.
[Mh] Termos MeSH primário: Neoplasias Ósseas/sangue
Calicreínas/sangue
Antígeno Prostático Específico/sangue
Neoplasias de Próstata Resistentes à Castração/sangue
[Mh] Termos MeSH secundário: Antagonistas de Androgênios/uso terapêutico
Antineoplásicos Hormonais/uso terapêutico
Neoplasias Ósseas/secundário
Progressão da Doença
Estramustina/uso terapêutico
Flutamida/uso terapêutico
Seres Humanos
Masculino
Metástase Neoplásica
Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico
Neoplasias de Próstata Resistentes à Castração/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Androgen Antagonists); 0 (Antineoplastic Agents, Hormonal); 35LT29625A (Estramustine); 76W6J0943E (Flutamide); EC 3.4.21.- (Kallikreins); EC 3.4.21.- (kallikrein-related peptidase 3, human); EC 3.4.21.77 (Prostate-Specific Antigen)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160609
[St] Status:MEDLINE
[do] DOI:10.4103/1008-682X.179159


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[PMID]:27684806
[Au] Autor:Qin Z; Li X; Zhang J; Tang J; Han P; Xu Z; Yu Y; Yang C; Wang C; Xu T; Xu Z; Zou Q
[Ad] Endereço:aDepartment of Urologic Surgery, The Affiliated Cancer Hospital of Jiangsu Province of Nanjing Medical University bDepartment of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
[Ti] Título:Chemotherapy with or without estramustine for treatment of castration-resistant prostate cancer: A systematic review and meta-analysis.
[So] Source:Medicine (Baltimore);95(39):e4801, 2016 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Recently, increasing relevant studies researched the efficacy of castration resistant prostate cancer (CRPC) patients using chemotherapy with or without estramustine, in order to assess the efficacy and toxicity of combining estramustine with chemotherapy for the treatment of CRPC. METHODS: Relevant randomized clinical trials were systematically searched from the databases Pubmed, Embase, and Web of science up to April 1, 2016. Data were centrally extracted and analyzed from the previous studies by 2 independent reviewers. The primary endpoint was overall survival (OS) with pooled hazard ratios. Secondary endpoints were prostate-specific antigen (PSA) response and grade 3 or 4 toxicity using pooled odds ratios. Stata version 12.0 software was used for statistical analysis. RESULTS: Overall, this meta-analysis identified 9 eligible articles, including a total of 956 patients, who had been accrued between January 1, 1993 and December 1, 2010 and randomly divided into chemotherapy with estramustine and without estramustine. Chemotherapy (with or without estramustine) consisted of docetaxel, paclitaxel, ixabepilone, epirubicin, and vinblastine. Patients who received chemotherapy with estramustine had a better improvement in PSA response rate, comparing those without estramustine (OR = 1.84, 95% CI = 1.20-2.80). However, OS between the 2 groups indicated no significant differences (HR = 0.90, 95% CI = 0.77-1.05). Besides, these results of meta-analysis showed no obvious differences between these 2 groups in grade 3 or 4 adverse effects, including anemia (OR = 0.78, 95% CI = 0.38-1.57), neutropenia (OR = 0.91, 95% CI = 0.59-1.43), thrombocytopenia (OR = 0.68, 95% CI = 0.19-2.42), nausea (OR = 2.34, 95% CI = 0.81-6.72), vomiting (OR = 2.43, 95% CI = 0.69-8.51), diarrhea (OR = 3.45, 95% CI = 0.93-12.76), fatigue (OR = 0.67, 95% CI = 0.32-1.41), neuropathy (OR = 0.54, 95% CI = 0.21-1.44), allergic reaction (OR = 1.60, 95% CI = 0.37-6.84), thromboembolic event (OR = 2.18, 95% CI = 0.86-5.51), and edema (OR = 1.02, 95% CI = 0.18-5.95). CONCLUSIONS: This meta-analysis indicated chemotherapy with additional estramustine increased the PSA response rate. However, OS and grade 3 or 4 toxicity were not improved for these patients with CRPC.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Estramustina/uso terapêutico
Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico
[Mh] Termos MeSH secundário: Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Estramustina/administração & dosagem
Estramustina/efeitos adversos
Seres Humanos
Masculino
Antígeno Prostático Específico/efeitos dos fármacos
Neoplasias de Próstata Resistentes à Castração/mortalidade
Ensaios Clínicos Controlados Aleatórios como Assunto
Análise de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
35LT29625A (Estramustine); EC 3.4.21.77 (Prostate-Specific Antigen)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170224
[Lr] Data última revisão:
170224
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160930
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000004801


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[PMID]:27452492
[Au] Autor:Murachi K; Kumagai T; Masuda T; Nakanishi T; Tanaka S; Tajima K; Takebe Y; Oda T
[Ad] Endereço:The Department of Marketing and Development of Urology, Nippon Shinyaku Co, LTD.
