Refining castration use for recurrent prostate cancer

改善复发性前列腺癌的去势疗法

• 批准号: 10819759
• 负责人: Ted Albert Skolarus
• 金额: $ 33.52万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10819759
• 关键词: Aftercare; Biometry; Castration; Chemicals; Clinical; Coupling; Data; Data Set; Diabetes Mellitus; Diagnosis; Disease Resistance; Drug resistance; Electronics; Guidelines; Heart Diseases; Injectable; Laboratories; Localized Disease; Malignant neoplasm of prostate; Methods; Modeling; Neoplasm Metastasis; Obesity; Osteoporosis; Outcome; PSA level; Pain; Patients; Pattern; Pharmaceutical Preparations; Pharmacy facility; Population; Prostate Cancer therapy; Provider; Radiation therapy; Recommendation; Recurrence; Recurrent Malignant Neoplasm; Resistance; Risk; Symptoms; System; Testosterone; Treatment Failure; Variant; androgen deprivation therapy; cancer recurrence; cancer survival; clinical decision-making; clinically relevant; common treatment; comorbidity; data registry; male; men; men' s group; neoplasm registry; population based; prostate cancer progression; randomized trial; side effect; survival outcome; tumor progression

Project Summary Project Background: Nearly all US men diagnosed with prostate cancer have localized disease. Most are treated, yet roughly one in three have their prostate cancer return via rising PSA levels. A common treatment for rising PSA is castration with long-acting injectable drugs termed androgen deprivation therapy (ADT). Understanding the best timing of ADT for these men is important because most do not have symptoms of recurrent cancer, yet will deal with major side effects (e.g., diabetes, osteoporosis, obesity, heart disease) in the hopes of survival benefits. However, there is limited evidence to guide castration timing and use when it comes to rising PSA levels after treatment. This results in vague guideline recommendations and widespread practice variation. Whether some men can avoid castration, its side effects, or castration-resistance without compromising survival remains unclear. Using biostatistical models informed by real-world practice variation can refine answers to these important issues. Project Objectives: This study will combine population-based cancer registry and electronic record data from a national delivery system with biostatistical modeling and randomized trial data to examine the impact of castration with ADT on progression and survival after localized prostate cancer treatment. We will take advantage of variable castration practices to identify populations of men that may and may not benefit from castration for recurrent prostate cancer. Project Methods: This clinically-relevant, high impact study has three aims. Aim 1: To examine variation in castration use after localized prostate cancer treatment. We will identify men treated for localized prostate cancer from 2005-2015 using national cancer registry data. We will characterize longitudinal castration practices with respect to timing, continuity, and clinical factors (e.g., PSA, risk group, salvage radiotherapy) using national administrative claims, pharmacy, and laboratory, as well as randomized trial data. Aim 2: To assess the impact of castration timing on prostate cancer progression. We will identify prostate cancer progression to castration-resistant disease among our population-based and randomized trial data. We will use biostatistical modeling to identify castration practices associated with the longest times to castration-resistance and survival outcomes. Aim 3: To refine populations of men most likely to benefit from castration for recurrent prostate cancer, and when. Based on our models and complementary datasets, we will propose criteria and timing for castration practices to help maximize outcomes after localized prostate cancer treatment. For some men, delaying or avoiding castration might be best, for others, earlier castration might be optimal.

项目总结

项目成果

National Long-term Survival Estimates After Radical Prostatectomy for Prostate Cancer.

前列腺癌根治性前列腺切除术后的全国长期生存估计。

• DOI: 10.1016/j.urology.2023.10.018
• 发表时间: 2024
• 期刊: Urology
• 影响因子: 2.1
• 作者: Stensland,KristianD;Caram,MeganEV;Herr,DanielJ;Burns,JenniferA;Sparks,JordanB;Elliott,DavidA;Shin,Chris;Morgan,ToddM;Zaslavsky,Alexander;Hollenbeck,BrentK;Tsodikov,Alexander;Skolarus,TedA
• 通讯作者: Skolarus,TedA

Outcomes after definitive radiation therapy for localized prostate cancer in a national health care delivery system.

在国家医疗保健服务系统中对局限性前列腺癌进行明确放射治疗后的结果。

• DOI: 10.1002/cncr.34916
• 发表时间: 2023
• 期刊: Cancer
• 影响因子: 6.2
• 作者: Herr,DanielJ;Elliott,DavidA;Duchesne,Gillian;Stensland,KristianD;Caram,MeganEV;Chapman,Christina;Burns,JenniferA;Hollenbeck,BrentK;Sparks,JordanB;Shin,Chris;Zaslavsky,Alexander;Tsodikov,Alexander;Skolarus,TedA
• 通讯作者: Skolarus,TedA

Efficiency of the Breslow estimator in semiparametric transformation models.

半参数变换模型中 Breslow 估计器的效率。

• DOI: 10.1007/s10985-023-09611-w
• 发表时间: 2024
• 期刊: Lifetime data analysis
• 影响因子: 1.3
• 作者: Devasia,TheresaP;Tsodikov,Alexander
• 通讯作者: Tsodikov,Alexander