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Local Therapy in Combination with Androgen Deprivation Therapy for Metastatic Prostate Cancer

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Hormone Therapy and Castration Resistance of Prostate Cancer

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Abstract

There is growing interest in the role of local therapy for the prostate in patients with metastatic disease. Several retrospective studies indicated that cytoreductive therapy for the prostate in addition to androgen deprivation therapy (ADT) had better oncological outcomes than ADT alone in patients with newly diagnosed metastatic prostate cancer. Others reported the benefit of prior local therapy with curative intention for patients who eventually developed treatment failure and subsequently progressed to metastatic disease. When local therapy, including radical prostatectomy and prostate radiotherapy, could improve the survival and palliate the obstructive symptoms/conditions in patients with newly diagnosed metastatic prostate cancer, this treatment option should be offered. The concept of local therapy for the prostate in those patients remains controversial, however, and lacks level 1 evidence. Several prospective studies are now under way to investigate whether a combination of local therapy and ADT has survival benefit when compared to ADT alone. The results from these prospective studies may propose a new concept in the treatment of newly diagnosed metastatic prostate cancer.

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Abbreviations

ADT:

Androgen deprivation therapy

BT:

Brachytherapy

CSS:

Cancer-specific survival

EBRT:

External beam radiation therapy

mCRPC:

Metastatic castration-resistant prostate cancer

mCSPC:

Metastatic castration-sensitive prostate cancer

mPCa:

Metastatic prostate cancer

NSR:

No surgery or radiation therapy

OS:

Overall survival

RP:

Radical prostatectomy

RT:

Radiotherapy

SEER:

Surveillance Epidemiology and End Results

TURP:

Transurethral resection of prostate

References

  1. Huggins C, Stephens R, Hodges C. Studies on prostatic cancer. 2. The effects of castration on advanced carcinoma of the prostate gland. Arch Surg. 1941;43:209–23.

    Article  CAS  Google Scholar 

  2. Tannock IF, de Wit R, Berry WR, Horti J, Pluzanska A, Chi KN, et al. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med. 2004;351(15):1502–12. https://doi.org/10.1056/NEJMoa040720.

    Article  CAS  PubMed  Google Scholar 

  3. de Bono JS, Logothetis CJ, Molina A, Fizazi K, North S, Chu L, et al. Abiraterone and increased survival in metastatic prostate cancer. N Engl J Med. 2011;364(21):1995–2005. https://doi.org/10.1056/NEJMoa1014618.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Ryan CJ, Smith MR, de Bono JS, Molina A, Logothetis CJ, de Souza P, et al. Abiraterone in metastatic prostate cancer without previous chemotherapy. N Engl J Med. 2013;368(2):138–48. https://doi.org/10.1056/NEJMoa1209096.

    Article  CAS  PubMed  Google Scholar 

  5. Scher HI, Fizazi K, Saad F, Taplin ME, Sternberg CN, Miller K, et al. Increased survival with enzalutamide in prostate cancer after chemotherapy. N Engl J Med. 2012;367(13):1187–97. https://doi.org/10.1056/NEJMoa1207506.

    Article  CAS  PubMed  Google Scholar 

  6. Beer TM, Armstrong AJ, Rathkopf DE, Loriot Y, Sternberg CN, Higano CS, et al. Enzalutamide in metastatic prostate cancer before chemotherapy. N Engl J Med. 2014;371(5):424–33. https://doi.org/10.1056/NEJMoa1405095.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. de Bono JS, Oudard S, Ozguroglu M, Hansen S, Machiels JP, Kocak I, et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Lancet. 2010;376(9747):1147–54. https://doi.org/10.1016/S0140-6736(10)61389-X.

    Article  CAS  PubMed  Google Scholar 

  8. Parker C, Nilsson S, Heinrich D, Helle SI, O'Sullivan JM, Fossa SD, et al. Alpha emitter radium-223 and survival in metastatic prostate cancer. N Engl J Med. 2013;369(3):213–23. https://doi.org/10.1056/NEJMoa1213755.

