Indications and Practice With Androgen Deprivation Therapy - 05/11/11

Doi : 10.1016/j.urology.2011.04.025

Judd W. Moul ^a, Adam S. Kibel ^b,^c,^⁎ , Mack Roach ^d, Robert Dreicer ^e,^f
^a Division of Urologic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
^b Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri
^c Division of Genetics, Washington University School of Medicine, St. Louis, Missouri
^d Department of Radiation Oncology, University of California San Francisco Comprehensive Cancer Center, San Francisco, California
^e Department of Solid Tumor Oncology, Taussig Cancer Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
^f Department of Medicine, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio

Reprint requests: Adam Kibel, M.D., Divisions of Urologic Surgery and Genetics, Washington University School of Medicine, St. Louis, MO

Résumé

The Cancer of the Prostate Strategic Urological Research Endeavor (CaPSURE) is an ongoing longitudinal observational study of current trends in prostate cancer staging and treatment across a spectrum of different treatment facilities in the United States. To date, the study has documented 2 principal findings: (a) a large variation exists in the treatment choices applied to similar patient presentations across the range of facility type, size, and geographic location in the United States; and (b) although it does not seem to make much difference in mortality outcomes which approach—hormonal therapy, radiotherapy, or surgery—is applied to men at low or intermediate risk, a survival benefit exists with surgery for men at high risk.

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Plan

Trends in Prostate Cancer Treatment Strategies

Primary Hormonal Therapy by Risk Group

Neoadjuvant Hormonal Therapy

Hormonal Therapy Before Radiotherapy

Treatment Side Effects

Current Treatment Trends for Prostate Cancer

Conclusions

Financial Disclosure: J. W. Moul is a member of the Speaker's Bureau for Sanofi-Aventis, Astra-Zeneca, GSK, and Ferring. A. S. Kibel has received grant/research support from Sanofi Aventis, worked as a consultant for Dendreon, Sanofi Aventis, and Centocor Ortho Biotech, is a member of the Speaker's Bureau for Sanofi Aventis and Dendreon, and receives financial or other material support from Dendreon, Sanofi Aventis, and Centocor Ortho Biotech; and R. Dreicer has received grant/research support from Millenium and worked as a consultant for Sanofi Aventis, Novartis, Astra Zeneca, GTX, EMD Serano, Boehringer Ingelheim, Centecor Ortho Biotech, and Millenium