[Ti] Título:[Efficacy and Prognostic Factors of Estracyt ® in Patients with Castration-Resistant Prostate Cancer (CRPC) : From the Data Analysis of Estracyt ® Special Drug Use Investigation].
[So] Source:Hinyokika Kiyo;62(6):295-306, 2016 Jun.
[Is] ISSN:0018-1994
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:Estracytâ—‹R (estramustine phosphate) is a medical drug for prostate cancer with cytotoxic activity causing disruption of microtubule organization and indirect androgen production suppressing activity by its metabolite, estradiol. Based on the data obtained from the Estracytâ—‹R Special Drug Use Investigation which surveyed the clinical efficacy and safety of Estracytâ—‹R in patients with prostate cancer whose relapse of prostate cancer after combined androgen blockade (CAB) therapy was confirmed, we evaluated the progression-free survival, prognostic factor, decrease in prostate specific antigen (PSA) level and safety. This surveillance was conducted at 147 institutions nationwide between October, 2010 and September, 2013 and clinical efficacy was evaluated in 239 cases and safety in 329 cases. The median duration of progression-free survival, PSA progression-free survival and PSA response were 169 days (95%CI, 142-190), 197 days (95%CI, 169-267) and 385 days, respectively. The decrease in PSA level was observed in 125 cases (52.3%). Rate of PSA decline >50 and >25% were 18.4 and 43.1, respectively, and rate of PSA best response (PSA decline > 50%) was 32.6%. Multivariate analysis demonstrated that long duration of prior CAB therapy, Estracytâ—‹R - pretreatment PSA value and bone metastasis influenced progression-free survival significantly. Adverse events were observed in 127 cases (38.6%). The major adverse events were anorexia which was observed in 35 cases (10.9%), gastrointestinal disorders observed in 32 cases (9.7%), abnormal laboratory test values observed in 31 cases (9.4%) and gynecomastia observed in 16 cases (4.9%). These results suggest the clinical efficacy and safety of Estracytâ—‹R for chemotherapy-naïve castration-resistant prostate cancer (CRPC), and Estracytâ—‹R is regarded as one of the treatment options for patients with CRPC, especially for patients who had long duration of prior CAB therapy.
[Mh] Termos MeSH primário: Antineoplásicos Alquilantes/uso terapêutico
Antineoplásicos Hormonais/uso terapêutico
Estramustina/uso terapêutico
Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Antineoplásicos Alquilantes/efeitos adversos
Antineoplásicos Hormonais/efeitos adversos
Estramustina/efeitos adversos
Seres Humanos
Masculino
Meia-Idade
Prognóstico
Antígeno Prostático Específico/sangue
Neoplasias de Próstata Resistentes à Castração/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents, Alkylating); 0 (Antineoplastic Agents, Hormonal); 35LT29625A (Estramustine); EC 3.4.21.77 (Prostate-Specific Antigen)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170107
[Lr] Data última revisão:
170107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160726
[St] Status:MEDLINE


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[PMID]:26907453
[Au] Autor:Zhong X; Lim EA; Hershman DL; Moinpour CM; Unger J; Lee SM
[Ad] Endereço:Columbia University, New York, NY; and Fred Hutchinson Cancer Research Center, Seattle, WA.
[Ti] Título:Identifying Severe Adverse Event Clusters Using the National Cancer Institute's Common Terminology Criteria for Adverse Events.
[So] Source:J Oncol Pract;12(3):e270-80, 245-6, 2016 Mar.
