Abiraterone for Prostate Cancer Not Previously Treated with Hormone Therapy
| Autor: | Joanna Gale, C.L. Ferguson, J. Martin Russell, Prabir Chakraborti, Carys Thomas, Mohan Hingorani, Joe M. O'Sullivan, Anjali Zarkar, Clare Gilson, Zafar Malik, John Wagstaff, Jo Bowen, Fiona McKinna, Angus Robinson, Claire Amos, Simon Chowdhury, Alison Birtle, Fawzi Adab, Peter Hoskin, San Aung, Robin Millman, Chris Parker, Neil McPhail, Alastair W. S. Ritchie, Robert Jones, Jason F. Lester, Noel W. Clarke, Susannah Brock, Gerhardt Attard, Andrew Protheroe, James D. Wylie, Omi Parikh, Johann S. de Bono, Nicholas D. James, Julian Money-Kyrle, Malcolm David Mason, William Cross, Emma Gray, David Matheson, Dominik Berthold, Silke Gillessen, Melissa R. Spears, David P. Dearnaley, Narayanan Srihari, Matthew R. Sydes, Mahesh K.B. Parmar, Chris Brawley |
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| Přispěvatelé: | STAMPEDE Investigators |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Oncology
Adult Male Prednisolone/administration & dosage medicine.medical_specialty Combination therapy medicine.medical_treatment Abiraterone Acetate/administration & dosage Abiraterone Acetate/adverse effects Aged Aged 80 and over Androgen Antagonists/administration & dosage Androgen Antagonists/adverse effects Antineoplastic Combined Chemotherapy Protocols/adverse effects Antineoplastic Combined Chemotherapy Protocols/therapeutic use Humans Middle Aged Neoplasm Metastasis/drug therapy Neoplasm Recurrence Local/drug therapy Prednisolone/adverse effects Prostate-Specific Antigen/blood Prostatic Neoplasms/drug therapy Prostatic Neoplasms/mortality Prostatic Neoplasms/radiotherapy Prostatic Neoplasms/surgery Steroid 17-alpha-Hydroxylase/antagonists & inhibitors Survival Analysis 030232 urology & nephrology Androgen deprivation therapy 03 medical and health sciences Prostate cancer chemistry.chemical_compound 0302 clinical medicine SDG 3 - Good Health and Well-being Internal medicine Medicine Gynecology Manchester Cancer Research Centre business.industry ResearchInstitutes_Networks_Beacons/mcrc Apalutamide Abiraterone acetate General Medicine medicine.disease Radiation therapy Prostate-specific antigen chemistry 030220 oncology & carcinogenesis Hormone therapy business |
| Zdroj: | STAMPEDE investigators 2017, ' Abiraterone for Prostate Cancer Not Previously Treated with Hormone Therapy ', New England Journal of Medicine, vol. 377, no. 4, pp. 338-351 . https://doi.org/10.1056/NEJMoa1702900 STAMPEDE Investigators & Gillessen, S 2017, ' Abiraterone for Prostate Cancer Not Previously Treated with Hormone Therapy ', The New England Journal of Medicine, vol. 377, no. 4, pp. 338-351 . https://doi.org/10.1056/NEJMoa1702900 The New England journal of medicine, vol. 377, no. 4, pp. 338-351 |
| ISSN: | 0028-4793 |
| DOI: | 10.1056/NEJMoa1702900 |
| Popis: | BACKGROUND: Abiraterone acetate plus prednisolone improves survival in men with relapsed prostate cancer. We assessed the effect of this combination in men starting long-term androgen-deprivation therapy (ADT), using a multigroup, multistage trial design.METHODS: We randomly assigned patients in a 1:1 ratio to receive ADT alone or ADT plus abiraterone acetate (1000 mg daily) and prednisolone (5 mg daily) (combination therapy). Local radiotherapy was mandated for patients with node-negative, nonmetastatic disease and encouraged for those with positive nodes. For patients with nonmetastatic disease with no radiotherapy planned and for patients with metastatic disease, treatment continued until radiologic, clinical, or prostate-specific antigen (PSA) progression; otherwise, treatment was to continue for 2 years or until any type of progression, whichever came first. The primary outcome measure was overall survival. The intermediate primary outcome was failure-free survival (treatment failure was defined as radiologic, clinical, or PSA progression or death from prostate cancer).RESULTS: A total of 1917 patients underwent randomization from November 2011 through January 2014. The median age was 67 years, and the median PSA level was 53 ng per milliliter. A total of 52% of the patients had metastatic disease, 20% had node-positive or node-indeterminate nonmetastatic disease, and 28% had node-negative, nonmetastatic disease; 95% had newly diagnosed disease. The median follow-up was 40 months. There were 184 deaths in the combination group as compared with 262 in the ADT-alone group (hazard ratio, 0.63; 95% confidence interval [CI], 0.52 to 0.76; PCONCLUSIONS: Among men with locally advanced or metastatic prostate cancer, ADT plus abiraterone and prednisolone was associated with significantly higher rates of overall and failure-free survival than ADT alone. (Funded by Cancer Research U.K. and others; STAMPEDE ClinicalTrials.gov number, NCT00268476 , and Current Controlled Trials number, ISRCTN78818544 .). |
| Databáze: | OpenAIRE |
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