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  • 1
    Language: English
    In: The Journal of Urology, April 2015, Vol.193(4), pp.e727-e727
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.juro.2015.02.2155 Byline: Philipp Nuhn Author Affiliation: Munich, Germany Article Note: (footnote) Source of Funding: none
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 2
    In: BJU International, December 2014, Vol.114(6b), pp.E11-E17
    Keywords: Neutrophil‐To‐Lymphocyte Ratio ; Prostate Cancer ; Chemotherapy ; Metastatic Castration‐Resistant Prostate Cancer ; Docetaxel ; Overall Survival
    ISSN: 1464-4096
    E-ISSN: 1464-410X
    Source: John Wiley & Sons, Inc.
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  • 3
    In: BJU International, December 2012, Vol.110(11b), pp.E575-E582
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2012.11286.x/abstract Byline: Jatinder Goyal(1)(*), Philipp Nuhn(1)(2)(*), Peng Huang(1), Prachi Tyagi(1), Daniel Oh(1), Michael A. Carducci(1), Mario A. Eisenberger(1), Emmanuel S. Antonarakis(1) Keywords: prostate cancer; chemotherapy; clinical trial; metastatic castration-resistant prostate cancer; docetaxel; overall survival Study Type - Prognosis (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Previous studies have reported better outcomes in cancer patients that enrolled in clinical trials, suggesting that trial participation in itself might be beneficial. We investigated the potential positive effect of clinical trial participation on survival outcomes of patients with metastatic castration-resistant prostate cancer who were treated with first-line docetaxel-containing chemotherapy. After accounting for potential baseline inequalities, participation in a clinical trial itself was associated with significantly longer overall survival in these patients. OBJECTIVE To study differences in baseline characteristics and outcomes of patients with metastatic castration-resistant prostate cancer (mCRPC) receiving first-line docetaxel-containing chemotherapy on prospective clinical studies (trial participants) versus those receiving this therapy outside of a clinical study (non-participants). PATIENTS AND METHODS Records from 247 consecutive chemotherapy-naive patients who were treated with docetaxel-containing chemotherapy for mCRPC at a single high-volume centre from 1998 to 2010 were reviewed. All patients received docetaxel either as clinical trial participants (n= 142; 11 separate studies) or as non-participants (n= 105). Univariable and multivariable Cox regression models predicted overall survival after chemotherapy initiation. RESULTS There was no significant difference between trial participation and non-participation with respect to patient age, type of primary treatment, tumour grade or clinical stage. Multivariable analyses showed a significantly lower risk of all-cause mortality (hazard ratio 0.567; P= 0.027) among trial participants vs non-participants. CONCLUSIONS Patients that were treated with docetaxel for mCRPC showed a significantly longer overall survival when enrolled in a clinical trial. Improved survival in trial participants may reflect the better medical oversight typically seen in patients enrolled in trials, more regimented follow-up schedules, or a positive effect on caregivers' attitudes because of greater contact with medical services. With the retrospective nature of this analysis and the small study population, prospective studies are needed to validate the present findings and to further investigate the relationship between clinical trial participation and outcomes. Author Affiliation: (1)Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Johns Hopkins University, Baltimore, MD, USA (2)Department of Urology, Ludwig-Maximilians-Universitat, Munich, Germany Correspondence: (*) Emmanuel S. Antonarakis, Prostate Cancer Research Program, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, 1650 Orleans Street, CRB1-1M45, Baltimore, MD 21231, USA. e-mail: eantona1@jhmi.edu Article Note: (*) These authors contributed equally to this study. Accepted for publication 23 March 2012 CAPTION(S): Supporting info item Testosterone levels and percentage of biopsy affected by tumour. Linear regression between the variables testosterone and percentage of tumour representation in the biopsy sample is displayed (P 0.01). In our centre, the tumour burden in the biopsy is expressed as the percentage of tumour in each prostatic lobe, ranging from 〉0% to 100%. Thus, the percentage of tumour represented in the biopsy adding the two prostatic lobes ranges from 〉0% to 200%. Testosterone levels and progression risk. Tumours were subclassified depending on their D'Amico risk of progression: low risk, PSA 10, DRE [less than or equal to] T2a and Gleason score [less than or equal to]6; intermediate risk, PSA 10-20, DRE = T2b and Gleason score 7; high risk, PSA 〉 20 or DRE a[yen] T2c or Gleason score a[yen]8. Low risk, testosterone 470 [+ or -] 171 ng/dL; intermediate risk, testosterone 445 [+ or -] 151 ng/dL; high risk, testosterone 365 [+ or -] 162 ng/dL; P= 0.03.
