Normal view MARC view ISBD view

Second generation anti-androgens and androgen deprivation therapy with radiation therapy in the definitive management of high-risk prostate cancer. [Review]

MedStar author(s):

Citation: Prostate Cancer & Prostatic Diseases. 26(1):30-40, 2023 Mar.PMID: 36203051Department: MedStar Georgetown University Hospital/MedStar Washington Hospital Center | Radiation Oncology ResidencyForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Androgen Antagonists | *Prostatic Neoplasms | Abiraterone Acetate/tu [Therapeutic Use] | Androgen Antagonists/tu [Therapeutic Use] | Androgen Receptor Antagonists/tu [Therapeutic Use] | Humans | Male | Prednisone/tu [Therapeutic Use] | Prostatic Neoplasms/dt [Drug Therapy] | Prostatic Neoplasms/rt [Radiotherapy] | Receptors, Androgen/ge [Genetics]Year: 2023 ISSN:

1365-7852

Name of journal: Prostate cancer and prostatic diseasesAbstract: BACKGROUND: Evolving data suggest that men with high-risk localized prostate cancer may benefit from more potent androgen receptor inhibition in the context of curative intent radiotherapy. Recently updated American Society for Clinical Oncology (ASCO) evidence-based guidelines and the National Comprehensive Cancer Network (NCCN) Guidelines have updated recommendations for the consideration of adding second generation anti-androgens to androgen deprivation therapy (ADT) in men receiving radiation therapy (RT) for noncastrate locally advanced high and very high risk nonmetastatic or node positive prostate cancer.CONCLUSIONS: Recent data suggest an overall survival benefit as well as increased probabilities of disease free and metastasis free survival in men with high and very high-risk localized, node positive, and oligometastatic hormone sensitive prostate cancer with abiraterone acetate and prednisone and support the use of potent AR inhibitors in this setting after informed decision making. Copyright © 2022. The Author(s), under exclusive licence to Springer Nature Limited.METHODS AND RESULTS: We conducted a comprehensive review of existing published and abstract presented evidence behind RT with ADT for the definitive management of high-risk prostate cancer, particularly focused on the current phase II and III trial evidence for the addition of second generation anti-androgens to ADT in definitive RT treatment of high-risk prostate cancer and specifically focused on the recent STAMPEDE trial results with abiraterone acetate. We review the biological mechanisms in which second generation anti-androgens may help mitigate ADT resistance and provide radiosensitization through inhibition of DNA repair. Finally, we discuss ongoing clinical trials of potent androgen receptor (AR) inhibitors with ADT in this non-metastatic high-risk radiotherapy setting that may inform on future treatment guidelines.All authors: Wang EC, Lee WR, Armstrong AJFiscal year: FY2023 Digital Object Identifier:

https://dx.doi.org/10.1038/s41391-022-00598-3

ORCID:

Wang, Edina C

Date added to catalog: 2023-04-11

Holdings ( 1 )
Title notes ( 4 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article		Available

BACKGROUND: Evolving data suggest that men with high-risk localized prostate cancer may benefit from more potent androgen receptor inhibition in the context of curative intent radiotherapy. Recently updated American Society for Clinical Oncology (ASCO) evidence-based guidelines and the National Comprehensive Cancer Network (NCCN) Guidelines have updated recommendations for the consideration of adding second generation anti-androgens to androgen deprivation therapy (ADT) in men receiving radiation therapy (RT) for noncastrate locally advanced high and very high risk nonmetastatic or node positive prostate cancer.

CONCLUSIONS: Recent data suggest an overall survival benefit as well as increased probabilities of disease free and metastasis free survival in men with high and very high-risk localized, node positive, and oligometastatic hormone sensitive prostate cancer with abiraterone acetate and prednisone and support the use of potent AR inhibitors in this setting after informed decision making. Copyright © 2022. The Author(s), under exclusive licence to Springer Nature Limited.

METHODS AND RESULTS: We conducted a comprehensive review of existing published and abstract presented evidence behind RT with ADT for the definitive management of high-risk prostate cancer, particularly focused on the current phase II and III trial evidence for the addition of second generation anti-androgens to ADT in definitive RT treatment of high-risk prostate cancer and specifically focused on the recent STAMPEDE trial results with abiraterone acetate. We review the biological mechanisms in which second generation anti-androgens may help mitigate ADT resistance and provide radiosensitization through inhibition of DNA repair. Finally, we discuss ongoing clinical trials of potent androgen receptor (AR) inhibitors with ADT in this non-metastatic high-risk radiotherapy setting that may inform on future treatment guidelines.

English