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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...

Lung Cancer
Kidney Cancer
Leukemia
Solid Tumors
Gastroesophageal Cancer
Gastrointestinal Cancer
Pancreatic Cancer
Prostate Cancer
Genomics/Genetics
Immunotherapy

FDA Pipeline: Priority Reviews in EGFR-Mutant Lung Cancer, Advanced Renal Cell Carcinoma; Fast Track Designations in CLL and Solid Tumors

Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to treatments for EGFR-mutant lung cancer and advanced renal cell carcinoma; granted Fast Track designation to agents in chronic lymphocytic leukemia (CLL) and locally advanced or metastatic solid tumors; and more....

Prostate Cancer

Adjuvant vs Salvage Radiotherapy Plus Short-Term ADT After Radical Prostatectomy for Localized Prostate Cancer

As reported in The Lancet Oncology by Sargos et al, the French phase III GETUG-AFU 17 trial has shown no event-free survival benefit for adjuvant radiotherapy vs salvage radiotherapy—both with short-term androgen-deprivation therapy (ADT)—after radical prostatectomy in men with localized prostate...

Prostate Cancer

Adjuvant vs Early Salvage Radiotherapy After Radical Prostatectomy in High-Risk Prostate Cancer

In a phase III noninferiority trial (RAVES) reported in The Lancet Oncology, Kneebone et al found that salvage radiotherapy did not meet noninferiority criteria for biochemical progression vs adjuvant radiotherapy, but was associated with nearly identical biochemical control rates and reduced...

Prostate Cancer

Biochemical Progression-Free Survival With Adjuvant vs Salvage Radiotherapy After Radical Prostatectomy: RADICALS-RT Trial

As reported in The Lancet by Christopher C. Parker, MD, and colleagues, initial findings in the phase III RADICALS-RT trial have shown no biochemical progression-free survival benefit and no difference in freedom from nonprotocol hormone therapy with adjuvant radiotherapy vs salvage radiotherapy...

Prostate Cancer
Supportive Care

New Study Finds Low Rates of Bone Mineral Density Testing in Men Treated With ADT for Prostate Cancer

A report published by Hu et al in JNCCN—Journal of the National Comprehensive Cancer Network found the rate of bone mineral density testing in people with prostate cancer undergoing androgen-deprivation therapy (ADT) has improved in recent years, but remains low. ADT is considered a cornerstone of...

Prostate Cancer

Rucaparib Produces Durable Responses in Previously Treated Metastatic Castration-Resistant Prostate Cancer

As reported in the Journal of Clinical Oncology by Wassim Abida, MD, PhD, of Memorial Sloan Kettering Cancer Center, and colleagues, the phase II TRITON2 trial has shown that the poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib produced durable responses in patients with previously treated...

Prostate Cancer

Meta-analysis of Adjuvant vs Early Salvage Radiotherapy in Localized and Locally Advanced Prostate Cancer

In a systematic review and meta-analysis reported in The Lancet, Claire L. Vale, PhD, and colleagues found that immediate adjuvant radiotherapy did not improve event-free survival vs early salvage radiotherapy in men with intermediate-risk or high-risk localized or locally advanced prostate cancer...

Prostate Cancer

Long-Term Impact of ADT in Favorable vs Unfavorable Intermediate-Risk Prostate Cancer

In an analysis of long-term data from NRG Oncology’s RTOG 9408 trial reported in JAMA Network Open, Zumsteg et al found that patients with favorable vs unfavorable intermediate-risk prostate cancer had improved overall survival, and that androgen-deprivation therapy (ADT) vs no ADT was associated...

Prostate Cancer

Quality of Life With Cabazitaxel vs Abiraterone or Enzalutamide in Metastatic Prostate Cancer

In a quality-of-life analysis from the phase IV CARD trial reported in The Lancet Oncology, Karim Fizazi, MD, and colleagues found that cabazitaxel was associated with improved pain response, time to pain progression, and time to symptomatic skeletal events vs abiraterone or enzalutamide in...

