3.Current opinions on the treatment of androgen-independent prostate cancer.
Xiao-xiang GUAN ; Long-bang CHEN
National Journal of Andrology 2006;12(11):1021-1025
Prostate cancer is a most common malignant neoplasm in males. In recent years, its incidence has been rising dramatically in China. Patients with recurrent prostate cancer may be treated with androgen deprivation strategies, but most cases will eventually develop into androgen-independent prostate cancer (AIPC). Until recently, chemotherapy has been shown to be effective in palliating the symptoms of the disease but not in improving survival. Current strategies for the treatment of AIPC have shown significant palliation, but no definitive increase in survival. Molecular mechanisms underlying the development of androgen-independent prostate cancer (AIPC) are poorly understood. However, there is growing evidence that different molecular profiles may result in the development of AIPC. In this paper, we not only review the molecular mechanism of AIPC, but also present some of the promising management principles and systemic chemotherapy options against AIPC.
Androgens
;
Antineoplastic Agents, Hormonal
;
therapeutic use
;
Antineoplastic Combined Chemotherapy Protocols
;
therapeutic use
;
Genetic Therapy
;
Humans
;
Male
;
Prostatic Neoplasms
;
drug therapy
;
therapy
5.Advances and perspective in clinical research on breast cancer.
Chinese Journal of Oncology 2007;29(12):881-883
Antineoplastic Agents, Hormonal
;
therapeutic use
;
Antineoplastic Agents, Phytogenic
;
therapeutic use
;
Breast Neoplasms
;
drug therapy
;
prevention & control
;
secondary
;
surgery
;
Chemotherapy, Adjuvant
;
methods
;
Early Detection of Cancer
;
methods
;
Female
;
Humans
;
Tamoxifen
;
therapeutic use
;
Taxoids
;
therapeutic use
6.Efficacy and safety of LY01005 versus goserelin implant in Chinese patients with prostate cancer: A multicenter, randomized, open-label, phase III, non-inferiority trial.
Chengyuan GU ; Zengjun WANG ; Tianxin LIN ; Zhiyu LIU ; Weiqing HAN ; Xuhui ZHANG ; Chao LIANG ; Hao LIU ; Yang YU ; Zhenzhou XU ; Shuang LIU ; Jingen WANG ; Linghua JIA ; Xin YAO ; Wenfeng LIAO ; Cheng FU ; Zhaohui TAN ; Guohua HE ; Guoxi ZHU ; Rui FAN ; Wenzeng YANG ; Xin CHEN ; Zhizhong LIU ; Liqiang ZHONG ; Benkang SHI ; Degang DING ; Shubo CHEN ; Junli WEI ; Xudong YAO ; Ming CHEN ; Zhanpeng LU ; Qun XIE ; Zhiquan HU ; Yinhuai WANG ; Hongqian GUO ; Tiwu FAN ; Zhaozhao LIANG ; Peng CHEN ; Wei WANG ; Tao XU ; Chunsheng LI ; Jinchun XING ; Hong LIAO ; Dalin HE ; Zhibin WU ; Jiandi YU ; Zhongwen FENG ; Mengxiang YANG ; Qifeng DOU ; Quan ZENG ; Yuanwei LI ; Xin GOU ; Guangchen ZHOU ; Xiaofeng WANG ; Rujian ZHU ; Zhonghua ZHANG ; Bo ZHANG ; Wanlong TAN ; Xueling QU ; Hongliang SUN ; Tianyi GAN ; Dingwei YE
Chinese Medical Journal 2023;136(10):1207-1215
BACKGROUND:
LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer.
METHODS:
We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels.
RESULTS:
On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]).
CONCLUSION:
LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile.
TRIAL REGISTRATION
ClinicalTrials.gov, NCT04563936.
Humans
;
Male
;
Antineoplastic Agents, Hormonal/therapeutic use*
;
East Asian People
;
Gonadotropin-Releasing Hormone/agonists*
;
Goserelin/therapeutic use*
;
Prostate-Specific Antigen
;
Prostatic Neoplasms/drug therapy*
;
Testosterone
8.Intermittent androgen deprivation for aggressive prostate cancer: 8 years of clinical experience.
Qiang SHAO ; Feng-Bo ZHANG ; Xiao-Dong ZHU ; Yuan DU ; Ye TIAN
National Journal of Andrology 2013;19(1):44-48
OBJECTIVETo investigate the safety and medication cycles of intermittent androgen deprivation (IAD) in the treatment of aggressive prostate cancer.
METHODSBased on prostate cancer clinical staging, we divided 178 patients with aggressive prostate cancer into groups A (T3-4N0M0), B (TXN1M0) and C (TXNXM1) to receive maximum androgen blockage for at least 6 months till the PSA level remained at < or = 0.2 microg/L for 3 months, followed by an off-period (without medication). The on-period was initiated when the PSA level was > 4 microg/L, and then stopped again when it was < or = 0.2 microg/L. We recorded and compared the patients' age, baseline PSA levels, Gleason scores, duration of on- and off-period, and time to tumor progression.