[Is] ISSN:1935-469X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Exploring the relationships among adverse events is important because those that arise from a common mechanism are amenable to a common intervention, which can improve symptom management, quality of life, and treatment adherence. To date, symptom cluster studies have used patient-reported data, which are not always available in clinical trials. In this study, we proposed using the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) to identify adverse event clusters because the CTCAE data are collected as standard practice and can therefore be used when patient-reported outcomes are unavailable. METHODS: The CTCAE data from a randomized clinical trial conducted by SWOG that compared docetaxel plus estramustine versus mitoxantrone plus predinsone in patients with advanced prostate cancer were used to identify severe adverse event clusters. A variable based hierarchical cluster analysis was conducted using the CTCAE for the 323 patients who experienced at least one grade 3 or higher adverse event. RESULTS: A total of 109 adverse event types were captured using the CTCAE. Four clusters had moderate associations: nausea, vomiting, and anorexia (n = 35, r = 0.45); joint/bone(myalgia, arthralgia, and arthritis) and muscle weakness (n = 26, r = 0.29); anemia and transfusion (n = 20, r = 0.38); and neutrophils/granulocytes, febrile neutropenia, and leukocytes/lymphopenia (n = 114, r = 0.29). Two clusters had weak associations: fatigue/malaise/lethargy and dehydration (n = 66, r = 0.12); and constipation, infection without neutropenia, and abdominal pain/cramping (n = 35, r = 0.13). CONCLUSION: Several severe adverse event clusters were identified in patients with advanced prostate cancer. Identifying adverse event clusters using CTCAE data from clinical trials is feasible.
[Mh] Termos MeSH primário: Adenocarcinoma/tratamento farmacológico
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Neoplasias da Próstata/tratamento farmacológico
[Mh] Termos MeSH secundário: Adenocarcinoma/secundário
Idoso
Idoso de 80 Anos ou mais
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Ensaios Clínicos Fase III como Assunto
Análise por Conglomerados
Estramustina/administração & dosagem
Seres Humanos
Masculino
Meia-Idade
Mitoxantrona/administração & dosagem
National Cancer Institute (U.S.)
Prednisona/administração & dosagem
Neoplasias da Próstata/patologia
Qualidade de Vida
Ensaios Clínicos Controlados Aleatórios como Assunto
Taxoides/administração & dosagem
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Taxoids); 15H5577CQD (docetaxel); 35LT29625A (Estramustine); BZ114NVM5P (Mitoxantrone); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160225
[St] Status:MEDLINE
[do] DOI:10.1200/JOP.2015.006106


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[PMID]:26576711
[Au] Autor:Blanchard P; Faivre L; Lesaunier F; Salem N; Mesgouez-Nebout N; Deniau-Alexandre E; Rolland F; Ferrero JM; Houédé N; Mourey L; Théodore C; Krakowski I; Berdah JF; Baciuchka M; Laguerre B; Davin JL; Habibian M; Culine S; Laplanche A; Fizazi K
[Ad] Endereço:Radiation Oncology, Gustave Roussy Cancer Center, Villejuif, France; University of Paris-Sud, Cancer Campus, Villejuif, France. Electronic address: pierre.blanchard@gustaveroussy.fr.
[Ti] Título:Outcome According to Elective Pelvic Radiation Therapy in Patients With High-Risk Localized Prostate Cancer: A Secondary Analysis of the GETUG 12 Phase 3 Randomized Trial.
[So] Source:Int J Radiat Oncol Biol Phys;94(1):85-92, 2016 Jan 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The role of pelvic elective nodal irradiation (ENI) in the management of prostate cancer is controversial. This study analyzed the role of pelvic radiation therapy (RT) on the outcome in high-risk localized prostate cancer patients included in the Groupe d'Etude des Tumeurs Uro-Genitales (GETUG) 12 trial. METHODS AND MATERIALS: Patients with a nonpretreated high-risk localized prostate cancer and a staging lymphadenectomy were randomly assigned to receive either goserelin every 3 months for 3 years and 4 cycles of docetaxel plus estramustine or goserelin alone. Local therapy was administered 3 months after the start of systemic treatment. Performance of pelvic ENI was left to the treating physician. Only patients treated with primary RT were included in this analysis. The primary endpoint was biochemical progression-free survival (bPFS). RESULTS: A total of 413 patients treated from 2002 to 2006 were included, of whom 358 were treated using primary RT. A total of 208 patients received pelvic RT and 150 prostate-only RT. Prostate-specific antigen (PSA) concentration, Gleason score, or T stage did not differ according to performance of pelvic RT; pN+ patients more frequently received pelvic RT than pN0 patients (P<.0001). Median follow-up was 8.8 years. In multivariate analysis, bPFS was negatively impacted by pN stage (hazard ratio [HR]: 2.52 [95% confidence interval [CI]: 1.78-3.54], P<.0001), Gleason score 8 or higher (HR: 1.41 [95% CI: 1.03-1.93], P=.033) and PSA higher than 20 ng/mL (HR: 1.41 [95% CI: 1.02-1.96], P=.038), and positively impacted by the use of chemotherapy (HR: 0.66 [95% CI: 0.48-0.9], P=.009). There was no association between bPFS and use of pelvic ENI in multivariate analysis (HR: 1.10 [95% CI: 0.78-1.55], P=.60), even when analysis was restricted to pN0 patients (HR: 0.88 [95% CI: 0.59-1.31], P=.53). Pelvic ENI was not associated with increased acute or late patient reported toxicity. CONCLUSIONS: This unplanned analysis of a randomized trial failed to demonstrate a benefit of pelvic ENI on bPFS in high-risk localized prostate cancer patients.
