Abiraterone for Prostate Cancer Not Previously Treated with Hormone Therapy.

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27 juillet 2017

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Serveur académique Lausannois

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Ce document est lié à :
info:eu-repo/semantics/altIdentifier/doi/10.1056/NEJMoa1702900

Ce document est lié à :
info:eu-repo/semantics/altIdentifier/pmid/28578639

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info:eu-repo/semantics/altIdentifier/eissn/1533-4406

Ce document est lié à :
info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_CF2E19F79ACD9

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Serveur Académique Lausannois

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Université de Lausanne et CHUV

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info:eu-repo/semantics/openAccess , Copying allowed only for non-profit organizations , https://serval.unil.ch/disclaimer

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Abiraterone Acetate/administration & dosage; Abiraterone Acetate/adverse effects; Adult; Aged; Aged, 80 and over; Androgen Antagonists/administration & dosage; Androgen Antagonists/adverse effects; Antineoplastic Combined Chemotherapy Protocols/adverse effects; Antineoplastic Combined Chemotherapy Protocols/therapeutic use; Humans; Male; Middle Aged; Neoplasm Metastasis/drug therapy; Neoplasm Recurrence, Local/drug therapy; Prednisolone/administration & dosage; Prednisolone/adverse effects; Prostate-Specific Antigen/blood; Prostatic Neoplasms/drug therapy; Prostatic Neoplasms/mortality; Prostatic Neoplasms/radiotherapy; Prostatic Neoplasms/surgery; Steroid 17-alpha-Hydroxylase/antagonists & inhibitors; Survival Analysis

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N.D. James et al., « Abiraterone for Prostate Cancer Not Previously Treated with Hormone Therapy. », Serveur académique Lausannois, ID : 10.1056/NEJMoa1702900

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Abiraterone acetate plus prednisolone improves survival in men with relapsed prostate cancer. We assessed the effect of this combination in men starting long-term androgen-deprivation therapy (ADT), using a multigroup, multistage trial design. We randomly assigned patients in a 1:1 ratio to receive ADT alone or ADT plus abiraterone acetate (1000 mg daily) and prednisolone (5 mg daily) (combination therapy). Local radiotherapy was mandated for patients with node-negative, nonmetastatic disease and encouraged for those with positive nodes. For patients with nonmetastatic disease with no radiotherapy planned and for patients with metastatic disease, treatment continued until radiologic, clinical, or prostate-specific antigen (PSA) progression; otherwise, treatment was to continue for 2 years or until any type of progression, whichever came first. The primary outcome measure was overall survival. The intermediate primary outcome was failure-free survival (treatment failure was defined as radiologic, clinical, or PSA progression or death from prostate cancer). A total of 1917 patients underwent randomization from November 2011 through January 2014. The median age was 67 years, and the median PSA level was 53 ng per milliliter. A total of 52% of the patients had metastatic disease, 20% had node-positive or node-indeterminate nonmetastatic disease, and 28% had node-negative, nonmetastatic disease; 95% had newly diagnosed disease. The median follow-up was 40 months. There were 184 deaths in the combination group as compared with 262 in the ADT-alone group (hazard ratio, 0.63; 95% confidence interval [CI], 0.52 to 0.76; P

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