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Prostate Cancer

LuPSMA Leads to Improved PSA Response, Fewer Severe Adverse Events Than Cabazitaxel in Patients With Metastatic Prostate Cancer

In the Australian phase II trial TheraP reported in The Lancet, Michael S. Hofman, FRACP, MBBS, and colleagues found that Lutetium-177–labeled PSMA-617 (LuPSMA) treatment was associated with a higher prostate-specific antigen (PSA) response rate and fewer severe adverse events vs cabazitaxel in...

Prostate Cancer

Bone Metastatic Burden and Survival Outcomes With Prostate Radiotherapy for Newly Diagnosed Metastatic Disease

In an analysis from the STAMPEDE trial reported in JAMA Oncology, Ali et al found that a lower number of bone metastases was associated with improved overall and failure-free survival in patients receiving prostate radiotherapy for newly diagnosed M1 metastatic prostate cancer. Study Details The...

Prostate Cancer

MRI-Targeted Biopsy vs Systematic Transrectal Ultrasonography Biopsy for Detection of Disease in Men at Risk for Prostate Cancer

In a Canadian phase III trial reported in JAMA Oncology, Klotz et al found that multiparametric magnetic resonance imaging (MRI) with targeted biopsy was noninferior to systematic 12-core transrectal ultrasonography biopsy in detecting International Society of Urological Pathology grade group 2...

prostate cancer

Felix Y. Feng, MD, on Prostate Cancer: Choosing Patients Who May Benefit From Apalutamide

Felix Y. Feng, MD, of the University of California, San Francisco, discusses study findings showing that molecular determinants may help clinicians select patients with nonmetastatic castration-resistant prostate cancer who may derive the most benefit from apalutamide and other androgen-signaling inhibitors (Abstract 8).

prostate cancer

Neeraj Agarwal, MD, on Prostate Cancer: Apalutamide vs Placebo in Treatment of Metastatic Disease

Neeraj Agarwal, MD, of Huntsman Cancer Institute at the University of Utah, discusses final results of the phase III TITAN study, which showed apalutamide plus androgen-deprivation therapy improved overall survival, reducing the risk of death up to 48%. This combination treatment also delayed castration resistance and maintained health-related quality of life for patients with metastatic castration-sensitive prostate cancer (Abstract 11).

bladder cancer
kidney cancer
prostate cancer

Christopher Sweeney, MBBS, and Thomas Powles, MD, PhD, on Treating GU Malignancies: Expert Views

A spirited discussion ensued when we asked Christopher Sweeney, MBBS, of Dana-Farber Cancer Institute, and Thomas Powles, MD, PhD, of Cancer Research UK Barts Centre, to compare notes on how they treat bladder, prostate, and kidney cancers.

Prostate Cancer

LuPSMA vs Cabazitaxel for Metastatic Castration-Resistant Prostate Cancer: Phase II TheraP Trial

Following disease progression on docetaxel, prostate-specific membrane antigen (PSMA)-targeted radionuclide therapy reduced the risk of disease progression or death by 37% vs cabazitaxel in men with metastatic castration-resistant prostate cancer in the phase II TheraP trial reported by Michael S....

Prostate Cancer

Dose-Intensified Radiotherapy Not Superior to Conventional Regimen for Biochemically Recurrent Prostate Cancer After Radical Prostatectomy

A dose-intensified approach to salvage radiotherapy failed to show superiority to a conventional dose strategy in patients with biochemically recurrent prostate cancer who had undergone radical prostatectomy, according to a study presented by Pirus Ghadjar, MD, and colleagues at the 2021...

Prostate Cancer

Update From ACIS Trial of Apalutamide Plus Abiraterone/Prednisone in Metastatic Prostate Cancer

The phase III ACIS trial met its primary endpoint at 6 months, showing that apalutamide plus abiraterone acetate/prednisone extended radiographic progression-free survival vs abiraterone acetate/prednisone alone in patients with chemotherapy-naive metastatic castration-resistant prostate cancer. An ...

prostate cancer

Christopher Sweeney, MBBS, on Prostate Cancer: Analyzing Biomarkers, Ipatasertib Plus Abiraterone

Christopher Sweeney, MBBS, of Dana-Farber Cancer Institute, discusses phase III findings from the IPATential150 trial, which showed the effectiveness of ipatasertib plus abiraterone as first-line treatment in patients with metastatic castration-resistant prostate cancer vs placebo plus abiraterone. Analyses of biomarkers linked to the PI3K/AKT pathway, a subtype with a poor prognosis, further support this therapeutic option (Abstract 13).