Prostate Cancer

Overall Survival With Apalutamide in Nonmetastatic Castration-Resistant Prostate Cancer: Analysis From the SPARTAN Trial

As reported in European Urology by Matthew R. Smith, MD, and colleagues, the final analysis of phase III SPARTAN trial has shown significant prolongation of overall survival with apalutamide vs placebo in patients with nonmetastatic castration-resistant prostate cancer and prostate-specific antigen ...

prostate cancer

Nicholas D. James, PhD, MBBS, on Prostate Cancer: Abiraterone Acetate Plus Prednisolone for Hormone-Naive Disease

Nicholas D. James, PhD, MBBS, of The Institute of Cancer Research, London, discusses long-term STAMPEDE trial results that showed patients with metastatic, hormone-naive prostate cancer benefited from abiraterone acetate plus prednisolone in terms of overall and failure-free survival, as well as skeletal-related events (Abstract 611O).

Prostate Cancer

Overall Survival Analysis From PROfound Trial: Olaparib for Metastatic Castration-Resistant Prostate Cancer

As reported in The New England Journal of Medicine and during the ESMO Virtual Congress 2020 (Abstract 610O) by Maha Hussain, MD, FACP, FASCO, and colleagues, an overall survival analysis from the phase III PROfound trial has shown a significant benefit with olaparib vs physician’s choice of...

Prostate Cancer
CNS Cancers
Leukemia

FDA Pipeline: Designations in Prostate Cancer, Glioblastoma, and Pediatric Leukemia

Recently, the U.S. Food and Drug Administration (FDA) granted designations to agents for metastatic castration-resistant prostate cancer, recurrent glioblastoma, and pediatric acute myeloid leukemia. Fast Track Designation for EPI-7386 in Metastatic Castration-Resistant Prostate Cancer The FDA...

Prostate Cancer

Role of F-18–NaF PET/CT in Patients With Metastatic Castration-Resistant Prostate Cancer Treated With Enzalutamide

In a phase II study reported in the Journal of Clinical Oncology, Kyriakopoulos et al found that use of quantitative total bone imaging with fluorine-18 (F-18)–sodium fluoride (NaF) positron-emission tomography/computed tomography (PET/CT) helped identify heterogeneity of response in bone lesions...

Prostate Cancer

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

As reported in The New England Journal of Medicine by Karim Fizazi, MD, and colleagues, the phase III ARAMIS trial has shown significantly prolonged overall survival with darolutamide vs placebo in men with nonmetastatic castration-resistant prostate cancer. The previously reported primary analysis ...

Prostate Cancer
Immunotherapy

Combination Immunotherapy Benefits Subset of Patients With Advanced Prostate Cancer

Results from a phase II trial led by researchers at The University of Texas MD Anderson Cancer Center suggest that a combination of ipilimumab (anti–CTLA-4) plus nivolumab (anti–PD-1) can generate durable responses in a subset of patients with metastatic castration-resistant prostate cancer, an...

Prostate Cancer
Genomics/Genetics

Racial Differences in Genomic Profiles of Primary and Metastatic Prostate Cancer

In a letter to the editor published in The New England Journal of Medicine, Brandon A. Mahal, MD, and colleagues described genomic differences in prostate cancer in Black, White, and Asian men. Study Details The study involved next-generation sequencing data from patients who had been treated for...

Prostate Cancer

Efficacy of High-Intensity Ultrasound Ablation for Prostate Cancer

For some patients with prostate cancer, surgery and/or radiation are considered standard treatments. However, these procedures may cause side effects, including urinary incontinence or impotency. A recent study published by Abreu et al in the Journal of Urology demonstrated that high-intensity...

Prostate Cancer

PROfound Trial Evaluates Olaparib in Homologous Recombination Repair Gene–Mutant Prostate Cancer

In a phase III trial (PROfound) reported in The New England Journal of Medicine, Johann de Bono, MB, ChB, PhD, of the Institute of Cancer Research and Royal Marsden Hospital, London, and colleagues found that olaparib significantly improved progression-free survival vs hormonal therapy in patients...

Prostate Cancer

Metastatic Prostate Cancer: Sorting Through the Treatment Maze

The message still needs to get out that metastatic castration-sensitive prostate cancer should be treated with both androgen-deprivation therapy (ADT) and either docetaxel or an androgen receptor pathway inhibitor. In spite of “overwhelming” support for ADT plus abiraterone/prednisone,...

