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Prostate Cancer

Is Focal Therapy With MRI-Guided Focused Ultrasound Safe and Effective for Grade Group 2 or 3 Prostate Cancer?

In a phase IIb study reported in The Lancet Oncology, Ehdaie et al found that focal ablation with magnetic resonance imaging (MRI)-guided focused ultrasound successfully treated a high proportion of patients with grade group 2 or 3 prostate cancer. As stated by the investigators, “Men with grade...

Prostate Cancer

Cabozantinib and Atezolizumab for Patients With Progressive Metastatic Castration-Resistant Prostate Cancer Post–Hormonal Therapy

As reported in The Lancet Oncology by Neeraj Agarwal, MD, and colleagues, findings in the expansion cohort of the phase Ib COSMIC-021 trial indicate activity of the combination of cabozantinib and atezolizumab in patients with metastatic castration-resistant prostate cancer whose disease progressed ...

Prostate Cancer

William Catalona, MD, on the Evolution of Views Regarding Active Surveillance in Men With Low-Risk Prostate Cancer

William Catalona, MD, Professor of Urology at Northwestern University’s Feinberg School of Medicine, and past Principal Investigator on the Northwestern-based prostate SPORE, explained the evolution of his views regarding active surveillance in men with low-risk prostate cancer. Although...

Prostate Cancer

Rates of Active Surveillance Rising Among Men With Low-Risk Prostate Cancer but Still Suboptimal

Most men with low-risk prostate tumors now opt for active surveillance, but overtreatment remains a problem, according to data presented during the 2022 American Urological Association (AUA) Annual Meeting.1 A retrospective analysis of more than 20,000 patients with low-risk prostate cancer showed...

Prostate Cancer

Potential Association of the 2012 USPSTF Grade D Recommendation Against PSA Screening With Changes in Prostate Cancer–Specific Mortality

In a study reported in JAMA Network Open, Burgess et al found that the 2012 U.S. Preventive Services Task Force (USPSTF) Grade D recommendation against prostate-specific antigen (PSA) screening for all men appeared to be associated with ending of a trend of annual reductions in prostate...

Prostate Cancer
Genomics/Genetics

Differences in Germline Variant Spectrum Between Black and White Men With Prostate Cancer

In a study presented at the 2022 ASCO Annual Meeting (Abstract 10502) and simultaneously published in JCO Precision Oncology, Veda N. Giri, MD, and colleagues found that Black men with prostate cancer exhibited a lower frequency and narrower spectrum of germline pathogenic or likely pathogenic...

prostate cancer
genomics/genetics

Neal D. Shore, MD, on Germline Genetic Testing and Its Impact on Prostate Cancer Clinical Decision-Making

Neal D. Shore, MD, of the Carolina Urologic Research Center, discusses his study findings, showing that germline genetic testing influenced care for patients with prostate cancer. Men whose genetic test was positive for a pathogenic germline variant received more recommendations for changes to follow-up and treatment, and for testing and counseling of relatives, than did patients with negative or uncertain test results (Abstract 10500).  

prostate cancer

Alicia K. Morgans, MD, MPH, and Michael S. Hofman, MBBS, on Prostate Cancer: New Data on Lutetium-177–PSMA-617 (LuPSMA) vs Cabazitaxel

Alicia K. Morgans, MD, MPH, of Dana-Farber Cancer Institute, and Michael S. Hofman, MBBS, of Peter MacCallum Cancer Centre, University of Melbourne, discuss follow-up results on LuPSMA vs cabazitaxel in patients with metastatic castration-resistant prostate cancer progressing after docetaxel treatment. The findings suggest that LuPSMA is a suitable option for this population, with fewer adverse events, higher response rates, improved patient-reported outcomes, and similar overall survival compared with cabazitaxel (Abstract 5000).

prostate cancer

Alicia K. Morgans, MD, MPH, and Ian D. Davis, PhD, MBBS, on Prostate Cancer: Updated Overall Survival Outcomes With Enzalutamide

Alicia K. Morgans, MD, MPH, of Dana-Farber Cancer Institute, and Ian D. Davis, PhD, MBBS, of Monash University and Eastern Health, discuss the latest findings from ANZUP Cancer Trials Group’s ENZAMET cooperative group trial of enzalutamide in patients with metastatic hormone-sensitive prostate cancer. The results corroborate the benefit of enzalutamide with improved overall survival, and involve some exploratory subgroup analyses (Abstract LBA5004).