Prostate Cancer

I Credit Cancer Research With Saving My Life

In December 2015, I thought I was through with cancer. I was diagnosed with prostate cancer in 2011 after a routine blood test showed that my prostate-specific antigen (PSA) level was high. I underwent prostatectomy, and although it was clear the cancer had breached the capsule of the prostate, for ...

prostate cancer

Linda G.W. Kerkmeijer, MD, PhD, on Prostate Cancer: Adding a Focal Boost to External-Beam Radiotherapy

Linda G.W. Kerkmeijer, MD, PhD, of the University Medical Center Utrecht and Radboud University Medical Center, discusses results from the phase III FLAME trial, which explored the question of whether biochemical disease–free survival can be improved by adding a focal boost to the intraprostatic lesion in whole-gland external-beam radiotherapy for patients with intermediate- and high-risk prostate cancers (Abstract 126).

Prostate Cancer

Increase in Metastatic Prostate Cancer Diagnoses in the United States After Reduction in PSA Screening

Reduced levels of screening for prostate cancer using prostate-specific antigen (PSA) testing correspond with recent increases in the diagnosis of metastatic disease in the United States, according to a study that will be presented by Vidit Sharma, MD, and colleagues at the 2021 Genitourinary...

Prostate Cancer

Long-Term Quality of Life With Ultrahypofractionated vs Conventionally Fractionated Radiotherapy for Prostate Cancer

As reported in The Lancet Oncology by Fransson et al, analysis of patient-reported quality of life in the Scandinavian phase III HYPO-RT-PC trial showed no significant differences at up to 6 years of follow-up between patients receiving ultrahypofractionated radiotherapy vs conventionally...

Prostate Cancer

Addition of Intraprostatic Focal Boost to External-Beam Radiotherapy in Localized Prostate Cancer

As reported in the Journal of Clinical Oncology by Kerkmeijer et al, the Dutch/Belgian phase III FLAME trial has shown that the addition of a focal boost to the intraprostatic lesion in patients receiving external-beam radiotherapy (EBRT) improved biochemical disease–free survival—without worsening ...

Prostate Cancer

Shorter Radiation Course for Men With Advanced Prostate Cancer: Safety and Efficacy

A study led by researchers from the University of California, Los Angeles (UCLA) Jonsson Comprehensive Cancer Center found that shortening a traditional 45-day course of radiation to a 5-day course delivered in larger doses was safe and as effective as conventional radiation for men with high-risk...

Prostate Cancer

Relugolix for Advanced Prostate Cancer

On December 18, 2020, relugolix was approved for the treatment of adult patients with advanced prostate cancer. Relugolix is the first oral gonadotropin-releasing hormone (GnRH) receptor antagonist to be approved in this setting.1,2 Supporting Efficacy Data Approval was based on findings in the...

Prostate Cancer

Variation in Active Surveillance for Low-Risk Prostate Cancer in the United States

In a cohort study reported in JAMA Network Open, Washington et al found that the use of active surveillance or watchful waiting for patients with low-risk prostate cancer in the United States varied by region, but not according to factors such as Black race or county-level socioeconomic status. As...

Lung Cancer
Prostate Cancer
Immunotherapy
Genomics/Genetics

FDA Pipeline: Two Reviews in NSCLC, Plus Prescribing Information Update for Darolutamide

Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to lorlatinib in ALK-positive non–small cell lung cancer (NSCLC) and Breakthrough Therapy designation to the combination of tiragolumab plus atezolizumab in NSCLC with high PD-L1 expression. The FDA also updated the...

Prostate Cancer

Does Following a Mediterranean Diet Reduce the Risk of Disease Progression in Men on Active Surveillance for Prostate Cancer?

In a study examining the effect of a Mediterranean diet in relation to prostate cancer progression in men on active surveillance, researchers found that men with localized prostate cancer who reported a baseline dietary pattern that more closely follows the key principles of a Mediterranean-style...