    Article  CAS  PubMed  Google Scholar 

  9. Cheever MA, Higano CS. PROVENGE (Sipuleucel-T) in prostate cancer: the first FDA-approved therapeutic cancer vaccine. Clin Cancer Res. 2011;17(11):3520–6. https://doi.org/10.1158/1078-0432.CCR-10-3126.

    Article  PubMed  Google Scholar 

  10. Sweeney CJ, Chen YH, Carducci M, Liu G, Jarrard DF, Eisenberger M, et al. Chemohormonal therapy in metastatic hormone-sensitive prostate cancer. N Engl J Med. 2015;373(8):737–46. https://doi.org/10.1056/NEJMoa1503747.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. James ND, Sydes MR, Clarke NW, Mason MD, Dearnaley DP, Spears MR, et al. Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial. Lancet. 2016;387(10,024):1163–77. https://doi.org/10.1016/S0140-6736(15)01037-5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Tucci M, Bertaglia V, Vignani F, Buttigliero C, Fiori C, Porpiglia F, et al. Addition of docetaxel to androgen deprivation therapy for patients with hormone-sensitive metastatic prostate cancer: a systematic review and meta-analysis. Eur Urol. 2016;69(4):563–73. https://doi.org/10.1016/j.eururo.2015.09.013.

    Article  CAS  PubMed  Google Scholar 

  13. Culp SH, Schellhammer PF, Williams MB. Might men diagnosed with metastatic prostate cancer benefit from definitive treatment of the primary tumor? A SEER-based study. Eur Urol. 2014;65(6):1058–66. https://doi.org/10.1016/j.eururo.2013.11.012.

    Article  PubMed  Google Scholar 

  14. Rusthoven CG, Jones BL, Flaig TW, Crawford ED, Koshy M, Sher DJ, et al. Improved survival with prostate radiation in addition to androgen deprivation therapy for men with newly diagnosed metastatic prostate cancer. J Clin Oncol. 2016;34(24):2835–42. https://doi.org/10.1200/JCO.2016.67.4788.

    Article  CAS  PubMed  Google Scholar 

  15. Gratzke C, Engel J, Stief CG. Role of radical prostatectomy in metastatic prostate cancer: data from the Munich Cancer Registry. Eur Urol. 2014;66(3):602–3. https://doi.org/10.1016/j.eururo.2014.04.009.

    Article  PubMed  Google Scholar 

  16. Won AC, Gurney H, Marx G, De Souza P, Patel MI. Primary treatment of the prostate improves local palliation in men who ultimately develop castrate-resistant prostate cancer. BJU Int. 2013;112(4):E250–5. https://doi.org/10.1111/bju.12169.

    Article  PubMed  Google Scholar 

  17. Bristow RE, Tomacruz RS, Armstrong DK, Trimble EL, Montz FJ. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol. 2002;20(5):1248–59. https://doi.org/10.1200/JCO.2002.20.5.1248.

    Article  PubMed  Google Scholar 

  18. Temple LK, Hsieh L, Wong WD, Saltz L, Schrag D. Use of surgery among elderly patients with stage IV colorectal cancer. J Clin Oncol. 2004;22(17):3475–84. https://doi.org/10.1200/JCO.2004.10.218.

    Article  PubMed  Google Scholar 

  19. Mickisch GH, Garin A, van Poppel H, de Prijck L, Sylvester R, European Organisation for Research and Treatment of Cancer (EORTC) Genitourinary Group, et al. Radical nephrectomy plus interferon-alfa-based immunotherapy compared with interferon alfa alone in metastatic renal-cell carcinoma: a randomised trial. Lancet. 2001;358(9286):966–70.

    Article  CAS  PubMed  Google Scholar 

  20. Comen E, Norton L, Massague J. Clinical implications of cancer self-seeding. Nat Rev Clin Oncol. 2011;8(6):369–77. https://doi.org/10.1038/nrclinonc.2011.64.

