Hormonal Agents

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The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform

Alice Dragomir - One of the best experts on this subject based on the ideXlab platform.

Armen Aprikian - One of the best experts on this subject based on the ideXlab platform.

Marie Vanhuyse - One of the best experts on this subject based on the ideXlab platform.

Francesco Massari - One of the best experts on this subject based on the ideXlab platform.

  • a meta analysis on overall survival and safety outcomes in patients with nonmetastatic castration resistant prostate cancer treated with novel Hormonal Agents
    Anti-Cancer Drugs, 2021
    Co-Authors: Alessandro Rizzo, Marco Oderda, Veronica Mollica, Sara Merler, Franco Morelli, Benedetta Fragomeno, Elena Taveri, Giulia Sorgentoni, Matteo Santoni, Francesco Massari
    Abstract:

    Several novel androgen receptor (AR)-inhibitors have been introduced for nonmetastatic castration-resistant prostate cancer (nmCRPC) treatment, with the improvement of survival outcomes which need to be balanced against the risk of adverse events. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating enzalutamide, apalutamide and darolutamide in nmCRPC patients, to assess overall survival (OS), incidence and risk of adverse drug events, adverse-events-related death and adverse-events-related treatment discontinuation. We selected three RCTs (SPARTAN, PROSPER and ARAMIS). New Hormonal Agents administration resulted in better OS, despite the increased risk of several any grade and grade 3-4 adverse events. In the decision-making process, careful evaluation of expected adverse events, patients' comorbidities and maintenance of quality of life are mandatory.

  • new Hormonal Agents in patients with nonmetastatic castration resistant prostate cancer meta analysis of efficacy and safety outcomes
    Clinical Genitourinary Cancer, 2019
    Co-Authors: Vincenzo Di Nunno, Veronica Mollica, Matteo Santoni, Lidia Gatto, Riccardo Schiavina, Michelangelo Fiorentino, Eugenio Brunocilla, Andrea Ardizzoni, Francesco Massari
    Abstract:

    In the past few years several Hormonal Agents have been tested in patients with nonmetastatic castration-resistant prostate cancer (nmCRPC) leading to an impressive improvement in terms of metastases-free survival (MFS). We performed a meta-analysis aimed to: (1) estimate the pooled effect of new Hormonal compounds in terms of MFS, overall survival (OS) in overall and specific subpopulations; and (2) estimate the effect of high-grade toxicities of these drugs. We identified 881 studies published between January 1, 2010 and February 16, 2018 on PubMed/Medline, Cochrane Library, and Scopus. Three randomized placebo controlled clinical trials were selected (PROSPER, SPARTAN, and ARAMIS). Because of the absence of individual data, all of the analyses performed were made on aggregated data provided in selected studies. We used the inverse variance technique for the meta-analysis of the hazard ratios collected for MFS and OS analysis. Fixed and randomized models were used. Relative risk and 95% confidence intervals and risk difference were estimated considering the number of Grade 3 adverse events in treatment and control arms. Administration of new Hormonal compounds in nmCRPC patients led to a significant benefit in MFS in the overall population and in all subgroups analyzed. These Agents might also improve OS but longer follow-up is needed to confirm this hypothesis. Indeed results of OS analysis should be carefully evaluated because none of the studies selected provided mature OS data. Administration of these Agents resulted in a significant increased risk of treatment-related death, high cardiovascular toxicity, hypertension, fractures, and falls. Administration of new Hormonal compounds prolongs the time of metastases occurrence and might prolong also survival in patients with nmCRPC. Treatment-related toxicity is an important issue because these Agents increase the risk of death, cardiovascular toxicity, hypertension, fractures, and risk of falls.

Roberta Ferraldeschi - One of the best experts on this subject based on the ideXlab platform.

  • switching and withdrawing Hormonal Agents for castration resistant prostate cancer
    Nature Reviews Urology, 2015
    Co-Authors: David Lorente, Joaquin Mateo, Zafeiris Zafeiriou, Alan D Smith, Shahneen Sandhu, Roberta Ferraldeschi, Johann S De Bono
    Abstract:

    The antiandrogen withdrawal syndrome (AAWS) is characterized by tumour regression and a decline in serum PSA on discontinuation of antiandrogen therapy in patients with prostate cancer. This phenomenon has been best described with the withdrawal of the nonsteroidal antiandrogens, bicalutamide and flutamide, but has also been reported with a wide range of Hormonal Agents. Mutations that occur in advanced prostate cancer and induce partial activation of the androgen receptor (AR) by Hormonal Agents have been suggested as the main causal mechanism of the AAWS. Corticosteroids, used singly or in conjunction with abiraterone, docetaxel and cabazitaxel might also be associated with the AAWS. The discovery of the Phe876Leu mutation in the AR, which is activated by enzalutamide, raises the possibility of withdrawal responses to novel Hormonal Agents. This Review focusses on the molecular mechanisms responsible for withdrawal responses, the role of AR mutations in the development of treatment resistance, and the evidence for the sequential use of antiandrogens in prostate cancer therapy. The implications of AR mutations for the development of novel drugs that target the AR are discussed, as are the challenges associated with redefining the utility of older treatments in the current therapeutic landscape.

  • abiraterone and novel antiandrogens overcoming castration resistance in prostate cancer
    Annual Review of Medicine, 2013
    Co-Authors: Roberta Ferraldeschi, Carmel Pezaro, Vasilios Karavasilis, J De Bono
    Abstract:

    Suppression of gonadal androgens by medical or surgical castration remains the mainstay of treatment for patients with advanced prostate cancer. However, the response to treatment is not durable, and transition to a "castration-resistant" state is invariable. Recent advances in our understanding of the androgen receptor signaling pathway have led to the development of therapeutic strategies to overcome castration resistance. This article reviews current concepts and challenges behind targeting continued androgen receptor signaling in castration-resistant prostate cancer and provides an overview of recently completed and ongoing clinical trials of novel Hormonal Agents, with a focus on abiraterone acetate and enzalutamide (MDV3100).

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