Publications by authors named "J Puente-Vazquez"

Article Synopsis
  • Triple therapy combining docetaxel, androgen deprivation therapy (ADT), and androgen receptor pathway inhibitors (ARPIs) shows survival advantages for patients with metastatic hormone-sensitive prostate cancer (mHSPC), especially in high-risk cases.
  • Current guidelines lack clarity on which ARPI to use after starting ADT and docetaxel.
  • This literature review aims to provide updated recommendations on ARPI selection based on patient risk and disease characteristics by assessing existing clinical trials and expert opinions.
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Androgen deprivation therapy (ADT) is the mainstay treatment for metastatic hormone-sensitive prostate cancer (mHSPC). The addition of docetaxel or new hormone therapies (abiraterone, apalutamide, or enzalutamide) improves overall survival and is currently the standard of care. However, the decision on the specific regimen to accompany ADT should be discussed with the patient, considering factors such as possible associated toxicities, duration of treatment, comorbidities, patient preferences, as there is no sufficient evidence to recommend one regimen over the other in most cases.

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Despite early renal carcinoma diagnosis is more frequent nowadays, ~25-30 % of patients have metastatic disease at presentation and another ~30 % develop recurrent or metastatic disease after radical treatment for localized disease. In recent years, treatment of renal carcinoma is increasing in complexity due to the inclusion of a number of effective systemic treatments prolonging survival and increasing the therapeutic strategies for tumor debulking, or even achieving surgical complete responses and prolonged disease-free intervals. Initial multimodal approaches with immunotherapeutic agents are now being validated in patients treated with the new-targeted agents.

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Prostate epithelial and stromal cells develop paracrine interactions, which may be responsible for the occurrence and progression of prostate pathologies. Strikingly, stromal cells exhibit pleiotropic effects on epithelial cell growth, ranging from stimulation to inhibition. Steroid hormone receptors are considered ligand-activated transcriptional factors.

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