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10. Focus on the Blind Spot of Stone Disease: Analysis of Lower Urinary Tract Stone Interventions from 2006 to 2020 Using German Nationwide Inpatient Data.

Author

Herout, Roman, Putz, Juliane, Borkowetz, Angelika, Baunacke, Martin, Koch, Rainer, Thomas, Christian, Huber, Johannes, and Groeben, Christer

Subjects
*BLADDER stones, *URINARY calculi, *TRANSURETHRAL prostatectomy, *SURGICAL enucleation, *URINARY organs
Abstract

Introduction: The aim of the study was to analyze contemporary treatment trends in bladder stone management in Germany over a 15-year period. Methods: We analyzed data from the nationwide German hospital billing database from 2006 to 2020. The significance of changes over time was evaluated via linear regression analysis. Results: Total case numbers of therapeutic interventions for lower urinary tract calculi increased from 6,770 in 2006 to 9,037 in 2020 (p < 0.001). Transurethral cystolithotripsy (TUCL) was the predominant procedure with increasing case numbers from 5,552 in 2006 to 7,699 in 2020 (p < 0.001). Also, the share of TUCL increased by 4% during the study period. TUCL with laser fragmentation was coded in 82 cases in 2006 and in 1,527 cases in 2020 (p < 0.001). Case numbers of percutaneous cystolithotripsy also increased over time from 406 to 430 cases (p = 0.005), but the share decreased by 20%. Inpatient shock wave lithotripsy is very rarely performed for bladder calculi with an average of 22 cases per year in all hospitals in Germany. Case numbers of open cystolithotomy (OCL) also increased from 614 cases in 2006 to 692 cases in 2020 (p = 0.006), but the share decreased by 15.5%. On average, 164 cases of stone removal from neobladders per year were performed, mainly transurethrally (47%) or via an open approach (21%). Case numbers of TUCL combined with transurethral resection of the prostate (TUR-P) declined from 1,712 in 2006 to 1,450 in 2020 (p = 0.014). However, this might be attributed to the concomitant rise of laser enucleation of the prostate with steadily increasing case numbers in Germany. Conclusion: We present contemporary population-based data on bladder stone treatment in Germany. TUCL is the predominant therapeutic modality with increasing case numbers, but OCL is still performed frequently. TUR-P is the procedure that is most often combined with TUCL. [ABSTRACT FROM AUTHOR]

Published
2024
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11. Assessing Biomarkers of Porcine Kidneys under Normothermic Machine Perfusion—Can We Gain Insight into a Marginal Organ?

Author

Steinhauser, Carla, Yakac, Abdulbaki, Markgraf, Wenke, Kromnik, Susanne, Döcke, Andreas, Talhofer, Philipp, Thiele, Christine, Malberg, Hagen, Sommer, Ulrich, Baretton, Gustavo B., Füssel, Susanne, Thomas, Christian, and Putz, Juliane

Subjects
LIPOCALIN-2, INFLAMMATION, KIDNEYS, REPERFUSION, BIOMARKERS, PERFUSION
Abstract

To identify potentially transplantable organs in a pool of marginal kidneys, 33 porcine slaughterhouse kidneys were perfused for 4 h with whole blood. During the normothermic perfusion, plasma, urine, and tissue samples were taken. Several biomarkers for tubule injury, endothelial activation, and inflammatory response were evaluated for a potential correlation with macroscopic appearance, histology, and filtration activity. Generally, biomarker levels increased during perfusion. TLR-4, EDN-1, and NGAL were not associated with any classification. In contrast, a steeper increase in NAG and IL-6 in plasma correlated with a poor macroscopic appearance at 4 h, indicating a higher inflammatory response in the kidneys with worse macroscopy early on, potentially due to more damage at the tubules. Although long-term effects on the graft could not be assessed in this setting, early observation under machine perfusion with whole blood was feasible. It allowed the assessment of kidneys under conditions comparable to reperfusion. This setting could give surgeons further insight into the quality of marginal kidneys and an opportunity to pre-treat them. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Stellenwert wasserbezogener Rehabilitationsmaßnahmen bei Stomaträgern

