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Posts Tagged ‘androgen-deprivation therapy’

URO TODAY: Physical activity effectively attenuates many of the side effects of androgen deprivation therapy and should be recommended to prostate survivors as an alternate therapy. READ MORE>

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NEW ENGLAND JOURNAL OF MEDICINE: A new drug just approved by the FDA for high risk prostate cancer patients suffering bone loss has performed well in a trial.

Denosumab was associated with increased bone mineral density at all sites and a reduction in the incidence of new vertebral fractures among men receiving androgen-deprivation therapy for non-metastatic prostate cancer.

Background: Androgen-deprivation therapy is well-established for treating prostate cancer but is associated with bone loss and an increased risk of fracture.

We investigated the effects of denosumab, a fully human monoclonal antibody against receptor activator of nuclear factor-{kappa}B ligand, on bone mineral density and fractures in men receiving androgen-deprivation therapy for nonmetastatic prostate cancer.

Methods: In this double-blind, multicenter study, we randomly assigned patients to receive denosumab at a dose of 60 mg subcutaneously every 6 months or placebo (734 patients in each group).

The primary end point was percent change in bone mineral density at the lumbar spine at 24 months. Key secondary end points included percent change in bone mineral densities at the femoral neck and total hip at 24 months and at all three sites at 36 months, as well as incidence of new vertebral fractures.

Results: At 24 months, bone mineral density of the lumbar spine had increased by 5.6% in the denosumab group as compared with a loss of 1.0% in the placebo group (P<0.001); significant differences between the two groups were seen at as early as 1 month and sustained through 36 months.

Denosumab therapy was also associated with significant increases in bone mineral density at the total hip, femoral neck, and distal third of the radius at all time points.

Patients who received denosumab had a decreased incidence of new vertebral fractures at 36 months (1.5%, vs. 3.9% with placebo) (relative risk, 0.38; 95% confidence interval, 0.19 to 0.78; P=0.006). Rates of adverse events were similar between the two groups.

Researchers: Matthew R. Smith, M.D., Ph.D., Blair Egerdie, M.D., Narciso Hernández Toriz, M.D., Robert Feldman, M.D., Teuvo L.J. Tammela, M.D., Fred Saad, M.D., Jiri Heracek, M.D., Ph.D., Maciej Szwedowski, M.D., Chunlei Ke, Ph.D., Amy Kupic, M.A., Benjamin Z. Leder, M.D., Carsten Goessl, M.D., for the Denosumab HALT Prostate Cancer Study Group.

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URO TODAY: The dual inhibition of both types 1 and 2 of the testosterone-reducing enzyme 5-AR with the new drug dutasteride may prove more useful than another commonly used drug, finasteride, in treating prostate cancer. READ MORE>

A review just published by the Department of Urologic Sciences, University of British Columbia Vancouver says:

Normal growth and function of the prostate are contingent on the reduction of testosterone to dihydro-testosterone (DHT) by 5-alpha reductase (5-AR) enzymes types 1 and 2.

It has been theorised that an over-abundance of DHT may be implicated in the pathogenesis of both benign prostatic hyperplasia (BPH) and prostate cancer.Dutasteride inhibits both types 1 and 2, whereas finasteride inhibits type 2 only.

Available data show that dutasteride, in contrast to finasteride, provides greater suppression of DHT than finasteride, is able to shrink tumour volume quicker and more dramatically than finasteride, and is more effective against genetic variants of 5-AR than is finasteride.

Thus, full clinical investigations of these and other approaches to the inhibition of 5-AR are ongoing and results are greatly anticipated.

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AUGUST 4: URO TODAY: Androgen deprivation therapy for prostate cancer has adverse side effects like reduced bone mass and increased risk for fracture, reduced lean mass and muscle strength, mood disturbance and increased fat mass.

An Australian investigation has examined the effects of long term exercise on reversing musculoskeletal-related side effects, and cardiovascular and diabetes risk factors in men receiving androgen deprivation. READ MORE>

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JULY 31: URO TODAY: Knowledge of the molecular and cellular changes that occur during the transition of hormone-naïve to castration-resistant prostate cancer is increasing rapidly. This might provide a window of opportunity for (future) drug development, and for treating patients with these potential devastating states of disease, say Dutch researchers. READ MORE>

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JULY 31: URO TODAY: Higher levels of immune cells called CD68(+) macrophages found in patients having androgen deprivation therapy may be associated with greater risk of advanced prostate cancer, according to a study in Quebec. Patients with elevated abundance of CD56(+) Natural Killer cells had lower risk of prostate cancer progression. READ MORE>

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JULY 15: NEW PROSTATE CANCER INFOLINK: Eight-year outcome data are now available for patients with Gleason score 8-10 prostate cancer treated with brachytherapy, external beam radiotherapy, and androgen deprivation therapy. The authors conclude that 8-year outcomes after this combination regimen show favourable biochemical and distant control, as well disease-specific survival rates for patients with Gleason scores of 8-10. READ MORE> and HERE>

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JULY 12: URO TODAY: Bone loss begins at 6 months with androgen deprivation therapy (ADT). A single infusion of zoledronic acid in patients receiving ADT reduces bone mineral loss and maintains bone mineral density (BMD) at least at 12 months during ADT. Further study is needed to determine the best dosing schedule to prevent ADT-induced bone loss in men with hormone-naive prostate carcinoma. READ MORE>

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JULY 10: URO TODAY:  Use of luteinizing hormone-releasing hormone agonists has decreased in the US Medicare and Veterans Health Administration populations since 2004 without a compensatory increase in the use of alternative forms of androgen deprivation therapy.

The shift in practice patterns is likely due to a decrease in Medicare reimbursement for these drugs, an increase in the use of intermittent therapy and increased recognition of the adverse effects associated with androgen deprivation therapy.  READ MORE>

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JULY 9: URO TODAY:  Men receiving androgen deprivation therapy for prostate cancer are at risk for bone loss and should receive appropriate bone density monitoring and preventive advice about calcium, vitamin D, exercise, and fall prevention. READ MORE>

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