[Mh] Termos MeSH primário: Irradiação Linfática
Neoplasias da Próstata/radioterapia
[Mh] Termos MeSH secundário: Idoso
Antineoplásicos Hormonais/uso terapêutico
Quimioterapia Adjuvante
Intervalos de Confiança
Intervalo Livre de Doença
Estramustina/administração & dosagem
Gosserrelina/administração & dosagem
Seres Humanos
Excisão de Linfonodo
Masculino
Meia-Idade
Análise Multivariada
Terapia Neoadjuvante/métodos
Gradação de Tumores
Estadiamento de Neoplasias
Antígeno Prostático Específico/sangue
Neoplasias da Próstata/sangue
Neoplasias da Próstata/tratamento farmacológico
Neoplasias da Próstata/mortalidade
Neoplasias da Próstata/patologia
Taxoides/administração & dosagem
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE III; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antineoplastic Agents, Hormonal); 0 (Taxoids); 0F65R8P09N (Goserelin); 15H5577CQD (docetaxel); 35LT29625A (Estramustine); EC 3.4.21.77 (Prostate-Specific Antigen)
[Em] Mês de entrada:1604
[Cu] Atualização por classe:151224
[Lr] Data última revisão:
151224
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151119
[St] Status:MEDLINE


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[PMID]:26433627
[Au] Autor:Inoue T; Ogura K; Kawakita M; Tsukino H; Akamatsu S; Yamasaki T; Matsui Y; Segawa T; Sugino Y; Kamoto T; Kamba T; Tanaka S; Ogawa O
[Ad] Endereço:Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
[Ti] Título:Effective and Safe Administration of Low-Dose Estramustine Phosphate for Castration-Resistant Prostate Cancer.
[So] Source:Clin Genitourin Cancer;14(1):e9-e17, 2016 Feb.
[Is] ISSN:1938-0682
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:UNLABELLED: Despite the favorable toxicity profile at the standard dose of 560 mg daily, the tolerability and toxicology of estramustine phosphate (EMP) have been a cause for concern at administration. Moreover, we do not know whether a lower dose of 280 mg of EMP daily can be administered with some efficacy and fewer side effects. The results of our phase II study suggest that low-dose EMP is a safe treatment option with the same efficacy in patients with castration-resistant prostate cancer. BACKGROUND: We evaluated the efficacy and safety of low-dose estramustine phosphate (EMP) in Japanese patients with castration-resistant prostate cancer (CRPC). PATIENTS AND METHODS: The present study was a single-arm, nonrandomized prospective study in which all patients received EMP orally twice daily for a total dose of 280 mg/day. A total of 31 patients with CRPC were enrolled from December 2009 to December 2012 at 5 institutions in Japan. The primary endpoint was the prostate-specific antigen (PSA) response, defined as a 50% decline in the serum PSA level, confirmed ≥ 3 weeks later. The secondary endpoints included the objective response rate, interval to PSA progression, PSA response duration, progression-free survival, disease-specific survival, overall survival, safety, and quality-of-life assessment using the Functional Assessment of Cancer Therapy-Prostate scores. RESULTS: Ten patients (32%) had a PSA response, and no patient had an objective response. The treatment was well tolerated, and the most frequent toxicities were grade 1 to 2 nausea/vomiting, anorexia, and gynecomastia. The median interval to PSA progression was 140 days (95% confidence interval [CI], 117-260 days). The PSA response duration was 119 days (95% CI, 49-219 days). The median progression-free survival was 213 days (95% CI, 167-422 days). The 3-year disease-specific survival and overall survival rates were 68.6% (median not reached; 95% CI, 33 months to not available) and 59.9% (median 42 months, 95% CI, 28 months to not available), respectively. CONCLUSION: Low-dose EMP seems to be a safe treatment option with some efficacy in patients with CRPC.