Prostate Cancer

AUA, ASTRO Release New Clinically Localized Prostate Cancer Guideline

Recently, the American Urological Association (AUA), in partnership with the American Society for Radiation Oncology (ASTRO), released the 2022 clinical practice guideline for the management of clinically localized prostate cancer. The guideline has been endorsed by the Society of Urologic Oncology ...

Prostate Cancer

Does Treatment With 5α-Reductase Inhibitors Impact the Risk of Dying of Prostate Cancer Among Men Without a Prior Diagnosis of the Disease?

In a Swedish study reported in JAMA Oncology, Björnebo et al found that longer use of 5α-reductase inhibitors (5-ARIs) for the treatment of benign prostatic hyperplasia was associated with a reduced risk of prostate cancer mortality among men without a prior diagnosis of prostate cancer. As stated...

Prostate Cancer
Symptom Management

Adverse Events Seen With Abiraterone or Enzalutamide Among Patients With Advanced Prostate Cancer

Men taking either of the two most common oral medications for advanced prostate cancer who had also undergone hormone therapy to treat their disease were at higher risk of serious metabolic or cardiovascular issues than patients who were receiving hormone therapy alone, according to findings...

Prostate Cancer

Addition of ADT and Pelvic Lymph Node Radiotherapy to Salvage Prostate Bed Radiotherapy After Prostatectomy

In a phase III trial (NRG Oncology/RTOG 0534 SPPORT) reported in The Lancet, Alan Pollack, MD, PhD, and colleagues found that both the addition of short-term androgen-deprivation therapy (ADT) and the addition of ADT and pelvic lymph node radiotherapy (PLNRT) to salvage prostate bed radiotherapy...

Prostate Cancer

Polygenic Score May Enable More Precise PSA Screening for Prostate Cancer

The use of a polygenic score incorporating variations in prostate-specific antigen (PSA) values that are not due to cancer may allow for more precise PSA screening, according to findings of a large genome-wide association study presented at the American Association for Cancer Research (AACR) Annual ...

Prostate Cancer

SWOG-1216: Orteronel vs Bicalutamide With ADT for Metastatic Hormone-Sensitive Prostate Cancer

As reported in the Journal of Clinical Oncology by Neeraj Agarwal, MD, and colleagues, the phase III SWOG-1216 trial showed no significant improvement in overall survival—the study’s primary endpoint—with orteronel plus androgen-deprivation therapy (ADT) vs bicalutamide plus ADT in patients with...

Prostate Cancer

Overall Survival in the ARCHES Trial: Addition of Enzalutamide to ADT for Metastatic Hormone-Sensitive Prostate Cancer

As reported in the Journal of Clinical Oncology by Andrew J. Armstrong, MD, ScM, and colleagues, the final overall survival analysis of the phase III ARCHES trial showed a significant benefit with the addition of enzalutamide to androgen-deprivation therapy (ADT) in patients with metastatic...

prostate cancer

Matthew R. Smith, PhD, MD, on Prostate Cancer: Phase III Data on Darolutamide, Androgen Deprivation, and Docetaxel

Matthew R. Smith, PhD, MD, of Massachusetts General Hospital Cancer Center, discusses overall survival findings from the ARASENS trial, which assessed the efficacy of the androgen receptor inhibitor darolutamide vs placebo in combination with androgen-deprivation therapy and docetaxel for patients with metastatic hormone-sensitive prostate cancer (Abstract 13).

