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    Home > Active Ingredient News > Urinary System > Dialogue with Professor Yang Yong: Abiraterone helps prostate cancer patients "full process" benefit | Choose the power of "Ze"

    Dialogue with Professor Yang Yong: Abiraterone helps prostate cancer patients "full process" benefit | Choose the power of "Ze"

    • Last Update: 2021-05-10
    • Source: Internet
    • Author: User
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    *It is only for medical professionals to read.
    How to use the "new weapon" for prostate cancer?
    Professor Yang Yong has "focused"! About 15 years ago, Lao Li (a pseudonym), a prostate cancer patient, had a radical prostatectomy.
    Unfortunately, the disease recurred biochemically a few years later.

    As his attending doctor, Professor Yang Yong from Peking University Cancer Hospital chose endocrine therapy for him, and the effect was very good.

     In 2014, 78-year-old Li had bone metastases.
    The elderly Li could not bear the pain caused by chemotherapy and chose to purchase the new drug abiraterone at his own expense.

    After one year of treatment, the disease stabilized.

    But the high price at that time put a lot of pressure on Lao Li's family.
    Fortunately, Abiraterone was listed in China and entered the medical insurance soon.
    The burden on Lao Li's family was significantly reduced and he continued to use the medicine until this year.

     Video of Professor Yang Yong Li Hui, who is now in his 80s, often discusses his feelings about medication and his thoughts with Professor Yang Yong.
    He believes that after using abiraterone plus hormone therapy, blood sugar and blood lipids will increase, but he can be treated by internal medicine.
    Properly control.

     "Why don't I try a new medicine combined with abiraterone?" At this time, a new type of antiandrogenic drug appeared.
    Professor Yang Yong suggested that Lao Li try to use a new type of antiandrogenic drug combined with abiraterone.

    Two months after the medicine was available, Lao Li's body had undergone tremendous changes.
    His appetite dropped significantly and his body became weaker and weaker, so he changed back to the previous medication regimen.

     "The old man has done a lot of research.
    He feels that although the abiraterone combined with hormones have side effects, they can be properly handled.
    Long-term use is of great help to the elderly and their physical condition is also very good.

    " Professor Yang Yong said "Different drug programs have their advantages and disadvantages, and patient experience is also very important, and the right combination of drugs can better help doctors treat patients.
    This is what I learned from patients.

    "Small team, great contribution.
    As the director of the Department of Urology, Peking University Cancer Hospital, Professor Yang Yong has treated countless prostate cancer patients and is the "male god" of many men.

     Video of Professor Yang Yong, Peking University Cancer Hospital Urology team is a very young Team.
    According to

    Professor Yang Yong, there are currently three professors, two associate professors, and 10 specialists in the
    team .
    “Although the team is small, we exist in Peking University Cancer Hospital and have a very good oncology specialist environment, including diagnosis and Some special tests, such as PSMA-PET/CT, nuclear magnetic special diagnosis, CT special diagnosis and so on.

    "Although the team led by Professor Yang Yong is very young and small in scale, it has all the resources for diagnosis and treatment of urinary tumors.
    It can do a better job in clinical practice and provide better services to patients.

     "Inside our team .
    There is also a division of labor, including prostate cancer, kidney cancer, bladder cancer, and urinary tumors.

    For different tumors, each person in charge carries out knowledge storage, so as to make the whole department harmonious and sustainable development, so as to facilitate the individualized treatment of patients.

    "Professor Yang Yong leads his "small" team to keep up with the international "trend" of prostate cancer treatment, master the experience of using new drugs and new treatment methods, and provide patients with better services.

    Early diagnosis and early treatment are the same as innovative drugs.
    Important prostate cancer is one of the common male malignant tumors, which seriously threatens the life and health of men.

    Prostate cancer has become the sixth most common male malignant tumor in China [1], and the mortality rate is tenth.

    And its incidence rate is rapid.
    Increasing trend.

     Comparing the survival rates of prostate cancer at home and abroad, there is still a huge room for improvement in the 5-year survival rate of prostate cancer in China.
    “The 5-year survival rate of prostate cancer is only 68%.
    That is, after a clear diagnosis of prostate cancer, 5 Within a year, about 32% of patients died of prostate cancer, which is very scary.

    "Early diagnosis and early treatment" is of great value in improving the outcome of this treatment.

    However, China’s “early diagnosis and early treatment” is not ideal.
    “About 50% to 60% of patients are already in the metastatic stage when they are first diagnosed, and most of them face advanced or metastatic prostate cancer in clinical practice.

    ” For those already suffering from prostate cancer.
    For cancer patients, early application of "innovative drugs" for active treatment has important clinical value for improving the survival of advanced prostate cancer.

    What is gratifying is that more and more outstanding innovative prostate cancer drugs have been approved for marketing in China and entered the national medical insurance catalog, which has brought more benefits to patients.

