Expert Point of View: Richard K. Valicenti, MD, FASTRO
“The absolute risk reduction in metastasis ranges from 2% to 12% by 10 years. Given this heterogeneity, there is a strong rationale for better prognostic markers to personalize treatment of prostate cancer. Nearly all men treated with androgen-deprivation therapy have variable side effects that decrease quality of life,” said invited study discussant Richard K. Valicenti, MD, FASTRO, of the University of California, Davis.
Richard K. Valicenti, MD, FASTRO
“Traditional criteria are not sufficient to individualize treatment for men with prostate cancer. Prognostic absolute risk estimators show great promise for a more personalized approach to the treatment of prostate cancer. Clinical and genomic classifiers may be able to estimate individual risk, so benefits outweigh the potential harm for a particular absolute risk reduction,” he continued.
Dr. Valicenti said that the results of Dr. Tward’s study “clearly justify testing of the combined clinical cell-cycle risk score in tiered and appropriately powered noninferiority prospective studies, according to National Comprehensive Cancer Network risk groups. Such studies could identify a highly individualized deintensified approach.”
DISCLOSURE: Dr. Valicenti has reported no conflicts of interest.
According to a retrospective study, the combined clinical and cell-cycle risk (CCR) score may be able to accurately predict which patients with intermediate- and high-risk prostate cancer will have little additional benefit from androgen-deprivation therapy added to dose-escalated radiotherapy and...