gynecologic cancers
breast cancer
pancreatic cancer
prostate cancer
genomics/genetics

Timothy A. Yap, MBBS, PhD, on Ovarian, Breast, Pancreatic, and Prostate Cancers With Genetic Mutations: A First-in-Human Trial of AZD5305

Timothy A. Yap, MBBS, PhD, of The University of Texas MD Anderson Cancer Center, discusses results from the PETRA study, a first-in-class, first-in-human trial of the next-generation PARP1-selective inhibitor AZD5305 in patients with BRCA1/2, PALB2, or RAD51C/D mutations in advanced or metastatic ovarian cancer, HER2-negative breast cancer, pancreatic, or prostate cancer. Target engagement was demonstrated across all dose levels, and antitumor activity was observed in selected tumor and molecular subtypes.

prostate cancer

PSMA-Targeted Radioligand Therapy for Metastatic Castration-Resistant Prostate Cancer

In this video, Drs. Celestia (Tia) Higano, Julie Graff, and Neal Shore discuss the role of prostate-specific membrane antigen (PSMA)-targeted radioligand therapy in the treatment of metastatic castration-resistant prostate cancer. The patient is an 81-year-old man with 13-year history of prostate cancer who had received multiple prior lines of treatment for his metastatic disease, but no prior taxane. After his PSA rose again, he opted to travel abroad for lutetium (Lu-177) PSMA therapy, since he was not eligible for trials in the United States. The faculty discuss the VISION trial and the current and future role of PSMA-targeted radioligand therapy in prostate cancer. Editor’s Note: This video was filmed prior to the FDA approval of Lu-177 PSMA radioligand therapy on March 23, 2022.

prostate cancer
genomics/genetics

First-Line Therapy for BRCA2-Mutated Metastatic Castration-Resistant Prostate Cancer

This is Part 3 of Updates in Prostate Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Celestia (Tia) Higano, Julie Graff, and Neal Shore discuss the first-line therapy for BRCA2-mutated metastatic castration-resistant prostate cancer. The patient is a 69-year-old man with new castration-resistant prostate cancer who was previously treated with androgen-deprivation therapy plus docetaxel for metastatic hormone-sensitive prostate cancer and has a known BRCA2 mutation. The faculty discuss their choices for first-line therapy for this patient, reviewing the current NCCN recommendations, the role of PARP inhibitors, and recent data from the PROpel and MAGNITUDE trials.

prostate cancer

Doublet or Triplet Androgen-Deprivation Therapy Options for Metastatic Prostate Cancer

This is Part 2 of Updates in Prostate Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Celestia (Tia) Higano, Julie Graff, and Neal Shore discuss doublet and triplet androgen-deprivation therapy options for metastatic prostate cancer. The patient is a 71-year-old man with metastatic prostate cancer, a PSA of 275, and a positive bone scan, who has begun to receive androgen-deprivation therapy. The faculty discuss what, if any, additional therapy they might add to this patient’s treatment regimen, weighing the current doublet and triplet combination options for metastatic hormone-sensitive prostate cancer. They review the results of the recent PEACE-1 and ARASENS trials and emphasize the importance of assessing bone mineral density and of encouraging genetic counseling for these patients.

prostate cancer

Elderly Patient With Metastatic Hormone-Sensitive Prostate Cancer

This is Part 1 of Updates in Prostate Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. �In this video, Drs. Celestia (Tia) Higano, Julie Graff, and Neal Shore discuss the management of metastatic hormone-sensitive prostate cancer in elderly patients. The patient is a fit 88-year-old man with a history of localized prostate cancer who was originally treated with stereotactic body radiation therapy and is reluctant to start androgen-deprivation therapy for his metastatic disease due to the potential side effects. The faculty discuss the importance of counseling patients about side effects of treatment and when to consider androgen-deprivation therapy rather than metastasis-directed therapy alone, reviewing the results of the phase III HERO trial.