     "New weapon" Abiraterone makes waves.
    "The biggest advancement in endocrine therapy for prostate cancer is the emergence of new endocrine therapy.

    " Professor Yang Yong said that historically, about 100 years ago, people realized that prostate cancer is dependent on androgen.
    Characteristics, starting from the initial orchiectomy and bilateral orchiectomy, it has been developed to androgen deprivation therapy (ADT) and other drug treatments such as relin.

    The castration of drugs can achieve the same effect as bilateral orchiectomy.

     "In recent years, there have been some new type of endocrine therapy, particularly in the emergence of new endocrine therapy abiraterone represented, allows us to treat prostate cancer from castrate levels of testosterone, testosterone across to zero level.

    That Reduce testosterone to a very low level in order to achieve the maximum effect of endocrine therapy.

    "Prostate cancer is a hormone-dependent tumor, and endocrine therapy for prostate cancer will be more widely used.
    Professor Yang Yong said that the curative effect of abiraterone And safety will also become a new choice for prostate cancer patients.

     For metastatic castration-resistant prostate cancer (mCRPC), the previous treatments were extremely limited.
    After the emergence of abiraterone, the patient's prognosis has been significantly improved.

    Professor Yang Yong introduced that in the initial COU-AA-301 and 302 studies, Abiraterone showed significant efficacy in the treatment of mCRPC.

    "With abiraterone, the overall survival (OS) of patients is significantly prolonged, but in fact this prolongation is still relatively limited.

    "Professor Yang Yong’s video testosterone zero era, good medicine should be used early.
    Later, the researchers learned from the COU-AA-301 and 302 studies and found that when the level of testosterone is lower, patients with metastatic hormone-sensitive prostate cancer (mHSPC) use it The better the effect of endocrine therapy, the longer the OS.

    "So people thought of moving abiraterone to the hormone-sensitive stage to achieve extremely low testosterone levels in order to obtain the greatest clinical benefit.
    This led to the subsequent LATITUDE study.
    .

    The results of the LATITUDE study exceeded Professor Yang Yong’s expectations and became a classic study in the history of prostate cancer treatment.
    The

     LATITUDE study confirmed [2] that abiraterone combined with prednisone and ADT combined treatment, compared with placebo + ADT, can be significantly Prolonging OS, delaying imaging progression, and improving the quality of life of patients.

    These are not
    achieved by ADT treatment or chemotherapy alone.
    Abiraterone can significantly improve the symptoms and quality of life of high-risk mHSPC patients, and it has become a clinical consensus that it has good safety.
    It has also been favored by more and more clinicians.

     In view of the good therapeutic effect and safety of abiraterone, domestic and foreign prostate cancer treatment guidelines or consensus have recommended it, supporting the early application of abiraterone in the first-line patients with high-risk mHSPC Endocrine therapy.

     This means that the early application of abiraterone in the mHSPC stage can more significantly improve the survival benefits of high-risk mHSPC patients.

    It can be seen from the LATITUDE study that the early use of AAP therapy from the mHSPC stage can allow patients to start from the first Obtained a huge lead in the first stage.

     How to use abiraterone well in clinical practice? Professor Yang Yong concluded: “Patients can be divided into two categories, one is high-load and high-progress patients, and the other is intermediate-risk patients.
    Metastatic patients.

    Patients with high load and high progression are more suitable to use abiraterone combined with hormone therapy as soon as possible, which can help patients improve symptoms as soon as possible, delay progression, improve quality of life, and avoid or delay the progression of the disease to the next stage; while patients with intermediate-risk metastatic disease can choose ADT combined with apatamide therapy.

    Then analyze the patient's personal characteristics and age, and choose a more individualized plan for the patient.

    "Professor Yang Yong, Department of Urology, Peking University Cancer Hospital, Director, Chief Physician, Professor/Ph.
    D.
    Supervisor, Member of the Urology Branch of the Chinese Anti-Cancer Association Member of the Standing Committee of the Urology Branch of the Beijing Anti-Cancer Association Member of the Standing Committee of the Urology Branch of the Beijing Medical Association References: [ 1]Zhang SW, Sun KX, Zheng RS, Zeng HM, Wang SM, Chen R, Wei WQ, He J.
    Cancer incidence and mortality in China, 2015[J].
    JNCC, 2020.
    DOI: https://doi.
    org/10.
    1016/j.
    jncc.
    2020.
    12.
    001.
    [2]Fizazi K, Tran N, Fein L, et al.
    Abiraterone acetate plus prednisone in patients with newly diagnosed high-risk metastatic castration-sensitive prostate cancer (LATITUDE): final overall survival analysis of a randomised, double-blind, phase 3 trial.
    [J].
    Lancet Oncol.
    2019 May;20(5):686-700.
     
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