[Mh] Termos MeSH primário: Antineoplásicos Hormonais/administração & dosagem
Estramustina/administração & dosagem
Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Progressão da Doença
Seres Humanos
Calicreínas/sangue
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Estudos Prospectivos
Antígeno Prostático Específico/sangue
Neoplasias de Próstata Resistentes à Castração/sangue
Neoplasias de Próstata Resistentes à Castração/mortalidade
Qualidade de Vida
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Antineoplastic Agents, Hormonal); 35LT29625A (Estramustine); EC 3.4.21.- (Kallikreins); EC 3.4.21.- (kallikrein-related peptidase 3, human); EC 3.4.21.77 (Prostate-Specific Antigen)
[Em] Mês de entrada:1610
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151005
[St] Status:MEDLINE


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[PMID]:26209502
[Au] Autor:Rosenthal SA; Hunt D; Sartor AO; Pienta KJ; Gomella L; Grignon D; Rajan R; Kerlin KJ; Jones CU; Dobelbower M; Shipley WU; Zeitzer K; Hamstra DA; Donavanik V; Rotman M; Hartford AC; Michalski J; Seider M; Kim H; Kuban DA; Moughan J; Sandler H
[Ad] Endereço:Radiation Oncology, Sutter Cancer Centers, Roseville, California. Electronic address: rosents@sutterhealth.org.
[Ti] Título:A Phase 3 Trial of 2 Years of Androgen Suppression and Radiation Therapy With or Without Adjuvant Chemotherapy for High-Risk Prostate Cancer: Final Results of Radiation Therapy Oncology Group Phase 3 Randomized Trial NRG Oncology RTOG 9902.
[So] Source:Int J Radiat Oncol Biol Phys;93(2):294-302, 2015 Oct 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Long-term (LT) androgen suppression (AS) with radiation therapy (RT) is a standard treatment of high-risk, localized prostate cancer (PCa). Radiation Therapy Oncology Group 9902 was a randomized trial testing the hypothesis that adjuvant combination chemotherapy (CT) with paclitaxel, estramustine, and oral etoposide plus LT AS plus RT would improve overall survival (OS). METHODS AND MATERIALS: Patients with high-risk PCa (prostate-specific antigen 20-100 ng/mL and Gleason score [GS] ≥ 7 or clinical stage ≥ T2 and GS ≥ 8) were randomized to RT and AS (AS + RT) alone or with adjuvant CT (AS + RT + CT). CT was given as four 21-day cycles, delivered beginning 28 days after 70.2 Gy of RT. AS was given as luteinizing hormone-releasing hormone for 24 months, beginning 2 months before RT plus an oral antiandrogen for 4 months before and during RT. The study was designed based on a 6% improvement in OS from 79% to 85% at 5 years, with 90% power and a 2-sided alpha of 0.05. RESULTS: A total of 397 patients (380 eligible) were randomized. The patients had high-risk PCa, 68% with GS 8 to 10 and 34% T3 to T4 tumors, and median prostate-specific antigen of 22.6 ng/mL. The median follow-up period was 9.2 years. The trial closed early because of excess thromboembolic toxicity in the CT arm. The 10-year results for all randomized patients revealed no significant difference between the AS + RT and AS + RT + CT arms in OS (65% vs 63%; P=.81), biochemical failure (58% vs 54%; P=.82), local progression (11% vs 7%; P=.09), distant metastases (16% vs 14%; P=.42), or disease-free survival (22% vs 26%; P=.61). CONCLUSIONS: NRG Oncology RTOG 9902 showed no significant differences in OS, biochemical failure, local progression, distant metastases, or disease-free survival with the addition of adjuvant CT to LT AS + RT. The trial results provide valuable data regarding the natural history of high-risk PCa treated with LT AS + RT and have implications for the feasibility of clinical trial accrual and tolerability using CT for PCa.