Author

Putz, Juliane, Borkowetz, Angelika, Schlumberger, Gina Benita, Huber, Johannes, and Thomas, Christian

Abstract

Hintergrund: Die Anlage eines Hautstomas nach exenterativen Beckeneingriffen stellt für Betroffene einen drastischen Einschnitt in die körperliche Integrität dar. Vielfach führen ästhetische und funktionelle Bedenken dazu, dass wasserbezogene Angebote zur Rehabilitation nicht genutzt werden. Fragestellung: Ziel war es, im Rahmen des Pilotprojekts „UROAquaFIT“ die Möglichkeit einer wasserbezogenen Rehabilitationsmaßnahme für Patienten nach Zystektomie mit inkontinenter Harnableitung zu evaluieren. Methode: Im Rahmen des Pilotkurses „UROAquaFIT“ wurde Patienten nach radikaler Zystektomie mit inkontinenter Harnableitung die Möglichkeit einer wasserbezogenen Rehabilitationsmaßnahme angeboten. Aufgeteilt in Kleingruppen erfolgte ein Wassergymnastikkurs unter Anleitung einer Physiotherapeutin und einer Stomatherapeutin unter ärztlicher Aufsicht. Daten zur Lebensqualität und der persönlichen Beurteilung des Kurses mittels Fragebögen wurden vor Beginn und 6 Monate nach Kursende erhoben und qualitativ ausgewertet. Darüber hinaus erfolgte eine Literaturrecherche (MEDLINE) zum Thema Aquagymnastik in der Onkologie. Ergebnis und Diskussion: Das Kursangebot wurde von allen Teilnehmern als durchweg positiv und bereichernd empfunden. Wohlbefinden und Selbstwertgefühl der Probanden konnten gesteigert werden. Wassergymnastik unter gezielter physio- und stomatherapeutischer Anleitung kann somit eine höchst effektive Rehabilitationsmaßnahme für Patienten nach inkontinenter Harnableitung darstellen. Darüber hinaus stärkt sie die körperliche Integrität der Betroffenen und erweitert somit die Möglichkeiten der sozialen Reintegration. Diese Form der Therapie sollte als fester Baustein in der Rehabilitation nach exenterativen Beckeneingriffen mit Stomaanlage verankert werden.

Published
2024
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15. The Diagnostic Value of the Added MR Imaging of the Scrotum in the Preoperative Workup of Sonographically Indeterminate Testicular Lesions—A Retrospective Multicenter Analysis

Author

Deininger, Susanne, primary, Lusuardi, Lukas, additional, Pallauf, Maximilian, additional, Hecht, Stefan, additional, Forstner, Rosemarie, additional, Meissnitzer, Matthias, additional, Distler, Florian A., additional, Erne, Eva, additional, Graf, Sebastian, additional, Lenart, Sebastian, additional, Putz, Juliane, additional, Deininger, Christian, additional, and Törzsök, Peter, additional

Published
2022
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19. Inulin Clearance During Ex vivoNormothermic Machine Perfusion as a Marker of Renal Function

Author

Markgraf, Wenke, Mühle, Richard, Lilienthal, Jannis, Kromnik, Susanne, Thiele, Christine, Malberg, Hagen, Janssen, Martin, and Putz, Juliane

Abstract

Normothermic machine perfusion (NMP) offers a unique opportunity to objectively assess donor organ quality. This study describes the evaluation of inulin clearance as a potential marker for the ex vivofunction of porcine kidneys during NMP. The function assessment was performed in both kidneys from slaughterhouse pigs (n = 20) and kidneys from pigs in a laboratory setting (n = 28). The kidneys were exposed to different warm ischemia times (WIT). After a period of static cold storage, the kidneys underwent a 4-hour NMP with autologous whole blood. Inulin clearance, hemodynamic parameters, and urine output were measured. Based on the inulin excretion behavior laboratory pig kidneys were assigned to three classes (functional, limited functional, and nonfunctional), slaughterhouse pig kidneys to two classes (limited functional and nonfunctional), respectively. Contrary to the marginal kidneys of the slaughterhouse pigs, the functional variation of kidneys of the laboratory pigs was associated with the WIT. A correlation between functional kidneys and a WIT less than 25 min was shown. Because none of the slaughterhouse pig kidneys could be assigned to the functional class, only the laboratory pig kidneys were used for examinations with functional markers. Renal blood flow and urine output during NMP correlated significantly (p< 0.01) with ex vivokidney function. This study demonstrated that inulin is a marker of high quality for the evaluation of suggested kidney function after NMP with whole blood. Furthermore, surrogate markers measured during NMP can be used to describe and predict the physiologic behavior of kidneys before transplantation.