Prostate Cancer

High-Dose Radiotherapy With Short- vs Long-Term Androgen Deprivation in Localized Prostate Cancer

As reported in The Lancet Oncology by Zapatero et al, 10-year results of the Spanish phase III DART 01/05 trial did not support the 5-year findings of significantly improved biochemical disease–free, metastasis-free, and overall survival with long-term vs short-term androgen deprivation plus...

Prostate Cancer

Less Prostate Cancer Screening Reduces Overdiagnosis but May Miss Aggressive Cases

Over the past 15 years, public health authorities have downgraded recommendations for the prostate-specific antigen (PSA) test as a screening tool to reduce the overdiagnosis and overtreatment of men with low-grade prostate cancer. Researchers from Weill Cornell Medicine have found that while these ...

Prostate Cancer

PEACE-1 Trial: Addition of Abiraterone Plus Prednisone to ADT and Docetaxel in De Novo Metastatic Castration-Sensitive Prostate Cancer

As reported in The Lancet by Fizazi et al, the phase III PEACE-1 trial has shown that the addition of abiraterone and prednisone to androgen-deprivation therapy (ADT) and docetaxel improved radiographic progression-free survival and overall survival in patients with de novo metastatic...

Prostate Cancer

Accounting for Genetic Factors That Cause Normal Variations in PSA Levels May Improve the Accuracy of Prostate Cancer Detection

The accuracy of prostate-specific antigen (PSA) screening for prostate cancer could be improved by accounting for genetic factors that cause changes in PSA levels not associated with cancer, according to data presented by Kachuri et al during the American Association for Cancer Research (AACR)...

prostate cancer

Julio M. Pow-Sang, MD, on Nonmetastatic Prostate Cancer: Update on Best Management Practices

Julio M. Pow-Sang, MD, of Moffitt Cancer Center, discusses the treatment landscape for localized prostate cancer and its heterogeneity, the critical importance of stratifying risk to determining treatment options, and the continued improvement of therapy in the field.

Prostate Cancer

Expert Point of View: Elisabeth I. Heath, MD, FACP, and Oliver Sartor, MD

Formal discussant of the ARASENS trial, Elisabeth I. Heath, MD, FACP, Professor of Oncology and Associate Center Director, Translational Sciences, at Karmanos Cancer Institute in Detroit, commented on the changing paradigm in prostate cancer treatment. “The narrative is changing to triplet therapy, ...

Prostate Cancer

Study Reports Modest Gain in Progression-Free Survival With Continued Enzalutamide in Advanced Prostate Cancer

Enzalutamide is a common first-line choice for patients with metastatic castration-resistant prostate cancer, but response in some patients eventually wanes and then patients are switched to a different treatment. According to the phase IIIb PRESIDE trial, reported at the 2022 ASCO Genitourinary...

Prostate Cancer

First-Line Olaparib Plus Abiraterone Extends Radiographic Progression-Free Survival in Men With Metastatic Castration-Resistant Prostate Cancer

The PARP inhibitor olaparib in combination with abiraterone demonstrated a statistically significant and clinically meaningful improvement in radiographic progression-free survival vs current standard-of-care abiraterone as a first-line treatment for patients with metastatic castration-resistant...

prostate cancer

Xin Gao, MD, on Prostate Cancer: Early-Phase Results on Bavdegalutamide

Xin Gao, MD, of Massachusetts General Hospital, discusses phase I/II findings on bavdegalutamide, an androgen receptor protein degrader, which showed clinical activity in heavily pretreated patients with metastatic castration-resistant prostate cancer who received one to two prior novel hormonal agents.

Prostate Cancer

Triplet Combination Improves Overall Survival in Metastatic Hormone-Sensitive Prostate Cancer

Triplet therapy with the oral androgen receptor inhibitor darolutamide plus docetaxel plus androgen-deprivation therapy significantly improved overall survival in patients with metastatic hormone-sensitive prostate cancer vs docetaxel plus androgen-deprivation therapy, according to results of the...

