Immunotherapy and endothelin receptor antagonists for treatment of castration-resistant prostate cancer.

Recently, novel therapies of prostate cancer, such as immunotherapy, endothelin receptor antagonists, novel androgen receptor antagonist and novel taxanes, and others have been introduced into clinical practice. This study was performed to summarize these results of immunotherapy and endothelin receptor antagonists in the treatment of castration-resistant prostate cancer (CRPC) and derive a more precise estimation of their effect on future treatment. The PubMed database, references of published trials, and review articles were searched. Two reviewers independently extracted data of these trials. We used hazard ratios (HRs) to assess the effects on overall survival (OS), progression-free survival (PFS), or time to disease progression (TTP), and relative risk (RR) for the different types of toxicity. In addition, 95% confidence intervals (CIs) give a sense of the precision of the estimate. Nine randomized controlled trials were ultimately identified. The pooled HR showed that immunotherapy could prolong OS significantly in patients with CRPC compared to placebo (HR = 0.70, 95% CI: 0.58-0.83, p < 0.001). Endothelin receptor antagonists also had modest benefits (HR = 0.90, 95% CI: 0.82-1.00, p = 0.046). Nevertheless, there were no significant benefits from both therapies on PFS or TTP. In addition, immunotherapy led to more fatigue, pyrexia, chills, and endothelin receptor antagonists led to more peripheral edema, anemia, and dyspnea. Our article suggested that the very acceptable toxicity and improving OS in patients with CRPC made immunotherapy an attractive option for such patients. However, future studies with thoughtful clinical trial designs are warranted.

[Androgen deprivation therapy for prostate cancer: a follow-up study of the patients' survival time].

OBJECTIVE: To explore the long-term survival and prognosis of prostate cancer patients after treated by androgen deprivation therapy. METHODS: We conducted a follow-up study of 124 patients with prostate cancer treated by androgen deprivation therapy, and compared the survival times of the patients with different pathological grades and clinical characteristics using Kaplan-Meiers survival curves. RESULTS: The mean survival time of the 124 patients after androgen deprivation therapy was 5. 912 years, with the median survival time of 7.81 years. The patients with bone metastases showed a shorter survival time than those with non-bone metastasis (P = 0.04). Pathological grades and PSA levels were not prognostic factors. No significant differences were found in the mean survival time between those died of prostate cancer (n = 35) and those from other factors (n = 23) (P = 0.50). CONCLUSION: Bone metastasis is an important prognostic factor in advanced prostate cancer following androgen deprivation therapy, which is more significantly correlated with the survival time of the patients than tumor grades and clinical classification.

An updated meta-analysis of XRCC4 polymorphisms and cancer risk based on 31 case-control studies.

OBJECTIVE: Evidence is accumulating that several genes encoding DNA repair molecules may be cancer-susceptibility genes. Recently, SNPs in XRCC4, a member of DNA repair genes, have been implicated in altering the risk of various cancers. However, the results of these studies are inconclusive or controversial. To derive a more precise estimation, we performed an updated meta-analysis. METHODS: A comprehensive search was conducted to examine all the eligible studies about XRCC4 polymorphism and cancer risk. We used odds ratios (ORs) with 95% confidence intervals (CIs) to assess the strength of the association. RESULTS: We included 31 studies investigated 8 SNPs in XRCC4. Overall, our paper showed significant associations between the rs28360071, rs2075686 polymorphisms and cancer risk. In addition, significant association was maintained in prostate cancer (rs28360071), lung cancer (rs6869366) and bladder cancer (rs1805377) subgroups analysis. CONCLUSIONS: We conducted a systematic search and combined the available results in this meta-analysis, which provided evidence of the associations between SNPs in XRCC4 and cancer risk. The results suggested that rs28360071 polymorphisms were significantly associated with cancer risk. However, future studies are needed to investigate molecular mechanisms underlying the biological functions of XRCC4 SNPs in cancer development.

[Perioperative treatment of senile benign prostatic hyperplasia patients undergoing transurethral electrovaporization of prostate].

OBJECTIVE: To investigate the perioperative treatment of senile patients with benign prostatic hyperplasia (BPH) undergoing transurethral electrovaporization of prostate (TUEVP). METHODS: Totally 131 BPH patients aged 75-88 years underwent TUEVP, general data and past history of illness of the patients obtained before surgery, including their mental state, self-care ability, diseases of the cardiovascular, cerebrovascular and respiratory systems, diabetes mellitus, thyroid diseases and medication, and preoperative routine examinations performed on the functions of the kidneys, lungs, heart and thyroid gland to assess their operation-endurance, chances of complications and perioperative countermeasures. RESULTS: Of the total number of patients, 128 recovered urination and 3 relapsed into urinary retention after withdrawal of the catheter, with 2 restored to health. One patient had to carry the stomal tube because of bladder contraction dysfunction, 2 (1.5%) developed secondary bleeding but recovered after conservative treatment, 1 (0.7%) deep vein thrombus, 1 acute hemorrhagic gastritis (0.7%) and 4 (3.0%) postoperative urinary tract infection, but with no TUEVP syndrome and no complications of the cerebrovascular and respiratory systems. A 3-6 months follow-up showed that IPSS decreased from 25.24 +/- 4.70 to 7.81 +/- 4.12, QOL dropped from 4.51 +/- 0.72 to 1.51 +/- 0.73, and Qmax increased from (10.14 +/- 6.31) ml/s to (18. 14 +/- 4. 12) ml/s. CONCLUSION: By proper perioperative treatment, TUEVP could be safely and smoothly performed in senile BPH patients, with fewer complications and better recovery.

[Long term survival results in advanced prostate cancer treated with combined androgen blockade].

OBJECTIVE: To understand long-term survival rate after combined androgen blockade (CAB) in patients with advanced prostate cancer. METHODS: A selected population of 59 patients with advanced prostate cancer were treated with CAB. 28.81% (17/59) of patients had clinical locally advanced disease (stage T3-4N0M0), and 45.76% (27/59) of patients had metastatic disease (stage TxNxM+). Overall, patients were followed for a median of 62 (range 6-136) months. RESULTS: Of the 59 patients with advanced prostate cancer, 3-year, 5-year and 7-year overall survival rates were 79.36%, 61.46% and 49.15%, respectively. The 5-year survival rate were 80.77% and 32.65% for clinical locally advanced disease and metastatic disease. Specifically, men with poorly differentiated prostate cancer had a 5-year survival of only 30% when compared with men with well-differentiated prostate disease who had a 5-year survival of 86.21%. CONCLUSION: Based on these findings, men with poorly differentiated cancer, stage T3c-4NxMx or TxNxM+ and PSA level above 30 microg/L had a high probability of dying from their advanced prostate cancer.