Published
2022
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20. High-urgency kidney transplantation in the Eurotransplant Kidney Allocation System: success or waste of organs? The Eurotransplant 15-year all-centre survey.

Author

UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service de chirurgie et transplantation abdominale, Assfalg, Volker, Hüser, Norbert, van Meel, Marieke, Haller, Bernhard, Rahmel, Axel, de Boer, Jan, Matevossian, Edouard, Novotny, Alexander, Knops, Noël, Weekers, Laurent, Friess, Helmut, Pratschke, Johann, Függer, Reinhold, Janko, Otmar, Rasoul-Rockenschaub, Susanne, Bosmans, Jean-Louis, Broeders, Nilufer, Peeters, Patrick, Mourad, Michel, Kuypers, Dirk, Slaviček, Jasna, Muehlfeld, Anja, Sommer, Florian, Viebahn, Richard, Pascher, Andreas, van der Giet, Markus, Zantvoort, Frans, Woitas, Rainer P, Putz, Juliane, Grabitz, Klaus, Kribben, Andreas, Hauser, Ingeborg, Pisarski, Przemyslaw, Weimer, Rolf, Lorf, Thomas, Fornara, Paola, Morath, Christian, Nashan, Björn, Lehner, Frank, Kliem, Volker, Sester, Urban, Grimm, Marc-Oliver, Feldkamp, Thorsten, Kleinert, Robert, Arns, Wolfgang, Mönch, Christian, Schoenberg, Markus Bo, Nitschke, Martin, Krüger, Bernd, Thorban, Stefan, Arbogast, Helmut P, Wolters, Heiner H, Maier, Tanja, Lutz, Jens, Heller, Katharina, Banas, Bernhard, Hakenberg, Oliver, Kalus, Martin, Nadalin, Silvio, Keller, Frieder, Lopau, Kai, Bemelman, Frederike José, Nurmohamed, Shaikh, Sanders, Jan-Stephan, de Fijter, Johan W, Christiaans, Maarten, Hilbrands, Luuk, Betjes, Michiel, van Zuilen, Arjan, Heemann, Uwe, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service de chirurgie et transplantation abdominale, Assfalg, Volker, Hüser, Norbert, van Meel, Marieke, Haller, Bernhard, Rahmel, Axel, de Boer, Jan, Matevossian, Edouard, Novotny, Alexander, Knops, Noël, Weekers, Laurent, Friess, Helmut, Pratschke, Johann, Függer, Reinhold, Janko, Otmar, Rasoul-Rockenschaub, Susanne, Bosmans, Jean-Louis, Broeders, Nilufer, Peeters, Patrick, Mourad, Michel, Kuypers, Dirk, Slaviček, Jasna, Muehlfeld, Anja, Sommer, Florian, Viebahn, Richard, Pascher, Andreas, van der Giet, Markus, Zantvoort, Frans, Woitas, Rainer P, Putz, Juliane, Grabitz, Klaus, Kribben, Andreas, Hauser, Ingeborg, Pisarski, Przemyslaw, Weimer, Rolf, Lorf, Thomas, Fornara, Paola, Morath, Christian, Nashan, Björn, Lehner, Frank, Kliem, Volker, Sester, Urban, Grimm, Marc-Oliver, Feldkamp, Thorsten, Kleinert, Robert, Arns, Wolfgang, Mönch, Christian, Schoenberg, Markus Bo, Nitschke, Martin, Krüger, Bernd, Thorban, Stefan, Arbogast, Helmut P, Wolters, Heiner H, Maier, Tanja, Lutz, Jens, Heller, Katharina, Banas, Bernhard, Hakenberg, Oliver, Kalus, Martin, Nadalin, Silvio, Keller, Frieder, Lopau, Kai, Bemelman, Frederike José, Nurmohamed, Shaikh, Sanders, Jan-Stephan, de Fijter, Johan W, Christiaans, Maarten, Hilbrands, Luuk, Betjes, Michiel, van Zuilen, Arjan, and Heemann, Uwe