Prostate Cancer
COVID-19

Effect of Timing of Radiotherapy Relative to ADT on Overall Survival in Prostate Cancer

In a study reported in JAMA Oncology, Dee et al found that radiotherapy (RT) initiated at up to 6 months after the start of androgen-deprivation therapy (ADT) was not associated with poorer overall survival vs initiation before ADT in men with prostate cancer. The investigators observed that these...

Prostate Cancer

BRCA Study: Clinic Is Saving Men’s Lives in Israel

Uriya, age 49, visits Israel’s Rabin Medical Center for a cancer screening. On the surface, he shows no signs of disease. However, results from a study by David Margel, MD, PhD, revealed Uriya is living with prostate cancer at an early yet curable stage. Uriya carries the BRCA gene. Rabin Medical...

Prostate Cancer

Rucaparib in Metastatic Castration-Resistant Prostate Cancer With Deleterious BRCA Alterations

As reported in the Journal of Clinical Oncology by Abida and colleagues, the phase II TRITON2 trial has shown that rucaparib produces durable responses in patients with metastatic castration-resistant prostate cancer with deleterious BRCA1 or BRCA2 alterations. The trial supported the May 2020...

Prostate Cancer

Classification of Prostate Cancer Using Tests for Small Noncoding RNAs in Urinary Exosomes

In a study reported in the Journal of Urology, Wang et al found that tests for small noncoding RNAs isolated from urinary exosomes accurately distinguished patients with vs without prostate cancer and patients with low- vs intermediate- or high-risk disease.  Study Details The investigators...

Prostate Cancer

TITAN Trial: Apalutamide Adds to Options for Men With Metastatic Hormone-Sensitive Prostate Cancer

Androgen-deprivation therapy has been, and remains, the standard of care for patients with metastatic prostate cancer. Patients are often surprised to learn that was all we would do to control their disease and sometimes asked why they would not receive chemotherapy, as for other cancers. I would...

Prostate Cancer

Many Choices Now for Men With Metastatic Hormone-Sensitive Prostate Cancer: How to Decide?

Based on the recently published ENZAMET, ARCHES, and TITAN trials,1-3 we now have several choices of systemic combination therapies for men with metastatic hormone-sensitive prostate cancer. Today, men are faced with decisions of androgen-deprivation therapy alone or combinations with abiraterone,...

Prostate Cancer

Enzalutamide Improves Survival vs Standard First-LineTreatment in Hormone-Sensitive Metastatic Prostate Cancer

As reported inThe New England Journal of Medicine by Ian D. Davis, MBBS, PhD, FRACP, FAChPM, of Monash University and Eastern Health in Melbourne, and colleagues, the phase III ENZAMET trial has shown that the androgen receptor inhibitor enzalutamide improved progression-free and overall survival...

Prostate Cancer

Addition of Apalutamide to Androgen-Deprivation Therapy in Metastatic Castration-Sensitive Prostate Cancer

As reported in The New England Journal of Medicine by Kim N. Chi, MD, of BC Cancer and Vancouver Prostate Centre, and colleagues, the first analysis of the phase III TITAN trial has shown that the addition of apalutamide to androgen-deprivation therapy improved radiographic progression-free and...

Prostate Cancer

Nonmetastatic Castration-Resistant Prostate Cancer

Nonmetastatic castration-resistant prostate cancer arises in the subset of men with biochemically recurrent disease (ie, rising prostate-specific antigen [PSA] level after definitive therapy in the absence of metastases) who develop PSA progression after chronic exposure to androgen-deprivation...

Prostate Cancer

Phase III Study of AR Antagonist in Nonmetastatic Castration-Resistant Prostate Cancer

In the phase III ARAMIS trial reported in The New England Journal of Medicine,1 Karim Fizazi, MD, PhD, of the Institut Gustave Roussy, Universite Paris-Sud, Villejuif, France, and colleagues found that the androgen-receptor (AR) antagonist darolutamide significantly prolonged metastasis-free...

Prostate Cancer

Novel Indications and New Drugs for Castration-Resistant or Castrate-Sensitive Prostate Cancer

The past year has witnessed the U.S. Food and Drug Administration (FDA) approval of a number of drugs for treatment of patients with metastatic castrate-resistant prostate cancer or castrate-sensitive prostate cancer. Castrate-Resistant Prostate Cancer Olaparib: On May 19, 2020, olaparib...

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