Prostate Cancer
Symptom Management

Study Finds Inflammation Due to Androgen-Deprivation Therapy May Contribute to Fatigue, Other Side Effects in Men With Prostate Cancer

Many patients with prostate cancer are treated with androgen-deprivation therapy. However, patients receiving androgen-deprivation therapy often experience higher levels of fatigue, depression, and cognitive impairment. In a new study published by Hoogland et al in the journal Cancer, researchers...

Prostate Cancer
Genomics/Genetics

Multiancestry Meta-analysis of Prostate Cancer Genetics

A research team has published findings from a study that brought together data from genomic prostate cancer studies. Including more than 200,000 men of European, African, Asian, and Hispanic ancestry from around the world, the study is reportedly the largest, most diverse genetic analysis ever...

Prostate Cancer

Addition of Capivasertib to Docetaxel/Prednisolone in Patients With Metastatic Castration-Resistant Prostate Cancer

In the phase II ProCAID study reported in the Journal of Clinical Oncology, Crabb et al found that the addition of the pan-AKT inhibitor capivasertib to docetaxel and prednisolone did not significantly improve progression-free survival in patients with metastatic castration-resistant prostate...

Prostate Cancer

FDA Approves First Oral Hormone Therapy for Treating Advanced Prostate Cancer

Today, the U.S. Food and Drug Administration (FDA) approved relugolix (Orgovyx) for the treatment of adult patients with advanced prostate cancer.  “Today’s approval marks the first oral drug in this class and it may eliminate some patients’ need to visit the clinic for treatments that require...

Prostate Cancer

Radiation Facility Volume and Overall Survival in Patients With Node-Positive Prostate Cancer Treated With External-Beam Radiation Therapy and Androgen-Deprivation Therapy

In a National Cancer Database analysis reported in JAMA Network Open, Patel et al found that treatment at facilities with high vs low radiation case volumes was associated with improved overall survival in men with node-positive prostate cancer receiving curative-intent external-beam radiation...

Prostate Cancer

Meta-analysis of Radiotherapy With Adjuvant vs Neoadjuvant Androgen-Deprivation Therapy for Localized Prostate Cancer

In an individual patient meta-analysis reported in the Journal of Clinical Oncology, Daniel E. Spratt, MD, and colleagues found that adjuvant androgen-deprivation therapy (ADT) was associated with improved progression free-survival vs neoadjuvant ADT in patients receiving radiotherapy for localized ...

Prostate Cancer

Emerging Data on PARP Inhibition in Prostate Cancer

Prostate cancer has lagged behind other solid tumors with regard to molecularly targeted therapy and precision medicine, with no targeted therapies approved specifically in prostate cancer, but that has changed with the recent approval in 2020 of a PARP (poly [ADP-ribose] polymerase) inhibitor for...

Prostate Cancer
Genomics/Genetics

Interference of Clonal Hematopoiesis in DNA Repair Genes With Prostate Cancer Plasma Cell-Free DNA Testing

In a study reported in JAMA Oncology, Jensen and colleagues found that clonal hematopoiesis of indeterminate potential (CHIP) involving DNA repair genes can interfere with prostate cancer plasma cell-free DNA testing used to determine eligibility for poly (ADP-ribose) polymerase (PARP) inhibitor...

Prostate Cancer
Genomics/Genetics

Study Shows Regional Variation in Genomic Testing for Men With Prostate Cancer

A study published by Michael S. Leapman, MD, and colleagues in JAMA Oncology found substantial regional variation in the use of genomic testing for prostate cancer, raising questions about access and other factors that might promote rapid adoption of new cancer technologies. “Little was known...

Prostate Cancer

Association of Fall and Fracture Risk With Androgen Receptor Inhibitor Therapy for Prostate Cancer

In a systematic review and meta-analysis reported in JAMA Network Open, Myint et al found that androgen receptor inhibitor therapy for prostate cancer was associated with an increased risk of both falls and fractures. Study Details The meta-analysis included 11 randomized trials reported through...