RESULTSThe baseline PSA levels of the 3 groups were (27.5 +/- 14.6), (43.4 +/- 21.8) and (62.8 +/- 44.6) microg/L, P < 0.01; the follow-ups averaged (38.4 +/- 9.6), (33.1 +/-14.0) and (28.3 +/- 14.3) months; and the times from medication initiation to tumor progression were (37.4 +/- 6.6), (27.4 +/- 10.2) and (16.6 +/- 4.4) months, respectively. Group A showed a longer off-period and more medication cycles than B and C (P < 0.01). Nineteen patients completed 5 cycles and 2 died of cardiovascular events in group A. PSA elevation and cancer progression occurred after 3 cycles at most in group C. Six died in group B, 1 of metastatic prostate cancer, and 36 died in group C, 21 of metastasis.
CONCLUSIONFor local aggressive prostate cancer, IAD can effectively slow down tumor progression, reduce adverse events and improve patients' quality of life.
Aged ; Aged, 80 and over ; Androgen Antagonists ; administration & dosage ; therapeutic use ; Antineoplastic Agents, Hormonal ; administration & dosage ; therapeutic use ; Humans ; Male ; Middle Aged ; Prostatic Neoplasms ; drug therapy ; Treatment Outcome
9.Limiting the use of primary endocrine therapy in elderly women with breast cancer.
Shaun W Y CHAN ; Patrick M Y CHAN ; Melanie D W SEAH ; Juliana J C CHEN ; Ern Yu TAN
Annals of the Academy of Medicine, Singapore 2014;43(9):469-472
Primary endocrine therapy (PET) is often included as a treatment option in elderly women with operable breast cancer. Elderly women tend to have pre-existing comorbidities and are often reluctant to undergo surgery. The benefit of surgery needs to be weighed against a relatively higher potential for operative morbidity and mortality, and a limited life expectancy. But while PET can provide relatively good locoregional control, it is not curative in nature and the possibility of local complications and metastasis remains. We retrospectively reviewed the outcome of PET in a series of 19 elderly women, older than 70 years of age, who had presented with operable non-metastatic breast cancer. Only about a third of these women were deemed medically unfit for surgery; the rest had declined surgery. Compliance was an issue, with almost half of these patients defaulting treatment and follow-up. Local control was achieved in most patients, but disease progression did occur in 5 patients. Three of these patients received additional treatment; which included surgery in 1 patient. PET should therefore not be considered an equivalent alternative to surgery in elderly women who were fi t to undergo surgery. However, having observed that only 1 of the 6 deaths in our study was related to breast cancer, PET does have a role in women whose life expectancy is more likely to be limited by coexisting morbidities than the breast cancer itself.
Aged
;
Aged, 80 and over
;
Antineoplastic Agents, Hormonal
;
therapeutic use
;
Breast Neoplasms
;
drug therapy
;
Drug Therapy
;
utilization
;
Female
;
Humans
;
Retrospective Studies
;
Tamoxifen
;
therapeutic use
10.A Case of Idiopathic Sclerosing Mesenteritis with Retroperitoneal Fibrosis.
June Ho BAE ; Seong Hwan KIM ; Sang Bong AHN ; Byoung Kwan SON ; Yun Ju JO ; Young Sook PARK ; Yu Min JUNG ; Yeon Soo CHANG
The Korean Journal of Gastroenterology 2011;58(4):221-225
Sclerosing mesenteritis is a rare inflammatory disease of the bowel mesentery. It produces tumor-like masses of the mesentery composed of varying degrees of fibrosis, chronic inflammation, and fat necrosis. It has been described variously as fibrosing mesenteritis, retractile mesenteritis, mesenteric Weber Christian disease, and systemic nodular panniculitis. The etiology and pathogenesis of the disease are as yet unknown, but autoimmune disorder, previous abdominal surgery, trauma, and ischemia could play a role. The clinical features include abdominal pain, vomiting, diarrhea, and constipation. Occasionally, patients with this condition may present with bowel obstruction. Rarely, It can be associated with other idiopathic inflammatory disorders such as retroperitoneal fibrosis, sclerosing cholangitis, and orbital pseudotumors. We report a case of idiopathic sclerosing mesenteritis with retroperitoneal fibrosis in a 58-year-old man.
Anti-Inflammatory Agents/therapeutic use
;
Antineoplastic Agents, Hormonal/therapeutic use
;
Diagnosis, Differential
;
Humans
;
Laparoscopy
;
Male
;
Middle Aged
;
Panniculitis, Peritoneal/complications/*diagnosis/drug therapy
;
Prednisolone/therapeutic use
;
Retroperitoneal Fibrosis/complications/*diagnosis/pathology
;
Tamoxifen/therapeutic use
;
Tomography, X-Ray Computed