Renal & Urology News July-August 2017 digital edition

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www.renalandurologynews.com

Abiraterone Plus ADT Ups Survival First-line use for hormone-sensitive high-risk prostate cancer could be a new standard of care SUPERIOR OUTCOMES AT 3 YEARS In the STAMPEDE trial, upfront use of abiraterone/prednisolone plus ADT versus ADT alone among men with hormone-sensitive locally advanced or metastatic PCa significantly increased the proportion of patients who had failure-free and overall survival and freedom from symptomatic skeletal events at 3 years, as shown here. 100

PERCENTAGE

80

88% 78%

83%

76%

75%

60

45%

40

Abiraterone/ prednisolone plus ADT ADT alone

20 0

No symptomatic skeletal events

Overall survival

Failure-free survival

Source: James ND, de Bono JS, Spears MR, et al. Abiraterone for prostate cancer not previously treated with hormone therapy. N Engl J Med. 2017;377:338-351.

RP Survival Benefit Challenged BY NATASHA PERSAUD MEN WITH LOCALIZED prostate cancer (PCa) treated with radical prostatectomy (RP) survive no longer than those undergoing observation, according to findings from PIVOT (Prostate Cancer Intervention versus Observation Trial).

For the trial, investigators randomly assigned 364 patients to have RP and 367 to undergo observation. During 19.5 years of follow-up, 223 RP patients (61.3%) and 245 observation patients (66.8%) died from any cause; 27 RP patients (7.4%) and 42 observation patients (11.4%) died from PCa. continued on page 7

CVD LINKED TO ANEMIA IN PATIENTS WITH CKD

The risk of coronary heart disease is upped by 41%, study finds. PAGE 9

BY JODY A. CHARNOW CHICAGO—Adding abiraterone to androgen-deprivation therapy (ADT) as first-line treatment for hormonesensitive locally advanced or metastatic prostate cancer (PCa) improves survival and delays disease progression compared with ADT alone, according to the findings of separate studies presented at the American Society of Clinical Oncology 2017 annual meeting and published in the New England Journal of Medicine (2017;377:338-351; 352-360). As a result of study findings, researchers say combined therapy with abiraterone and ADT in this population could represent a new standard of care. In the randomized double-blind phase 3 LATITUDE trial, which

Hypogonadism Ups ED Risk In Testicular CA BY JODY A. CHARNOW Two new studies suggest that hypogonadism in testicular cancer survivors (TCS) is associated with a number of chronic health problems, including erectile dysfunction (ED), dyslipidemia, hypertension, and metabolic syndrome. At the 2017 American Society of Clinical Oncology (ASCO) annual meeting in Chicago, researchers reported on a study of 491 TCS showing that 38% of them suffered from hypogonadism, defined as a serum testosterone level of 300 ng/dL or less or the use of testosterone replacement therapy. A significantly higher proportion of hypogonadal men than those with normal testosterone levels had ED (20% vs. 12%), hypertension (19% vs. 11%), and dyslipidemia (20% vs. 6%) “Our findings underscore the need for clinicians to assess testicular cancer survivors for physical signs or symptoms of hypogonadism and to measure testosterone levels in those who do,” continued on page 7

included 1199 patients with newly diagnosed metastatic hormone-naïve prostate cancer (mHNPC), investigators led by Karim Fizazi, MD, PhD, head of the Department of Cancer Medicine at Gustave Roussy, University Paris-Sud in Villejuif, France, found patients who received abiraterone and prednisone in addition to ADT had a 38% decreased risk of death and 53% decreased risk of radiographic progression compared with those who received placebo and ADT. The median length of radiographic progression-free survival was 33.0 months in the abiraterone arm compared with 14.8 months among the placebo recipients, the researchers reported. continued on page 7

IN THIS ISSUE 9

Study finds minimal risk of PCa in men who have a vasectomy

10

Bladder CA patient death risk is linked to smoking intensity

12

Prostatic urethral lift benefits are durable out to 5 years

12

Mortality risk is greater when MIBC recurrence is symptomatic

14

Negative confirmatory PCa biopsies may be a good sign

24

Greater use of RP for high-risk localized PCa reported

25

ED may predict development of Parkinson’s disease

Intensive BP lowering may benefit patients with CKD. PAGE 18


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