Prostate Cancer

FDA Approves Gallium-68 PSMA-11 for PSMA-Targeted PET Imaging in Prostate Cancer

On December 1, the U.S. Food and Drug Administration (FDA) approved gallium-68 PSMA-11—the first drug for positron-emission tomography (PET) imaging of prostate-specific membrane antigen (PSMA)-positive lesions in men with prostate cancer. Gallium-68 PSMA-11 is indicated for patients with suspected ...

Prostate Cancer

Darolutamide Improves Overall Survival in Nonmetastatic, Castration-Resistant Prostate Cancer: ARAMIS Trial

As reported in The New England Journal of Medicine by Karim Fizazi, MD, of the Institut Gustave Roussy, University of Paris-Saclay, Villejuif, and colleagues, the phase III ARAMIS trial has shown significantly prolonged overall survival with darolutamide vs placebo in men with nonmetastatic...

Prostate Cancer

A Urologic Surgeon Assesses the Current State of Prostate Cancer

Despite decades of research, multinational clinical trials, regular guideline updates by the U.S. Preventive Services Task Force, and coordinated efforts by ASCO and other major oncology organizations, the management strategy for prostate cancer remains controversial. To keep the oncology community ...

Prostate Cancer

Fluciclovine PET Imaging Benefits Radiotherapy Treatment Planning Compared With Conventional Imaging in Prostate Cancer

The addition of the radiotracer fluciclovine to positron-emission tomography (PET) imaging for radiotherapy treatment planning led to superior failure-free survival compared with conventional imaging in men with prostate cancer who had undergone radical prostatectomy and were experiencing biologic ...

Prostate Cancer

Adoption of Hypofractionated Radiation Therapy After Change in Prostate Cancer Clinical Pathway

In a study reported in JCO Oncology Practice, Schad et al found that modifying the prostate cancer clinical pathway in an integrated oncology network to designate moderately hypofractionated external-beam radiotherapy (mHF-EBRT) as the recommended curative EBRT monotherapy in low- and...

Prostate Cancer

Adjuvant vs Neoadjuvant Androgen-Deprivation Therapy With Radiotherapy for Prostate Cancer

Sequencing of androgen-deprivation therapy with radiotherapy has a significant impact on long-term outcomes in localized prostate cancer, according to data presented during the virtual edition of the 2020 American Society for Radiation Oncology (ASTRO) Annual Meeting.1 Pooled individual patient...

Prostate Cancer

No Biochemical Progression-Free Survival Benefit With Adjuvant vs Salvage Radiotherapy After Radical Prostatectomy for Prostate Cancer

As reported in The Lancet by Christopher C. Parker, MD, of Royal Marsden NHS Foundation Trust, Sutton, United Kingdom, and colleagues, initial findings in the phase III RADICALS-RT trial have shown no biochemical progression-free survival benefit with adjuvant radiotherapy vs a policy of salvage...

Prostate Cancer
Genomics/Genetics

FDA Expands Approval of Companion Diagnostic for Olaparib in Prostate Cancer

On November 9, the U.S. Food and Drug Administration (FDA) approved FoundationOne Liquid CDx to be used as a companion diagnostic for olaparib. As a companion diagnostic, FoundationOne Liquid CDx will use a blood-based biopsy to identify patients with BRCA1, BRCA2, and/or ATM alterations and...

prostate cancer

Justin Oh, MD, on Prostate Cancer: Brachytherapy vs External-Beam Radiation Therapy

Justin Oh, MD, of the University of British Columbia, discusses results from the ASCENDE-RT trial, which compared a low-dose–rate brachytherapy boost to a dose-escalated external-beam boost for patients with high- and intermediate-risk prostate cancers (Abstract 127).

Prostate Cancer
Genomics/Genetics

Study Finds Distinct Genomic Alterations May Contribute to More Aggressive Prostate Cancer in Black Men

A study by Liu et al published in Molecular Cancer Research investigated why Black men appear to be more likely to develop aggressive prostate cancer than White men. Researchers found that prostate tumors in Black men had higher frequencies of distinct genetic alterations, which may contribute to...