Abstract

BACKGROUND: In the Eurotransplant Kidney Allocation System (ETKAS), transplant candidates can be considered for high-urgency (HU) status in case of life-threatening inability to undergo renal replacement therapy. Data on the outcomes of HU transplantation are sparse and the benefit is controversial. METHODS: We systematically analysed data from 898 ET HU kidney transplant recipients from 61 transplant centres between 1996 and 2010 and investigated the 5-year patient and graft outcomes and differences between relevant subgroups. RESULTS: Kidney recipients with an HU status were younger (median 43 versus 55 years) and spent less time on the waiting list compared with non-HU recipients (34 versus 54 months). They received grafts with significantly more mismatches (mean 3.79 versus 2.42; P < 0.001) and the percentage of retransplantations was remarkably higher (37.5 versus 16.7%). Patient survival (P = 0.0053) and death with a functioning graft (DwFG; P < 0.0001) after HU transplantation were significantly worse than in non-HU recipients, whereas graft outcome was comparable (P = 0.094). Analysis according to the different HU indications revealed that recipients listed HU because of an imminent lack of access for dialysis had a significantly worse patient survival (P = 0.0053) and DwFG (P = 0.0462) compared with recipients with psychological problems and suicidality because of dialysis. In addition, retransplantation had a negative impact on patient and graft outcome. CONCLUSIONS: Facing organ shortages, increasing wait times and considerable mortality on dialysis, we question the current policy of HU allocation and propose more restrictive criteria with regard to individuals with vascular complications or repeated retransplantations in order to support patients on the non-HU waiting list with a much better long-term prognosis.

Published
2016

21. High-urgency kidney transplantation in the Eurotransplant Kidney Allocation System: success or waste of organs? The Eurotransplant 15-year all-centre survey