[Mh] Termos MeSH primário: Antagonistas de Androgênios/uso terapêutico
Antineoplásicos Hormonais/uso terapêutico
Neoplasias da Próstata/tratamento farmacológico
Neoplasias da Próstata/radioterapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Antineoplásicos Hormonais/efeitos adversos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Quimioterapia Adjuvante/efeitos adversos
Quimioterapia Adjuvante/métodos
Terapia Combinada/métodos
Progressão da Doença
Término Precoce de Ensaios Clínicos
Estramustina/uso terapêutico
Etoposídeo/uso terapêutico
Seres Humanos
Masculino
Meia-Idade
Gradação de Tumores
Paclitaxel/uso terapêutico
Antígeno Prostático Específico/sangue
Neoplasias da Próstata/mortalidade
Neoplasias da Próstata/patologia
Fatores de Tempo
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Androgen Antagonists); 0 (Antineoplastic Agents, Hormonal); 35LT29625A (Estramustine); 6PLQ3CP4P3 (Etoposide); EC 3.4.21.77 (Prostate-Specific Antigen); P88XT4IS4D (Paclitaxel)
[Em] Mês de entrada:1512
[Cu] Atualização por classe:170421
[Lr] Data última revisão:
170421
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150726
[St] Status:MEDLINE


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[PMID]:26135933
[Au] Autor:Mitsui Y; Arichi N; Hiraki M; Harada Y; Yasumoto H; Shiina H
[Ad] Endereço:Department of Urology, Shimane University School of Medicine, 89-1 Enya-cho, 693-8501 Izumo, Japan. mitsui@med.shimane-u.ac.jp.
[Ti] Título:Tissue Chromogranin A Expression during Prostate Cancer Progression: Prediction of Chemosensitivity.
[So] Source:Urol J;12(3):2165-72, 2015 Jul 01.
[Is] ISSN:1735-546X
[Cp] País de publicação:Iran
[La] Idioma:eng
[Ab] Resumo:PURPOSE: We investigated the clinical significance of chromogranin A (CgA) expression as a neuroendocrine (NE) marker during prostate cancer (PCa) progression, especially as a potential predictor of chemotherapeutic response in castration-resistant PCa (CRPC) patients based on immunohistochemical findings. MATERIALS AND METHODS: Sixteen CRPC patients who underwent combination (docetaxel/estramustine/ carboplatin; DEC) chemotherapy were retrospectively studied. Immunostaining of CgA was performed using prostate biopsy samples obtained at the initial PCa diagnosis, during androgen deprivation therapy, at the time of CRPC diagnosis, and after 2 cycles of DEC therapy. The positive rate was expressed as the mean percentage of positively stained tumor cells against the total number of tumor cells. Differences in positive rates among the treatment courses were compared using a Mann-Whitney test. RESULTS: The mean percentage of CgA-positive PCa cells increased in a stepwise manner until CRPC development and then significantly decreased after DEC therapy. Subanalysis of CgA at CRPC diagnosis showed a more evident reduction of CgA expression after DEC therapy in patients who also had a high level of CgA as compared to those with a low CgA level (P = .003). Likewise, longer prostate-specific antigen progression-free survival was related to CRPC and high CgA (P = .028). CONCLUSION: NE differentiation of PCa cells is accelerated despite androgen deprivation and reaches a peak at the time of CRPC diagnosis. Although further studies using larger samples are needed, CgA expression in CRPC may be a candidate tissue biomarker to reflect the chemotherapy sensitivity of individual PCa cells.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Cromogranina A/biossíntese
Neoplasias da Próstata/metabolismo
[Mh] Termos MeSH secundário: Idoso
Carboplatina/administração & dosagem
Progressão da Doença
Intervalo Livre de Doença
Estramustina/administração & dosagem
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Prognóstico
Próstata/metabolismo
Próstata/patologia
Antígeno Prostático Específico/metabolismo
Neoplasias da Próstata/tratamento farmacológico
Neoplasias da Próstata/patologia
Estudos Retrospectivos
Taxoides/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Chromogranin A); 0 (Taxoids); 15H5577CQD (docetaxel); 35LT29625A (Estramustine); BG3F62OND5 (Carboplatin); EC 3.4.21.77 (Prostate-Specific Antigen)
[Em] Mês de entrada:1603
[Cu] Atualização por classe:150703
[Lr] Data última revisão:
150703
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150703
[St] Status:MEDLINE



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