    Article  PubMed  Google Scholar 

  21. Kaplan RN, Riba RD, Zacharoulis S, Bramley AH, Vincent L, Costa C, et al. VEGFR1-positive haematopoietic bone marrow progenitors initiate the pre-metastatic niche. Nature. 2005;438(7069):820–7. https://doi.org/10.1038/nature04186.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Psaila B, Lyden D. The metastatic niche: adapting the foreign soil. Nat Rev Cancer. 2009;9(4):285–93. https://doi.org/10.1038/nrc2621.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Kadmon D, Heston WD, Fair WR. Treatment of a metastatic prostate derived tumor with surgery and chemotherapy. J Urol. 1982;127(6):1238–42.

    Article  CAS  PubMed  Google Scholar 

  24. Dewan MZ, Galloway AE, Kawashima N, Dewyngaert JK, Babb JS, Formenti SC, et al. Fractionated but not single-dose radiotherapy induces an immune-mediated abscopal effect when combined with anti-CTLA-4 antibody. Clin Cancer Res. 2009;15(17):5379–88. https://doi.org/10.1158/1078-0432.CCR-09-0265.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Postow MA, Callahan MK, Barker CA, Yamada Y, Yuan J, Kitano S, et al. Immunologic correlates of the abscopal effect in a patient with melanoma. N Engl J Med. 2012;366(10):925–31. https://doi.org/10.1056/NEJMoa1112824.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Lock M, Muinuddin A, Kocha WI, Dinniwell R, Rodrigues G, D’Souza D. Abscopal effects: case report and emerging opportunities. Cureus. 2015;7(10):e344. https://doi.org/10.7759/cureus.344.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Shiraishi K, Ishiwata Y, Nakagawa K, Yokochi S, Taruki C, Akuta T, et al. Enhancement of antitumor radiation efficacy and consistent induction of the abscopal effect in mice by ECI301, an active variant of macrophage inflammatory protein-1alpha. Clin Cancer Res. 2008;14(4):1159–66. https://doi.org/10.1158/1078-0432.CCR-07-4485.

    Article  CAS  PubMed  Google Scholar 

  28. Nesslinger NJ, Sahota RA, Stone B, Johnson K, Chima N, King C, et al. Standard treatments induce antigen-specific immune responses in prostate cancer. Clin Cancer Res. 2007;13(5):1493–502. https://doi.org/10.1158/1078-0432.CCR-06-1772.

    Article  CAS  PubMed  Google Scholar 

  29. D’Amico AV, Manola J, Loffredo M, Renshaw AA, DellaCroce A, Kantoff PW. 6-month androgen suppression plus radiation therapy vs radiation therapy alone for patients with clinically localized prostate cancer: a randomized controlled trial. JAMA. 2004;292(7):821–7. https://doi.org/10.1001/jama.292.7.821.

    Article  PubMed  Google Scholar 

  30. Roach M 3rd, Bae K, Speight J, Wolkov HB, Rubin P, Lee RJ, et al. Short-term neoadjuvant androgen deprivation therapy and external-beam radiotherapy for locally advanced prostate cancer: long-term results of RTOG 8610. J Clin Oncol. 2008;26(4):585–91. https://doi.org/10.1200/JCO.2007.13.9881.

    Article  PubMed  Google Scholar 

  31. Denham JW, Steigler A, Lamb DS, Joseph D, Turner S, Matthews J, et al. Short-term neoadjuvant androgen deprivation and radiotherapy for locally advanced prostate cancer: 10-year data from the TROG 96.01 randomised trial. Lancet Oncol. 2011;12(5):451–9. https://doi.org/10.1016/S1470-2045(11)70063-8.