Prostate Cancer

Development of a Clinical Prognostic Stage Group System for Nonmetastatic Prostate Cancer

As reported in JAMA Oncology, Dess et al have developed a novel clinical prognostic stage group system for nonmetastatic prostate cancer that “meets criteria set forth by the American Joint Committee on Cancer [AJCC] Precision Medicine Core committee… [and outperforms] the existing [AJCC] system...

prostate cancer

Daniel E. Spratt, MD, on Prostate Cancer: Relugolix vs Leuprolide

Daniel E. Spratt, MD, of the University of Michigan Rogel Cancer Center, discusses phase III results of the HERO trial, which suggested benefits of the oral medication relugolix: a substantially faster time to castration with longer duration, fewer cardiac events, and a faster return to normal testosterone levels compared with leuroplide (Abstract 35).

prostate cancer

Daniel E. Spratt, MD, on Prostate Cancer: Short-Term Adjuvant vs Neoadjuvant Hormone Therapy

Daniel E. Spratt, MD, of the University of Michigan Rogel Cancer Center, discusses a pooled analysis of two phase III trials showing adjuvant androgen-deprivation therapy (ADT) improves biochemical control and reduces distant metastasis when compared with a neoadjuvant approach, with no difference in late gastrointestinal or genitourinary toxicities. The analysis also showed that delaying radiotherapy to deliver neoadjuvant ADT did not benefit most patients (Abstract 32).

prostate cancer

Cynthia Menard, MD, on Prostate Cancer: PSMA PET- and CT-Guided Intensification of Radiotherapy

Cynthia Menard, MD, of the University of Montreal, discusses a study on the use of prostate-specific membrane antigen PET and CT to guide treatment. The scans led to high rates of new lesion detection and therefore intensification of radiotherapy for patients with prostate cancer, without an increase in side effects (Abstract 34).

prostate cancer

Paul Sargos, MD, on Prostate Cancer: Adjuvant or Early Salvage Radiotherapy Plus Androgen Deprivation

Paul Sargos, MD, of the Institut Bergonié, discusses phase III findings from the GETUG-AFU 17 study, which compared adjuvant vs early salvage radiotherapy, both combined with short-term androgen-deprivation therapy after radical prostatectomy for localized prostate cancer. Although lacking statistical power, the study showed no benefit in event-free survival for adjuvant compared to salvage radiotherapy (Abstract 33).

prostate cancer

Neha Vapiwala, MD, on Prostate Cancer: Imaging and the Decision to Treat With Radiation

Neha Vapiwala, MD, of the University of Pennsylvania, who served as a discussant for LBA1, summarizes her review of this study of patients with prostate cancer who had biochemical recurrence in the post-prostatectomy setting, who were candidates for salvage radiotherapy, and who received either conventional imaging or PET scans to help determine the course of treatment.

Breast Cancer
Gynecologic Cancers
Prostate Cancer
Genomics/Genetics

FDA Approves Companion Diagnostic for Three Targeted Therapies for Advanced Ovarian, Breast, and Non–Small Cell Lung Cancers

On October 27, the U.S. Food and Drug Administration (FDA) approved the FoundationOne Liquid CDx test for three new companion diagnostic indications to help match patients who may benefit from treatment with specific FDA-approved targeted therapies. The new indications are for alpelisib (Piqray) in ...

Prostate Cancer

Fluciclovine PET Imaging vs Conventional Imaging in Prostate Cancer

The addition of the radiotracer fluciclovine to positron-emission tomography (PET) imaging for treatment planning led to superior failure-free survival compared with conventional imaging in men with prostate cancer who had undergone radical prostatectomy and were experiencing biologic recurrence of ...

Prostate Cancer

Ipatasertib/Abiraterone Combination Shows Potential in Metastatic Castration-Resistant Prostate Cancer With PTEN Loss

Ipatasertib plus abiraterone plus prednisone achieved significantly superior radiographic progression–free survival and antitumor activity compared with placebo plus abiraterone plus prednisonein patients with metastatic castration-resistant prostate cancer and PTEN loss, according to the results...

Prostate Cancer

Olaparib Improves Outcomes in Metastatic Castration-Resistant Prostate Cancer With BRCA1/2 Alterations

The PARP inhibitor olaparib reduced the risk of death by 31% compared with a second hormonal treatment (enzalutamide or abiraterone) in men with metastatic castration-resistant prostate cancer characterized by BRCA1, BRCA2, or ATM mutations, in the final analysis of the phase III PROfound trial...

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