Incidencia, prevalencia y patrones de tratamiento del cáncer de próstata metastásico hormonosensible en España: Estudio ECHOS / Incidence, prevalence, and treatment patterns in metastatic hormone-sensitive prostate cancer in Spain: ECHOS study

Introducción y objetivo: El manejo de los pacientes con cáncer de próstata hormonosensible metastásico (CPHSm) ha cambiado en los últimos años debido a la autorización de nuevos medicamentos. El objetivo fue caracterizar la prevalencia, incidencia y patrones de tratamiento para el CPHSm en España.Pacientes y métodos: Estudio multicéntrico, observacional, longitudinal, retrospectivo en condiciones de práctica clínica habitual con pacientes con CPHSm atendidos en hospitales españoles entre 2015 y 2019 (estudio ECHOS). Las historias clínicas se extrajeron de la base de datos BIG-PAC (geográficamente representativa).Resultados: Se incluyeron los datos de 379 hombres con CPHSm. La prevalencia varió entre 12,2-14,6%. Hubo de 671 a 824 nuevos casos anualmente, con una tendencia creciente. La incidencia media en el periodo del estudio fue de 2,5%, con valores anuales en el rango 2,2-3%. Los nuevos casos anuales de pacientes de novo y recurrentes osciló en el rango 7-11 y 77-104, respectivamente, sin tendencia observada. Mayoritariamente eran pacientes recurrentes (91%) y de alto volumen tumoral (68,6%). La primera línea de tratamiento fue la combinación de docetaxel y terapia de deprivación de andrógenos (TDA) (53%), seguida por TDA sola (23,8%), combinación de TDA y abiraterona (11,1%) y radioterapia (8,6%). En los 12 meses anteriores al diagnóstico de metástasis, la mayoría se sometieron a una prostatectomía (84,9%). El resto había recibido radioterapia (12%) o no recibieron tratamiento (3,8%).Conclusiones: El estudio ECHOS proporciona datos epidemiológicos y patrones de tratamiento actuales en la práctica clínica en pacientes con CPHSm en España. Los resultados obtenidos destacan la necesidad médica de terapias dirigidas. (AU)

Introduction and objective: The management of patients with metastatic hormone-sensitive prostate cancer (mHSPC) has changed in recent years due to the approval of new drugs. The aim of this study was to evaluate the prevalence, incidence, and treatment patterns in mHSPC in Spain.Patients and methods: Multicenter, observational, longitudinal, retrospective study in routine clinical practice of patients diagnosed with mHSPC treated in Spanish hospitals between 2015 and 2019 (ECHOS study). Electronic medical records were extracted from BIG-PAC database, which contains geographically representative Spanish centers.Results: Data from 379 men with mHSPC were included. The prevalence of mHSPC ranged between 12.2-14.6% per year, representing from 671 to 824 annual cases with an increasing trend. The mean incidence along the 4-year period was 2.5%, with annual incidence ranging 2.2-3.0%. New annual cases of de novo and recurrent disease ranged between 7-11 and 77-104, respectively, with no trend being observed. These patients were mostly recurrent (91%) with high-volume disease (68.6%). The most common first-line therapy was ADT combined with docetaxel (53%), followed by ADT alone (23.8%), combination of ADT and abiraterone (11.2%), and radiotherapy (8.6%). In the last 12 months before diagnosis of metastasis, most men had been submitted to radical prostatectomy (84.9%). The remaining patients had received radiotherapy (12%) or no treatment at all (3.8%).Conclusions: The ECHOS study provides epidemiologic data and current patterns of treatment in clinical practice of patients with mHSPC in Spain. These results emphasize the medical need of targeted treatments in these clinical settings. (AU)

Incidence, prevalence, and treatment patterns in metastatic hormone-sensitive prostate cancer in Spain: ECHOS study.