    Keywords: Prostate Cancer ; Chemotherapy ; Clinical Trial ; Metastatic Castration‐Resistant Prostate Cancer ; Docetaxel ; Overall Survival
    ISSN: 1464-4096
    E-ISSN: 1464-410X
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  • 4
    Language: German
    In: Der Onkologe, 2017, Vol.23(3), pp.232-233
    Description: To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s00761-017-0191-0 Byline: Philipp Nuhn (1), Christian Bolenz (2) Author Affiliation: (1) Klinik fur Urologie, Universitatsmedizin Mannheim, Universitat Heidelberg, Theodor-Kutzer-Ufer 1a3, 68167, Mannheim, Deutschland (2) Klinik fur Urologie und Kinderurologie, Universitatsklinikum Ulm, Ulm, Deutschland Article History: Registration Date: 20/01/2017 Online Date: 07/02/2017
    Keywords: Medicine & Public Health ; Oncology ; Medicine;
    ISSN: 0947-8965
    E-ISSN: 1433-0415
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  • 5
    Language: English
    In: The Journal of Urology, April 2011, Vol.185(4), pp.e800-e801
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
    Source: ScienceDirect Journals (Elsevier)
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  • 6
    Language: English
    In: The Journal of Urology, 2010, Vol.183(4), pp.e696-e696
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
    Source: ScienceDirect Journals (Elsevier)
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  • 7
    Language: English
    In: BJU international, December 2014, Vol.114(6b), pp.E11-E17
    Description: To determine whether the pretreatment neutrophil-to-lymphocyte ratio (NLR), a measure of systemic inflammatory response, is associated with overall survival (OS) in men receiving chemotherapy with docetaxel for metastatic castration-resistant prostate cancer (mCRPC). Records from 238 consecutive patients who were treated with first-line docetaxel-containing chemotherapy for mCRPC at a single high-volume centre from 1998 to 2010 (and who had adequate information to enable calculation of NLR) were reviewed. Univariable and multivariable Cox regression models were used to predict OS after chemotherapy initiation. In univariable analyses, the NLR as a discrete variable (optimal threshold 3.0) was significantly associated with OS (P = 0.001). In multivariable analyses, a lower NLR (≤3.0) was associated with lower risk of all-cause mortality (P = 0.002). In Kaplan-Meier analysis, the median OS was higher (18.3 vs 14.4 months) in patients that did not have an elevated NLR than in those with an elevated NLR (log-rank; P 〈 0.001). Men who were treated with first-line docetaxel for mCRPC who had a low pretreatment NLR (≤3.0) had significantly longer OS. NLR may be a potentially useful clinical marker of systemic inflammatory response in predicting OS in men with mCRPC who receive docetaxel and may be helpful to stratify patients for clinical trials. These findings derived from a retrospective analysis need to be validated in larger populations in prospective studies, and in the context of different therapies.
    Keywords: Chemotherapy ; Docetaxel ; Metastatic Castration-Resistant Prostate Cancer ; Neutrophil-to-Lymphocyte Ratio ; Overall Survival ; Prostate Cancer ; Adenocarcinoma -- Blood ; Lymphocytes -- Cytology ; Neutrophils -- Cytology ; Prostatic Neoplasms, Castration-Resistant -- Blood
    ISSN: 14644096
    E-ISSN: 1464-410X
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  • 8
    In: BJU International, September 2011, Vol.108(5), pp.673-678
    Description: OBJECTIVE: • To analyse the safety and efficacy of simultaneous standard anti-angiogenic therapy and stereotactic radiosurgery (SRS) in patients with spinal and cerebral metastases from renal cell carcinoma.PATIENTS AND METHODS: • In all, 106 patients with spinal (n= 55) or cerebral (n= 51) metastatic lesions and an Eastern Cooperative Oncology Group status of 0 or 1 were treated with sorafenib or sunitinib and simultaneous SRS. • The primary endpoint was local control. • Secondary endpoints were toxicity and overall survival.RESULTS: • Median follow up was 14.7 months (range 1-42 months). Forty-five patients were treated with sunitinb and 61 patients with sorafenib. Two patients had asymptomatic tumour haemorrhage after SRS. • No skin toxicity, neurotoxicity or myelopathy occurred after SRS, and SRS did not alter the adverse effects of anti-angiogenic therapy. • Local tumour control 15 months after SRS was 98% (95% confidence interval 89-99%). The median pain score before SRS was 5 (range 1-8) and was lowered to 0 (range 0-2, P 〈 0.01) after SRS. There were no treatment-related deaths or late complications after SRS. • Overall survival was 17.4 months in patients with spinal lesions and 11.1 month in patients with cerebral lesions (P= 0.038).CONCLUSIONS: • Simultaneous systemic anti-angiogenic therapy and SRS for selected patients with renal cell carcinoma who have spinal and cerebral metastases is safe and effective. • Single-fraction delivery allows for efficacious integration of focal radiation treatment into oncological treatment concepts without additional toxicity. • Further studies are needed to determine the limits of SRS for renal cell carcinoma metastases outside the brain and spine.
    Keywords: Renal Cell Cancer ; Cyberknife ; Sunitinib ; Sorafenib ; Stereotactic ; Robotic Surgery ; Spinal Tumours ; Cerebral Metastasis
    ISSN: 1464-4096
    E-ISSN: 1464-410X
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  • 9
    In: Cancer, 01 January 2015, Vol.121(1), pp.43-50
    Description: Alteration of mammalian target of rapamycin biomarkers predicts survival outcomes in patients with clear cell renal carcinoma. This marker panel has prognostic value in addition to standard clinical and pathologic predictors of outcome.
    Keywords: Renal Cell Carcinoma ; Biomarkers ; Validation ; Mammalian Target Of Rapamycin
    ISSN: 0008-543X
    E-ISSN: 1097-0142
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  • 10
    Language: English
    In: The Journal of Urology, 2010, Vol.183(4), pp.e642-e642
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
    Source: ScienceDirect Journals (Elsevier)
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