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Grant Details

Grant Number: 5R01CA140272-02 Interpret this number
Primary Investigator: Shahinian, Vahakn
Organization: University Of Michigan At Ann Arbor
Project Title: Optimizing Use of Androgen Deprivation Therapy for Prostate Cancer
Fiscal Year: 2010
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Abstract

For over half a century, androgen deprivation therapy (ADT) has been known to have beneficial effects on prostate cancer due to the testosterone dependence of prostate tumor cells, yet its optimal use still remains undefined. Historically limited to palliative treatment, the 1990s witnessed a dramatic growth in its use across a variety of clinical scenarios, culminating in nearly half of men with prostate cancer receiving ADT within a year of diagnosis and over a quarter of prostate cancer survivors being on androgen deprivation in any given year. More recent developments have changed the landscape for ADT further and pose an ongoing challenge to optimizing its use for prostate cancer. Clinical trials published in 2002 and 2004 have clearly established an overall survival benefit for the use of ADT as an adjuvant to radiation in men with locally advanced or high risk localized disease. However, even as evidence of efficacy for ADT has become clearer, there has been increasing awareness since 2005 of potentially life-threatening adverse effects such as osteoporosis, bone fractures, cardiovascular disease and development of diabetes. One challenge is therefore to determine which patients are more likely to benefit rather than be harmed from use of ADT. A second issue is that these newly noted complications of ADT fall outside the usual purview of cancer care. The presence of a primary care provider (PCP) or a model where patients see both a POP and cancer specialist may therefore help mitigate the adverse effects of ADT. To address these issues, we propose to take a population-based approach, using SEER-Medicare data, to achieve the following specific aims: 1) identify subgroups of patients at particular risk of complications from ADT and 2) Examine the effect of model of care delivery (cancer specialist dominant vs. POP dominant) on care of men on ADT.

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Publications

Patterns of bone mineral density testing in men receiving androgen deprivation for prostate cancer.
Authors: Shahinian VB, Kuo YF
Source: J Gen Intern Med, 2013 Nov;28(11), p. 1440-6.
EPub date: 2013 May 14.
PMID: 23670565
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Reducing bias in the assessment of treatment effectiveness: androgen deprivation therapy for prostate cancer.
Authors: Kuo YF, Montie JE, Shahinian VB
Source: Med Care, 2012 May;50(5), p. 374-80.
PMID: 22635250
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High-risk prostate cancer: is androgen deprivation monotherapy still appropriate?
Authors: Shahinian VB
Source: Asian J Androl, 2012 May;14(3), p. 419-20.
EPub date: 2012 Feb 6.
PMID: 22306913
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Androgen deprivation for prostate cancer: the case for "first, do no harm".
Authors: Shahinian VB
Source: Cancer, 2012 Jul 1;118(13), p. 3232-5.
PMID: 22072504
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Risk of colorectal cancer in men on long-term androgen deprivation therapy for prostate cancer.
Authors: Gillessen S, Templeton A, Marra G, Kuo YF, Valtorta E, Shahinian VB
Source: J Natl Cancer Inst, 2010 Dec 1;102(23), p. 1760-70.
EPub date: 2010 Nov 10.
PMID: 21068432
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