Management of nonmetastatic castration-resistant prostate cancer
The widespread use of prostate-specific antigen (PSA) resulted in stage migration of prostate cancer where androgen deprivation therapy (ADT) is administered for biochemical recurrence in patients following primary treatment. A proportion of these patients progress to a disease state termed nonmetas...
Saved in:
Published in | Current opinion in supportive & palliative care Vol. 12; no. 3; p. 366 |
---|---|
Main Authors | , |
Format | Journal Article |
Language | English |
Published |
United States
01.09.2018
|
Online Access | Get more information |
Cover
Loading…
Abstract | The widespread use of prostate-specific antigen (PSA) resulted in stage migration of prostate cancer where androgen deprivation therapy (ADT) is administered for biochemical recurrence in patients following primary treatment. A proportion of these patients progress to a disease state termed nonmetastatic castration-resistant prostate cancer (nmCRPC), with a rising PSA despite ADT and without evidence of metastases on conventional imaging. We will review the treatment options in nmCRPC, especially in light of recent trials showing significant improvement in metastasis-free survival with newer agents.
Historically, nmCRPC patients were followed-up if PSA doubling-time (PSADT) exceeded 10 months. Treatment options for patients with shorter PSADT included hormonal manipulations that often resulted in transient PSA decline. Denosumab was found to delay the onset of bone metastasis but did not impact survival. Recently, phase 3 trials showed that second-generation antiandrogens resulted in a significant delay in metastasis and a trend toward survival improvement in a select group of nmCRPC patients.
The importance of reducing mortality and morbidity associated with metastasis has led to the acceptance of new primary endpoints in the design of trials for nmCRPC and might result in widespread approval of new agents for this disease state. |
---|---|
AbstractList | The widespread use of prostate-specific antigen (PSA) resulted in stage migration of prostate cancer where androgen deprivation therapy (ADT) is administered for biochemical recurrence in patients following primary treatment. A proportion of these patients progress to a disease state termed nonmetastatic castration-resistant prostate cancer (nmCRPC), with a rising PSA despite ADT and without evidence of metastases on conventional imaging. We will review the treatment options in nmCRPC, especially in light of recent trials showing significant improvement in metastasis-free survival with newer agents.
Historically, nmCRPC patients were followed-up if PSA doubling-time (PSADT) exceeded 10 months. Treatment options for patients with shorter PSADT included hormonal manipulations that often resulted in transient PSA decline. Denosumab was found to delay the onset of bone metastasis but did not impact survival. Recently, phase 3 trials showed that second-generation antiandrogens resulted in a significant delay in metastasis and a trend toward survival improvement in a select group of nmCRPC patients.
The importance of reducing mortality and morbidity associated with metastasis has led to the acceptance of new primary endpoints in the design of trials for nmCRPC and might result in widespread approval of new agents for this disease state. |
Author | Saad, Fred Traboulsi, Samer L |
Author_xml | – sequence: 1 givenname: Samer L surname: Traboulsi fullname: Traboulsi, Samer L organization: Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada – sequence: 2 givenname: Fred surname: Saad fullname: Saad, Fred |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30015690$$D View this record in MEDLINE/PubMed |