Prostate Cancer

Observation vs Screening Spinal MRI in Patients With Castration-Resistant Prostate Cancer and Asymptomatic Spinal Metastases

As reported in The Lancet Oncology by David Dearnaley, FRCR, and colleagues, the phase III PROMPTS study has shown that a strategy of routine screening with spinal magnetic resonance imaging (MRI) and preemptive treatment to prevent clinical spinal cord compression is likely not warranted in...

Prostate Cancer

FDA Approves Radioligand for Metastatic Castration-Resistant Prostate Cancer

On March 23, the U.S. Food and Drug Administration approved lutetium Lu-177 vipivotide tetraxetan (Pluvicto) for the treatment of adult patients with prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer who have been treated with androgen receptor...

prostate cancer
immunotherapy

Tanya B. Dorff, MD, on Prostate Cancer: Early Data on PSCA-Targeted CAR T-Cell Therapy

Tanya B. Dorff, MD, of City of Hope National Medical Center, discusses the first-in-human phase I findings showing that prostate stem cell antigen (PSCA) CAR T-cell therapy is feasible in patients with metastatic castration-resistant prostate cancer, with preliminary antitumor activity exhibited.

prostate cancer

Neil E. Fleshner, MD, MPH, on High-Risk Prostate Cancer: New Data on Abiraterone and Cabazitaxel

Neil E. Fleshner, MD, MPH, of the Princess Margaret Cancer Centre, discusses phase II results from the ACDC-RP trial, which indicate a significant tumor response to neoadjuvant abiraterone acetate plus prednisone and leuprolide, with or without cabazitaxel, in patients with high-risk prostate cancer. Those who exhibited either a complete response or minimal residual disease experienced higher rates of progression-free survival. According to Dr. Fleshner, genomic efforts are underway to determine predictors of response.

Prostate Cancer

All-Cause Mortality After Adjuvant vs Early Salvage Radiation Therapy Following Radical Prostatectomy for pN1 Prostate Cancer

In a study in a German cohort reported in the Journal of Clinical Oncology, Tilki et al found that adjuvant radiation therapy was associated with reduced all-cause mortality vs early salvage radiation therapy after radical prostatectomy among men with pN1 prostate cancer. The benefit increased with ...

Bladder Cancer
Kidney Cancer
Prostate Cancer
Immunotherapy

Genitourinary Oncology 2021–2022 Almanac

The past year has witnessed tremendous advances in genitourinary oncology. I am pleased to review these findings in this year’s Genitourinary Oncology Almanac from The ASCO Post. I hope that you will find this roadmap helpful in highlighting a selection of these exciting developments. Checkpoint...

Prostate Cancer

Study Reports Modest Gain in Progression-Free Survival With Continued Enzalutamide in Advanced Prostate Cancer

Enzalutamide is a common first-line choice for patients with metastatic castration-resistant prostate cancer, but response in some patients eventually wanes and then patients are switched to a different treatment. According to the phase IIIb PRESIDE trial, reported at the 2022 ASCO Genitourinary...

Prostate Cancer

Expert Point of View: Elisabeth I. Heath, MD, FACP, and Oliver Sartor, MD

Formal discussant of the ARASENS trial, Elisabeth I. Heath, MD, FACP, Professor of Oncology and Associate Center Director, Translational Sciences, at Karmanos Cancer Institute in Detroit, commented on the changing paradigm in prostate cancer treatment. “The narrative is changing to triplet therapy, ...

Prostate Cancer

Triplet Combination of Darolutamide, Docetaxel, and Androgen-Deprivation Therapy Extends Survival in Metastatic Hormone-Sensitive Prostate Cancer

Triplet therapy with the oral androgen receptor inhibitor darolutamide plus docetaxel plus androgen-deprivation therapy significantly improved overall survival in patients with metastatic hormone-sensitive prostate cancer vs docetaxel plus androgen-deprivation therapy, according to results of the...