    Article  CAS  PubMed  Google Scholar 

  32. Aus G, Abrahamsson PA, Ahlgren G, Hugosson J, Lundberg S, Schain M, et al. Three-month neoadjuvant hormonal therapy before radical prostatectomy: a 7-year follow-up of a randomized controlled trial. BJU Int. 2002;90(6):561–6.

    Article  CAS  PubMed  Google Scholar 

  33. Soloway MS, Pareek K, Sharifi R, Wajsman Z, McLeod D, Wood DP Jr, et al. Neoadjuvant androgen ablation before radical prostatectomy in cT2bNxMo prostate cancer: 5-year results. J Urol. 2002;167(1):112–6.

    Article  PubMed  Google Scholar 

  34. Friedlander JI, Duty BD, Okeke Z, Smith AD. Obstructive uropathy from locally advanced and metastatic prostate cancer: an old problem with new therapies. J Endourol. 2012;26(2):102–9. https://doi.org/10.1089/end.2011.0227.

    Article  PubMed  Google Scholar 

  35. Qin XJ, Ma CG, Ye DW, Yao XD, Zhang SL, Dai B, et al. Tumor cytoreduction results in better response to androgen ablation: a preliminary report of palliative transurethral resection of the prostate in metastatic hormone sensitive prostate cancer. Urol Oncol. 2012;30(2):145–9. https://doi.org/10.1016/j.urolonc.2010.02.010.

    Article  PubMed  Google Scholar 

  36. Levine ES, Cisek VJ, Mulvihill MN, Cohen EL. Role of transurethral resection in dissemination of cancer of prostate. Urology. 1986;28(3):179–83.

    Article  CAS  PubMed  Google Scholar 

  37. Tabata K, Satoh T, Tsumura H, Ishii D, Fujita T, Matsumoto K, et al. Radiotherapy for prostate in men with metastatic prostate cancer: a propensity-score matching analysis. Paper presented at the 111th Annual Meeting of the American Urological Association; 2016.

    Google Scholar 

  38. Oefelein MG. Prognostic significance of obstructive uropathy in advanced prostate cancer. Urology. 2004;63(6):1117–21. https://doi.org/10.1016/j.urology.2004.01.026.

    Article  PubMed  Google Scholar 

  39. Grimm MO, Kamphausen S, Hugenschmidt H, Stephan-Odenthal M, Ackermann R, Vogeli TA. Clinical outcome of patients with lymph node positive prostate cancer after radical prostatectomy versus androgen deprivation. Eur Urol. 2002;41(6):628–34; discussion 34

    Article  PubMed  Google Scholar 

  40. Schmeller N, Lubos W. Early endocrine therapy versus radical prostatectomy combined with early endocrine therapy for stage D1 prostate cancer. Br J Urol. 1997;79(2):226–34.

    Article  CAS  PubMed  Google Scholar 

  41. Parker CC, Sydes MR, Mason MD, Clarke NW, Aebersold D, de Bono JS, et al. Prostate radiotherapy for men with metastatic disease: a new comparison in the Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy (STAMPEDE) trial. BJU Int. 2013;111(5):697–9. https://doi.org/10.1111/bju.12087.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan

    Hideyasu Tsumura M.D., Ken-Ichi Tabata & Masatsugu Iwamura

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  1. Hideyasu Tsumura M.D.
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  2. Ken-Ichi Tabata
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  3. Masatsugu Iwamura
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Correspondence to Hideyasu Tsumura M.D. .

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Editors and Affiliations

  1. Department of Urology, Tohoku University School of Medicine, Sendai, Japan

    Yoichi Arai

  2. Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Osamu Ogawa

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Tsumura, H., Tabata, KI., Iwamura, M. (2018). Local Therapy in Combination with Androgen Deprivation Therapy for Metastatic Prostate Cancer. In: Arai, Y., Ogawa, O. (eds) Hormone Therapy and Castration Resistance of Prostate Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-10-7013-6_20

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  • DOI: https://doi.org/10.1007/978-981-10-7013-6_20

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