трихомониаза у мужчин от чего можно было заразиться
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трихомониаза у мужчин от чего можно было заразиться, De Novo Metastatic Prostate Cancer: Are We Moving toward a , Survival in Patients With De Novo Metastatic Prostate Cancer, Management of de Novo Metastatic Hormone-Sensitive Prostate , Metastatic Hormone-Sensitive Prostate Cancer: Toward an Era , New Treatment Options for Men Presenting With De Novo , , .
The efficacy of the NHA apalutamide plus ADT compared with ADT plus placebo was assessed in the double-blind phase III trial TITAN []. Eligible patients had mHSPC with at least one lesion detectable on bone scanning; previous docetaxel therapy was allowed. Among the 1052 enrolled patients, 10.7% had received prior docetaxel chemotherapy and 62.7% had high-volume disease; more than 80% of patients had metastatic synchronous disease. A total of 40% of the patients in the control group crossed over to the experimental arm after the initial unblinding at 22.7 months of follow-up. At a median follow-up of 44 months, apalutamide in combination with ADT significantly decreased the risk of death by 35% compared with ADT alone (mOS: NR vs. 52.2 months, HR: 0.65, 95%CI: 0.53–0.79, p < 0.0001) and by 48% after adjusting for crossover. The subgroup analysis pointed out that a benefit from apalutamide was detected in almost all subgroups, notably in both cases of low- and high-volume mHSPC; a trend toward favoring the placebo in men who had received previous chemotherapy was registered, although these patients represented only 10% of the trial population and no interaction between the efficacy of apalutamide and prior docetaxel was detected in a post hoc interaction test []. In a post hoc analysis, similar to what was performed by Hamid et al. [], the transcriptional profiling of primary PC samples from 222 patients enrolled in TITAN revealed that most patients had a high-Decipher-risk disease. In the control group, patients with a high Decipher risk had a poorer prognosis than those with a low-to-average Decipher risk, while no prognostic difference between these two different classes of risk was observed in the apalutamide group. Both basal and AR-A low subtypes showed significant benefit from apalutamide, suggesting that apalutamide is beneficial, especially for the highest-risk molecular subtypes []. A more persistent benefit of the addition of apalutamide to ADT in men with a high Decipher genomic classifier score compared with patients with a low genomic classifier score was also confirmed in a cohort of 233 patients from the SPARTAN trial []. In an exploratory analysis that investigated correlations between the biomarkers and OS in TITAN, the detection of circulating tumoral DNA (ctDNA) or any androgen receptor (AR) genomic alterations at baseline and any AR genomic alterations or PI3K pathway activation at the end of the study treatment were significantly associated with a poor OS in multivariate analyses from both treatment groups [].2.2. Triplet Therapy, De novo metastatic hormone-sensitive prostate cancer usually has a dismal prognosis, which has slightly improved in recent years thanks to the introduction of new hormonal agents and chemotherapy combined with androgen deprivation therapy from the , Overall survival (OS) in metastatic hormone-sensitive prostate cancer (mHSPC) has improved in clinical trials over the last 20 years. 1, 2 It is unclear whether new treatments have translated to improvements in survival rates in clinical practice. We sought to quantify trends in OS among patients with newly diagnosed de novo (synchronous) mHSPC in 2 national registries in the United States .
Prostate cancer treatments paradigms are in continuous evolution, especially in the metastatic setting. In this context, the Genito-Urinary Group of Italian Association of Radiotherapy and Clinical Oncology aimed to create a consensus on radiation therapy indication in de novo metastatic hormone-sensitive prostate cancer both on primary tumor and metastatic sites., The advent of more effective treatment combinations for metastatic hormone-sensitive prostate cancer (mHSPC) has been built on successes in therapy development for metastatic, castration-resistant prostate cancer (mCRPC). Both disease phases hold similar In this review, we take stock of the current landscape of treatment for metastatic hormone-sensitive prostate cancer, including , Newly presenting or de novo metastatic hormone-sensitive prostate cancer (mHSPC) accounts for 5% to 10% of all prostate cancer (PC) diagnoses, but it is responsible for nearly 50% of PC-related deaths. 1 De novo mHSPC is characterized by an aggressive course with faster development of castration resistance and worse overall survival (OS) in , , , .