prostate

Question 1

PCPT Trial (Prostate Cancer Prevention Trial)

Answer 1

2003 NEJM Thompson – The influence of finasteride on the development of prostate cancer - PH - PMID:12824459 - 1-prevalence; 18,882 men ≥55 yrs with normal DRE & PSA ≤3.0 randomized to 5mg daily Finasteride VS Placebo for 7 yrs; Prostate cancer detected in 803 of 4368 (18.4%) VS 1147 of 4692 (24.4%); More high Gleason grade (7-10) tumors in Finasteride group;

Question 2

REDUCE Trial

Answer 2

2010 NEJM Andriole – Effect of dutasteride on the risk of prostate cancer - PH - PMID:20357281 - 6729 pts; Dutaseride 0.5 mg daily VS Placebo; Prostate ca detected in 659 of 3305 VS 858 of 3424, Risk Reduction 22.8%, p

Question 3

PIVOT Trial

Answer 3

2012 NEJM Wilt – Radical prostatectomy versus observation for localized prostate cancer - PH - PMID:22808955 - 731 men with localized prostate cancer, median followup 10 yrs; NO survival benefit with surgery;

Question 4

RTOG 9408 Trial

Answer 4

• 2011 NEJM Jones – Radiotherapy and short-term androgen deprivation for localized prostate cancer - PH - PMID:21751904 - 1979 pts with low risk prostate cancer randomized 987 RT + ADT VS 992 RT; Median follow-up 9.1 yrs; 10-yrs OS 62% VS 57%, p=0.03;

Question 5

SWOG 9346 Trial

Answer 5

2013 NEJM Hussain – Intermittent versus continuous androgen deprivation in prostate cancer.pdf - PH - PMID:23550669 - 1535 pts randomized 765 continous-ADT VS 770 intermittent-ADT; Median follow-up 9.8 yrs; Median survival 5.8 yrs continuous-ADT VS 5.1 yrs intermittent ADT (HR for death with intermittent therapy, 1.10; 90% CI 0.99 to 1.23); IADT trended towards inferiority; side effect profile better with IADT;

Question 6

COU-AA-302 Trial

Answer 6

2012 NEJM Ryan – Abiraterone in Metastatic Prostate Cancer without Previous Chemotherapy.pdf – PH - PMID:23228172 – 1088 pts randomized Abiraterone + Prednisone VS Prednisone alone; Median radiographic PFS 16.5 m VS 8.3 m, HR 0.53, p

Question 7

PREVAIL Trial

Answer 7

2014 NEJM Beer – Enzalutamide in Metastatic Prostate Cancer before Chemotherapy.pdf - PH - PMID:24881730 - 1717 pts randomized Enzalutamide VS Placebo; 1-radiographic PFS/OS; Stopped early given benefit; HR for 0.71 for death;

Question 8

TAX 327 Trial

Answer 8

2004 NEJM Tannock – Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer.pdf - PH - PMID:15470213 – Figure OS - Table Response Pain PSA QOL - Table Adverse Effects - phase 3; Accrual 3/2000-6/2002; 1-OS; 1006 pts randomized Docetaxel q3w VS Docetaxel qw VS Mitoxantrone; Median Survival 18.9 m VS 17.4 m VS 16.5 m; 45% patients had atleast 50% drop in PSA with q3w docetaxel, HR for death 0.76 with q3w docetaxel;

Question 9

TROPIC Trial

Answer 9

2010 Lancet de Bono – Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment - PH - PMID:20888992 - phase 3; 1-OS; 755 pts randomized 378 cabazitaxel VS 377 mitoxantrone; Median Survival 15.1 m VS 12.7 m, HR 0.70, p

Question 10

ALSYMPCA Trial

Answer 10

2013 NEJM Parker – Alpha Emitter Radium-223 and Survival in Metastatic Prostate Cancer.pdf - PH - PMID:23863050 - phase 3; 921 pts; Radium-223 VS placebo; Median OS 14.9 m VS 11.3 m (HR 0.70 95% CI 0.58 to 0.83 P