INTRODUCTION AND OBJECTIVE: The management of patients with metastatic hormone-sensitive prostate cancer (mHSPC) has changed in recent years due to the approval of new drugs. The aim of this study was to evaluate the prevalence, incidence, and treatment patterns in mHSPC in Spain. PATIENTS AND METHODS: Multicenter, observational, longitudinal, retrospective study in routine clinical practice of patients diagnosed with mHSPC treated in Spanish hospitals between 2015 and 2019 (ECHOS study). Electronic medical records were extracted from BIG-PAC database, which contains geographically representative Spanish centers. RESULTS: Data from 379 men with mHSPC were included. The prevalence of mHSPC ranged between 12.2-14.6% per year, representing from 671 to 824 annual cases with an increasing trend. The mean incidence along the 4-year period was 2.5%, with annual incidence ranging 2.2-3.0%. New annual cases of de novo and recurrent disease ranged between 7-11 and 77-104, respectively, with no trend being observed. These patients were mostly recurrent (91%) with high-volume disease (68.6%). The most common first-line therapy was ADT combined with docetaxel (53%), followed by ADT alone (23.8%), combination of ADT and abiraterone (11.2%), and radiotherapy (8.6%). In the last 12 months before diagnosis of metastasis, most men had been submitted to radical prostatectomy (84.9%). The remaining patients had received radiotherapy (12%) or no treatment at all (3.8%). CONCLUSIONS: The ECHOS study provides epidemiologic data and current patterns of treatment in clinical practice of patients with mHSPC in Spain. These results emphasize the medical need of targeted treatments in these clinical settings.

Simple and stereoselective syntheses of nucleoside analogues with a benzo[c]furan glycone moiety.

A series of d4T analogues have been synthesised in which the 2',3'-didehydro-2',3'-dideoxyribose moiety is replaced by a benzo[c]furan core. A simple strategy has been developed to access a range of compounds for biological screening. In addition, a stereoselective approach has been achieved with view to permit more detailed studies.

[The procollagen-III peptide in the clinical surveillance of alcoholic hepatopathy and other chronic hepatopathies]. / Il peptide del procollagene-III nella sorveglianza clinica dell'epatopatia alcolica e di altre epatopatie croniche.

Liver fibrosis determines the course and prognosis of alcoholic liver disease. Evaluation of serum concentration of procollagen-III peptides (sPIIIP) is considered a biochemical test useful for evaluating a fibrotic process. We have investigated 30 healthy subjects and 53 patients with alcoholic liver disease, histologically diagnosed by percutaneous liver biopsy in four clusters: steatosis (11), fibrosteatosis (11), chronic active hepatitis (11) and cirrhosis (20). SPIIIP levels were increased in patients with cirrhosis and chronic active hepatitis; while they were regular in patients with steatosis and fibrosteatosis. Evaluation of serum concentration of sPIIIP by radioimmunoassay seems to be an useful test for identifying patients with alcoholic liver disease with a good prognosis and patients in progress to cirrhosis and it is an useful test for control the course and evolution of chronic liver disease.

[Determination of serum procollagen-III peptide in chronic liver diseases. Clinical usefulness]. / La determinazione sierica del peptide del procollagene-III nella epatopatia cronica. Utilità clinica.

Liver fibrosis determines the course and prognosis of chronic liver disease. Histological examination of liver biopsy is essential for diagnosing hepatic disease. Evaluation of serum concentration procollagen III peptides (sPIIIP) by radioimmunoassay (RIA) is a biochemical test useful for evaluating a fibrotic process. We have investigated 20 healthy subjects and 50 patients with chronic liver disease, histologically diagnosed by percutaneous liver biopsy: steatosis (8), fibrosteatosis (7), chronic persistent hepatitis (10), chronic active hepatitis (7), cirrhosis (18). SPIIIP levels were increased in patients with cirrhosis and chronic active hepatitis and in these groups of patients such levels were well correlated with histological activity of hepatic disease. Evaluation of serum concentration of PIIIP by RIA seems to be a useful test for evaluating a fibrotic process in chronic liver diseases evolving towards cirrhosis.

[Determination of serum bile acids in hepatobiliary diseases. Clinical applicability]. / La determinazione sierica degli acidi biliari nelle malattie epatobiliari. Applicabilità clinica.

Determination of serum bile acids has long been regarded as the most sensitive indicator of liver function. An assessment was made of the clinical applicability of RIA evaluation of two of these acids, cholylglycine (CG) and sulpholithochocholyglycine (SLGG), on an empty stomach and 2hr after a cholecystokinetic meal in 109 liver patients ans 20 controls. After the meal test, both acids proved more sensitive than the usual liver function indices. Different mean values were observed for different diseases. They were in good correlation with the extent of histological damage. Values were highest in obstructive icterus, cirrhosis and neoplasia of the liver, fairly highly high in steatofibrosis, ACH and PCH, and normal in viral hepatitis in the course of resolution, aspecific reactive hepatitis, and steatosis. The meal test thus proved a good indicator of liver disease. Its wider use is to be hoped for in order that its limits and applications may be better understood.