Author

Assfalg, Volker, Hueser, Norbert, van Meel, Marieke, Haller, Bernhard, Rahmel, Axel, de Boer, Jan, Matevossian, Edouard, Novotny, Alexander, Knops, Noel, Weekers, Laurent, Friess, Helmut, Pratschke, Johann, Fuegger, Reinhold, Janko, Otmar, Rasoul-Rockenschaub, Susanne, Bosmans, Jean-Louis, Broeders, Nilufer, Peeters, Patrick, Mourad, Michel, Kuypers, Dirk, Slavicek, Jasna, Muehlfeld, Anja, Sommer, Florian, Viebahn, Richard, Pascher, Andreas, van der Giet, Markus, Zantvoort, Frans, Woitas, Rainer P., Putz, Juliane, Grabitz, Klaus, Kribben, Andreas, Hauser, Ingeborg, Pisarski, Przemyslaw, Weimer, Rolf, Lorf, Thomas, Fornara, Paola, Morath, Christian, Nashan, Bjoern, Lehner, Frank, Kliem, Volker, Sester, Urban, Grimm, Marc-Oliver, Feldkamp, Thorsten, Kleinert, Robert, Arns, Wolfgang, Moench, Christian, Schoenberg, Markus Bo, Nitschke, Martin, Krueger, Bernd, Thorban, Stefan, Arbogast, Helmut P., Wolters, Heiner H., Maier, Tanja, Lutz, Jens, Heller, Katharina, Banas, Bernhard, Hakenberg, Oliver, Kalus, Martin, Nadalin, Silvio, Keller, Frieder, Lopau, Kai, Bemelman, Frederike Jose, Nurmohamed, Shaikh, Sanders, Jan-Stephan, de Fijter, Johan W., Christiaans, Maarten, Hilbrands, Luuk, Betjes, Michiel, van Zuilen, Arjan, Heemann, Uwe, Assfalg, Volker, Hueser, Norbert, van Meel, Marieke, Haller, Bernhard, Rahmel, Axel, de Boer, Jan, Matevossian, Edouard, Novotny, Alexander, Knops, Noel, Weekers, Laurent, Friess, Helmut, Pratschke, Johann, Fuegger, Reinhold, Janko, Otmar, Rasoul-Rockenschaub, Susanne, Bosmans, Jean-Louis, Broeders, Nilufer, Peeters, Patrick, Mourad, Michel, Kuypers, Dirk, Slavicek, Jasna, Muehlfeld, Anja, Sommer, Florian, Viebahn, Richard, Pascher, Andreas, van der Giet, Markus, Zantvoort, Frans, Woitas, Rainer P., Putz, Juliane, Grabitz, Klaus, Kribben, Andreas, Hauser, Ingeborg, Pisarski, Przemyslaw, Weimer, Rolf, Lorf, Thomas, Fornara, Paola, Morath, Christian, Nashan, Bjoern, Lehner, Frank, Kliem, Volker, Sester, Urban, Grimm, Marc-Oliver, Feldkamp, Thorsten, Kleinert, Robert, Arns, Wolfgang, Moench, Christian, Schoenberg, Markus Bo, Nitschke, Martin, Krueger, Bernd, Thorban, Stefan, Arbogast, Helmut P., Wolters, Heiner H., Maier, Tanja, Lutz, Jens, Heller, Katharina, Banas, Bernhard, Hakenberg, Oliver, Kalus, Martin, Nadalin, Silvio, Keller, Frieder, Lopau, Kai, Bemelman, Frederike Jose, Nurmohamed, Shaikh, Sanders, Jan-Stephan, de Fijter, Johan W., Christiaans, Maarten, Hilbrands, Luuk, Betjes, Michiel, van Zuilen, Arjan, and Heemann, Uwe

Abstract

In the Eurotransplant Kidney Allocation System (ETKAS), transplant candidates can be considered for high-urgency (HU) status in case of life-threatening inability to undergo renal replacement therapy. Data on the outcomes of HU transplantation are sparse and the benefit is controversial. We systematically analysed data from 898 ET HU kidney transplant recipients from 61 transplant centres between 1996 and 2010 and investigated the 5-year patient and graft outcomes and differences between relevant subgroups. Kidney recipients with an HU status were younger (median 43 versus 55 years) and spent less time on the waiting list compared with non-HU recipients (34 versus 54 months). They received grafts with significantly more mismatches (mean 3.79 versus 2.42; P < 0.001) and the percentage of retransplantations was remarkably higher (37.5 versus 16.7%). Patient survival (P = 0.0053) and death with a functioning graft (DwFG; P < 0.0001) after HU transplantation were significantly worse than in non-HU recipients, whereas graft outcome was comparable (P = 0.094). Analysis according to the different HU indications revealed that recipients listed HU because of an imminent lack of access for dialysis had a significantly worse patient survival (P = 0.0053) and DwFG (P = 0.0462) compared with recipients with psychological problems and suicidality because of dialysis. In addition, retransplantation had a negative impact on patient and graft outcome. Facing organ shortages, increasing wait times and considerable mortality on dialysis, we question the current policy of HU allocation and propose more restrictive criteria with regard to individuals with vascular complications or repeated retransplantations in order to support patients on the non-HU waiting list with a much better long-term prognosis.

Published
2016

22. High-urgency kidney transplantation in the Eurotransplant Kidney Allocation System: success or waste of organs? The Eurotransplant 15-year all-centre survey