Prostate Cancer

Expert Point of View: Celestia S. Higano, MD

MAGNITUDE is challenging from a statistical point of view,” said formal discussant Celestia S. Higano, MD, currently Adjunct Professor, Department of Urologic Sciences at the University of British Columbia, Vancouver, Canada, and formerly of Fred Hutchinson Cancer Research Center in Seattle....

Prostate Cancer
Genomics/Genetics

PARP Inhibitor Plus Abiraterone Benefits Subgroups of Patients With Metastatic Castration-Resistant Prostate Cancer

The combination of the poly (ADP-ribose) polymerase (PARP) inhibitor niraparib plus abiraterone acetate and prednisone as first-line therapy significantly improved radiographic progression-free survival vs abiraterone and placebo alone in men with metastatic castration-resistant prostate cancer...

Prostate Cancer

Addition of Ipatasertib to Abiraterone Plus Prednisolone Improves Radiographic Progression–Free Survival in Metastatic Castration-Resistant Prostate Cancer With PTEN Loss

In a phase III trial (IPATential150) reported in The Lancet, Christopher Sweeney, MD, of Dana-Farber Cancer Institute, and colleagues, found that the addition of the AKT inhibitor ipatasertib to abiraterone and prednisolone produced a significant improvement in radiographic progression-free...

Prostate Cancer

Shorter-Course Radiation Therapy: A New Practice Standard After Prostatectomy?

Hypofractionated radiotherapy to the prostate bed proved to be noninferior to conventionally fractionated radiotherapy after prostatectomy regarding gastrointestinal and genitourinary side effects, according to the results of the phase III NRG Oncology GU003 trial, presented at the 2021 American...

Prostate Cancer

STAMPEDE: In Nonmetastatic Castration-Sensitive Prostate Cancer, Abiraterone Added to Androgen-Deprivation Therapy Improves Survival

The addition of 2 years of abiraterone acetate plus prednisolone (AAP) to androgen-deprivation therapy improves metastasis-free survival and overall survival compared with androgen-deprivation therapy alone in men with nonmetastatic castration-sensitive prostate cancer, according to a primary...

Prostate Cancer

Expert Point of View: Eleni Efstathiou, MD

Invited discussant of the PEACE-1 trial, Eleni Efstathiou, MD, of the Houston Methodist Cancer Center and Athens Medical Center, Greece, reminded listeners: “Androgen signaling inhibition is the prevailing therapeutic strategy in advanced prostate cancer, with reproducible outcomes. Many studies...

Prostate Cancer

PEACE-1: Abiraterone Plus Androgen-Deprivation Therapy and Docetaxel Boosts Survival in Metastatic Castration-Sensitive Prostate Cancer

The addition of abiraterone acetate plus prednisone on top of androgen-deprivation therapy plus docetaxel improved survival in patients with de novo metastatic castration-sensitive prostate cancer vs androgen-deprivation therapy plus docetaxel alone. These results were from the phase III PEACE-1...

Prostate Cancer

Maintained Benefit of Apalutamide Plus Androgen-Deprivation Therapy Shown in Metastatic Castration-Sensitive Prostate Cancer

As reported in the Journal of Clinical Oncology by Kim N. Chi, MD, of BC Cancer and Vancouver Prostate Centre, and colleagues, the final overall survival analysis of the phase III TITAN trial showed significant benefit of apalutamide plus androgen-deprivation therapy vs placebo plus...

Prostate Cancer

Expert Point of View: Mary-Ellen Taplin, MD

Invited discussant of the VISION trial, Mary-Ellen Taplin, MD, of Dana-Farber Cancer Institute, Boston, commented on the study, noting that she was a co-investigator of the trial. “Patients with metastatic castration-resistant prostate cancer have a number of treatment options. There are 10...

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