BookMark | eNpNT8tKxEAQHERxH_oHIvmBrD3vyU0JrgorCup5mUdHImYSZuLBv3dEBftSRVVRVK_IYRwjEnJGYUOh0RdPj-0G_h-X6oAsqZa0FkypBVnl_AYgTaPkMVlwACpVA0tyeW-jfcUB41yNXVV6B5xtnu3c-8oXkgobY50w90UtqSmN3zYWN3pMJ-Sos-8ZT39xTV6218_tbb17uLlrr3a1L1tUbTRKQMMEAGu6zvnOKfSUBhmC9gqVE0abRjgO2pT9QVAVOHXGS-as52xNzn96pw83YNhPqR9s-tz_vcK-AJ0_TGs |
CitedBy_id | crossref_primary_10_1188_20_CJON_369_378 |
ContentType | Journal Article |
DBID | NPM |
DOI | 10.1097/SPC.0000000000000356 |
DatabaseName | PubMed |
DatabaseTitle | PubMed |
DatabaseTitleList | PubMed |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database |
DeliveryMethod | no_fulltext_linktorsrc |
Discipline | Medicine |
EISSN | 1751-4266 |
ExternalDocumentID | 30015690 |
Genre | Journal Article |
GroupedDBID | --- .Z2 0R~ 53G 5GY 5VS 8L- AAAAV AAHPQ AAIQE AARTV AASCR ABASU ABBUW ABDIG ABJNI ABVCZ ABXVJ ABZAD ACDDN ACEWG ACGFO ACGFS ACILI ACNWC ACWDW ACWRI ACXJB ACXNZ ADGGA ADHPY ADNKB AEETU AENEX AFDTB AHQNM AHVBC AINUH AJIOK AJNWD AJNYG AJZMW ALMA_UNASSIGNED_HOLDINGS ALMTX AMJPA AMKUR AMNEI AOHHW AWKKM BQLVK C45 CS3 DIWNM DUNZO E.X EBS EEVPB EJD EX3 F5P FCALG FL- GNXGY GQDEL HLJTE HZ~ IKREB IN~ IPNFZ KD2 L-C NPM O9- OJAPA OLC OPUJH OUVQU OVD OVDNE OXXIT P2P RIG RLZ S4S TEORI TSPGW V2I W3M WOQ WOW ZZMQN |
ID | FETCH-LOGICAL-c3566-87e50e8240029ffbcfb6ec11d5dd7c6e6b487894b3078003d416d31b8c52bac32 |
IngestDate | Wed Oct 16 00:49:12 EDT 2024 |
IsPeerReviewed | false |
IsScholarly | true |
Issue | 3 |
Language | English |
LinkModel | OpenURL |
MergedId | FETCHMERGED-LOGICAL-c3566-87e50e8240029ffbcfb6ec11d5dd7c6e6b487894b3078003d416d31b8c52bac32 |
PMID | 30015690 |
ParticipantIDs | pubmed_primary_30015690 |
PublicationCentury | 2000 |
PublicationDate | 2018-09-00 |
PublicationDateYYYYMMDD | 2018-09-01 |
PublicationDate_xml | – month: 09 year: 2018 text: 2018-09-00 |
PublicationDecade | 2010 |
PublicationPlace | United States |
PublicationPlace_xml | – name: United States |
PublicationTitle | Current opinion in supportive & palliative care |
PublicationTitleAlternate | Curr Opin Support Palliat Care |
PublicationYear | 2018 |
SSID | ssj0058965 |
Score | 2.1822681 |
SecondaryResourceType | review_article |
Snippet | The widespread use of prostate-specific antigen (PSA) resulted in stage migration of prostate cancer where androgen deprivation therapy (ADT) is administered... |
SourceID | pubmed |
SourceType | Index Database |
StartPage | 366 |
Title | Management of nonmetastatic castration-resistant prostate cancer |
URI | https://www.ncbi.nlm.nih.gov/pubmed/30015690 |
Volume | 12 |
hasFullText | |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3dS8MwEA9OYfgifn9LH3wb1aVZ-vGmDMcQNoRtsLeRr8LEadnmi3-9l6RptzlF7UNpmxDS_tLL3fG7O4Su66mQoCanPmEMDBSqsM8D0vCx5DEoGKGITEmWTjdsDxqPQzosy6Wa6JI5vxEfa-NK_oMqPANcdZTsH5AtBoUHcA34whkQhvOvMC65K4aPoePV5kyHCI1FTTCXEdcHi1pridAr0zEeoF1qrpfIebnPy-lHdQBVzn-cvWdaO9fcIr1AMqZdM-ZW88UKm3-qyc0vs7F1ME_UtFY4lHvMrqCWKwia-xdwXBCoYHuwMjGigGJgi6MUQjNYWBxkQQIS2--LZLYZf3tPTZsx0h2ELnWH75tNDFrEBHnbUqI_t67ky3ZNFVSJYi3zutp_Y_dmGichdQGUSXS7bjrbqOqGWDE1jMrR30U7ua3g3Vvg99CGet1H1U7OhjhAdyX-3lvqLeHvrcPfc_h7Fv9DNGg99JttP6-I4QuYWQhbl6J1FWveb5CkKRcpD5XAWFIpIxGqkIP9GScNDpIbLAEiQd2WBPNY0IAzQYIjtAmTUSfISziBXpLUFSgoggUswJhxyTkFBEHSn6Jj--6jzKY9GbmvcvZtyznaLlfQBdpK4T9Tl6C0zfmVweETAilAMg |
link.rule.ids | 786 |
linkProvider | National Library of Medicine |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Management+of+nonmetastatic+castration-resistant+prostate+cancer&rft.jtitle=Current+opinion+in+supportive+%26+palliative+care&rft.au=Traboulsi%2C+Samer+L&rft.au=Saad%2C+Fred&rft.date=2018-09-01&rft.eissn=1751-4266&rft.volume=12&rft.issue=3&rft.spage=366&rft_id=info:doi/10.1097%2FSPC.0000000000000356&rft_id=info%3Apmid%2F30015690&rft_id=info%3Apmid%2F30015690&rft.externalDocID=30015690 |