Author

MS Nefrologie, Circulatory Health, Assfalg, Volker, Hüser, Norbert, van Meel, Marieke, Haller, Bernhard, Rahmel, Axel, de Boer, Jan, Matevossian, Edouard, Novotny, Alexander, Knops, Noël, Weekers, Laurent, Friess, Helmut, Pratschke, Johann, Függer, Reinhold, Janko, Otmar, Rasoul-Rockenschaub, Susanne, Bosmans, Jean-Louis, Broeders, Nilufer, Peeters, Patrick, Mourad, Michel, Kuypers, Dirk, Slaviček, Jasna, Muehlfeld, Anja, Sommer, Florian, Viebahn, Richard, Pascher, Andreas, van der Giet, Markus, Zantvoort, Frans, Woitas, Rainer P, Putz, Juliane, Grabitz, Klaus, Kribben, Andreas, Hauser, Ingeborg, Pisarski, Przemyslaw, Weimer, Rolf, Lorf, Thomas, Fornara, Paola, Morath, Christian, Nashan, Björn, Lehner, Frank, Kliem, Volker, Sester, Urban, Grimm, Marc-Oliver, Feldkamp, Thorsten, Kleinert, Robert, Arns, Wolfgang, Mönch, Christian, Schoenberg, Markus Bo, Nitschke, Martin, Krüger, Bernd, Thorban, Stefan, Arbogast, Helmut P, Wolters, Heiner H, Maier, Tanja, Lutz, Jens, Heller, Katharina, Banas, Bernhard, Hakenberg, Oliver, Kalus, Martin, Nadalin, Silvio, Keller, Frieder, Lopau, Kai, Bemelman, Frederike José, Nurmohamed, Shaikh, Sanders, Jan-Stephan, de Fijter, Johan W, Christiaans, Maarten, Hilbrands, Luuk, Betjes, Michiel, van Zuilen, Arjan D, Heemann, Uwe, MS Nefrologie, Circulatory Health, Assfalg, Volker, Hüser, Norbert, van Meel, Marieke, Haller, Bernhard, Rahmel, Axel, de Boer, Jan, Matevossian, Edouard, Novotny, Alexander, Knops, Noël, Weekers, Laurent, Friess, Helmut, Pratschke, Johann, Függer, Reinhold, Janko, Otmar, Rasoul-Rockenschaub, Susanne, Bosmans, Jean-Louis, Broeders, Nilufer, Peeters, Patrick, Mourad, Michel, Kuypers, Dirk, Slaviček, Jasna, Muehlfeld, Anja, Sommer, Florian, Viebahn, Richard, Pascher, Andreas, van der Giet, Markus, Zantvoort, Frans, Woitas, Rainer P, Putz, Juliane, Grabitz, Klaus, Kribben, Andreas, Hauser, Ingeborg, Pisarski, Przemyslaw, Weimer, Rolf, Lorf, Thomas, Fornara, Paola, Morath, Christian, Nashan, Björn, Lehner, Frank, Kliem, Volker, Sester, Urban, Grimm, Marc-Oliver, Feldkamp, Thorsten, Kleinert, Robert, Arns, Wolfgang, Mönch, Christian, Schoenberg, Markus Bo, Nitschke, Martin, Krüger, Bernd, Thorban, Stefan, Arbogast, Helmut P, Wolters, Heiner H, Maier, Tanja, Lutz, Jens, Heller, Katharina, Banas, Bernhard, Hakenberg, Oliver, Kalus, Martin, Nadalin, Silvio, Keller, Frieder, Lopau, Kai, Bemelman, Frederike José, Nurmohamed, Shaikh, Sanders, Jan-Stephan, de Fijter, Johan W, Christiaans, Maarten, Hilbrands, Luuk, Betjes, Michiel, van Zuilen, Arjan D, and Heemann, Uwe

Published
2016

23. High-urgency kidney transplantation in the Eurotransplant Kidney Allocation System: success or waste of organs? The Eurotransplant 15-year all-centre survey

