Impacto del cáncer de próstata localmente avanzado/metastásico en la calidad de vida / Impact of locally advanced or metastatic prostate cancer on the quality of life

Objetivo: El objetivo de este estudio fue evaluar la calidad de vida relacionada con la salud en pacientes con cáncer de próstata en fases avanzadas para obtener información adicional sobre la salud de los pacientes. El creciente interés por conocer la perspectiva del paciente y la escasez de estudios prospectivos en esta población motivaron esta investigación. Material y métodos: Se presenta un estudio observacional realizado en 131 consultas de urología, con una muestra de 601 pacientes con cáncer de próstata localmente avanzado o metastásico, evaluados en 2 visitas: basal y a los 12 meses. Se recogieron variables sociodemográficas, clínicas, de calidad de vida (cuestionarios PROSQoLI y EuroQoL-5D-5L) y ansiedad/depresión (cuestionario HADS). Resultados: La edad media (DE) era de 73,8 (8,2) años y el 87,2% eran jubilados o pensionistas. El 58,7% de los pacientes presentaba cáncer de próstata localmente avanzado. La sintomatología urinaria fue la más frecuente, disminuyendo significativamente al cabo de un año (p < 0,05). Los problemas urinarios y el cansancio fueron las dimensiones más afectadas y el dolor/malestar la dimensión presente en más pacientes (65,3%). Según el modelo de regresión lineal, la astenia y el dolor fueron 2 de los factores más relacionados con una peor calidad de vida. La presencia de ansiedad/depresión fue baja. Finalmente, el estado de salud valorado por el clínico fue más positivo que el valorado por los pacientes. Conclusiones: Este estudio amplía la escasa información existente sobre la calidad de vida de la población con cáncer de próstata avanzado, información de utilidad en el manejo clínico de los pacientes

Objective: The aim of this study was to assess the health-related quality of life of patients with prostate cancer in advanced phases to obtain additional information on the patients’ health. The growing interest in understanding the patient's perspective and the scarcity of prospective studies of this population motivated this research study. Material and methods: We present an observational study performed on 131 urology consultations, with a sample of 601 patients with locally advanced or metastatic prostate cancer, assessed during 2 visits: baseline and at 12 months. We collected demographic, clinical, quality-of-life (PROSQoLI and EuroQoL-5D-5L questionnaires) and anxiety/depression (HADS questionnaire) endpoints. Results: The mean age (SD) was 73.8 (8.2) years, and 87.2% of the participants were retired or pensioners. Some 58.7% of the patients presented locally advanced prostate cancer. Urinary symptoms were the most common, decreasing significantly after one year (P< .05). Urinary problems and fatigue were the most affected measures, and pain/discomfort was the dimension present in most patients (65.3%). According to the linear regression model, asthenia and pain were 2 of the factors most closely related to a poorer quality of life. The presence of anxiety/depression was low. Finally, the health condition as assessed by the clinician was more positive than when assessed by the patients. Conclusions: This study broadens the scarce information on the quality of life of the population with advanced prostate cancer, information of use for the clinical management of these patients

Impact of locally advanced or metastatic prostate cancer on the quality of life. / Impacto del cáncer de próstata localmente avanzado/metastásico en la calidad de vida.

OBJECTIVE: The aim of this study was to assess the health-related quality of life of patients with prostate cancer in advanced phases to obtain additional information on the patients' health. The growing interest in understanding the patient's perspective and the scarcity of prospective studies of this population motivated this research study. MATERIAL AND METHODS: We present an observational study performed on 131 urology consultations, with a sample of 601 patients with locally advanced or metastatic prostate cancer, assessed during 2 visits: baseline and at 12 months. We collected demographic, clinical, quality-of-life (PROSQoLI and EuroQoL-5D-5L questionnaires) and anxiety/depression (HADS questionnaire) endpoints. RESULTS: The mean age (SD) was 73.8 (8.2) years, and 87.2% of the participants were retired or pensioners. Some 58.7% of the patients presented locally advanced prostate cancer. Urinary symptoms were the most common, decreasing significantly after one year (P<.05). Urinary problems and fatigue were the most affected measures, and pain/discomfort was the dimension present in most patients (65.3%). According to the linear regression model, asthenia and pain were 2 of the factors most closely related to a poorer quality of life. The presence of anxiety/depression was low. Finally, the health condition as assessed by the clinician was more positive than when assessed by the patients. CONCLUSIONS: This study broadens the scarce information on the quality of life of the population with advanced prostate cancer, information of use for the clinical management of these patients.

The insulin-like growth factor pathway as a target for cancer therapy

The insulin-like growth factor (IGF) system is emerging as a promising new target in cancer therapy. Experimental models and epidemiological studies have demonstrated that the IGF system plays a key role in malignant transformation and cancer progression. Different strategies are being pursued to target this pathway. Several monoclonal antibodies and tyrosine kinase inhibitors targeting the IGF-1 receptor are in clinical development. Early clinical trials indicate these drugs have acceptable safety profiles, and there is pharmacodynamic evidence that actual target inhibition is achievable in patients. Emerging efficacy data as single agent and in combination with chemotherapy is encouraging yet too early for firm conclusions. This manuscript reviews the role of the IGF system in human malignancy and its interactions with other signaling pathways, and summarizes the available data of IGF-1R inhibitors currently in clinical trials (AU)