Author

Assfalg, Volker, primary, Hüser, Norbert, additional, van Meel, Marieke, additional, Haller, Bernhard, additional, Rahmel, Axel, additional, de Boer, Jan, additional, Matevossian, Edouard, additional, Novotny, Alexander, additional, Knops, Noël, additional, Weekers, Laurent, additional, Friess, Helmut, additional, Pratschke, Johann, additional, Függer, Reinhold, additional, Janko, Otmar, additional, Rasoul-Rockenschaub, Susanne, additional, Bosmans, Jean-Louis, additional, Broeders, Nilufer, additional, Peeters, Patrick, additional, Mourad, Michel, additional, Kuypers, Dirk, additional, Slaviček, Jasna, additional, Muehlfeld, Anja, additional, Sommer, Florian, additional, Viebahn, Richard, additional, Pascher, Andreas, additional, van der Giet, Markus, additional, Zantvoort, Frans, additional, Woitas, Rainer P., additional, Putz, Juliane, additional, Grabitz, Klaus, additional, Kribben, Andreas, additional, Hauser, Ingeborg, additional, Pisarski, Przemyslaw, additional, Weimer, Rolf, additional, Lorf, Thomas, additional, Fornara, Paola, additional, Morath, Christian, additional, Nashan, Björn, additional, Lehner, Frank, additional, Kliem, Volker, additional, Sester, Urban, additional, Grimm, Marc-Oliver, additional, Feldkamp, Thorsten, additional, Kleinert, Robert, additional, Arns, Wolfgang, additional, Mönch, Christian, additional, Schoenberg, Markus Bo, additional, Nitschke, Martin, additional, Krüger, Bernd, additional, Thorban, Stefan, additional, Arbogast, Helmut P., additional, Wolters, Heiner H., additional, Maier, Tanja, additional, Lutz, Jens, additional, Heller, Katharina, additional, Banas, Bernhard, additional, Hakenberg, Oliver, additional, Kalus, Martin, additional, Nadalin, Silvio, additional, Keller, Frieder, additional, Lopau, Kai, additional, Bemelman, Frederike José, additional, Nurmohamed, Shaikh, additional, Sanders, Jan-Stephan, additional, de Fijter, Johan W., additional, Christiaans, Maarten, additional, Hilbrands, Luuk, additional, Betjes, Michiel, additional, van Zuilen, Arjan, additional, and Heemann, Uwe, additional

Published
2016
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25. Systemic Triple Therapy in Metastatic Hormone-Sensitive Prostate Cancer (mHSPC): Ready for Prime Time or Still to Be Explored?

Author

Thomas, Christian, Baunacke, Martin, Erb, Holger H. H., Füssel, Susanne, Erdmann, Kati, Putz, Juliane, and Borkowetz, Angelika

Subjects
THERAPEUTICS, SURVIVAL, HORMONES, ANTIANDROGENS, COMBINATION drug therapy, METASTASIS, CELLULAR signal transduction, PROSTATE tumors, IMMUNOTHERAPY
Abstract

Simple Summary: Currently, a combination therapy of standard androgen deprivation therapy (ADT) plus docetaxel or androgen receptor-axis-targeted therapy is the gold standard for metastatic hormone-sensitive prostate cancer (mHSPC) treatment. Compared to ADT monotherapy, combination treatment prolongs overall survival by at least 18 months. The latest data has shown that triple treatment with standard ADT plus docetaxel plus abiraterone is superior to standard ADT plus docetaxel. Ongoing clinical trials are investigating triple therapy protocols by affecting diverse signaling pathways that are pivotal in prostate cancer. In this review, we will explore if triple therapy has the potential to be the new standard for mHSPC treatment in the near future. For decades, mono androgen deprivation therapy (ADT) has been the gold standard for metastatic hormone-sensitive prostate cancer (mHSPC) treatment. Several studies have been published within the last seven years demonstrating a significant survival advantage by combination treatment with standard ADT plus docetaxel or androgen receptor-axis-targeted therapy (ARAT) compared to ADT monotherapy. As a result, overall survival can be prolonged by at least 18 months. Recently published congress data of the PEACE-1 study suggests that in the future, triple therapy might be the new gold standard. In addition to this study, which has shown that triple treatment with standard ADT plus docetaxel plus abiraterone is superior to standard ADT plus docetaxel, several other phase III triple therapy studies are currently ongoing. The different modes of action that are investigated reach from AR-targeting over mitotic inhibition and immunotherapy to PARP and AKT inhibition. In this review we will explore if triple therapy has the potential to be the new standard for mHSPC treatment in the near future. [ABSTRACT FROM AUTHOR]

Published
2022
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