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prostate cancer
issues in oncology

Peter C. Black, MD, on Prostate Cancer Health-Care Disparities: Expert Perspective

Peter C. Black, MD, of the Vancouver Prostate Centre, University of British Columbia, reviews three studies on early detection and treatment of Black patients with prostate cancer: a large-scale analysis of genomic profiling; the use of PSA screening; and integrating a patient-specific genomic classifier to improve risk classification and treatment recommendations for Black men (Abstracts 5003, 5004, and 5005).

Prostate Cancer

All-Cause Mortality Risk With Adjuvant vs Early Salvage Radiotherapy After Radical Prostatectomy

In a retrospective cohort study reported in the Journal of Clinical Oncology, Tilki et al found that adjuvant radiotherapy was associated with reduced risk for all-cause mortality vs early salvage radiotherapy among men at high risk for disease recurrence following radical prostatectomy. As stated...

prostate cancer

Karim Fizazi, MD, PhD, on Prostate Cancer: Abiraterone Acetate, Prednisone, and Radiotherapy in Metastatic Disease

Karim Fizazi, MD, PhD, of Institut Gustave Roussy, discusses first results from the phase III PEACE1 trial, which showed that abiraterone plus androgen-deprivation therapy and docetaxel improves radiographic progression-free survival in men with de novo metastatic prostate cancer (Abstract 5000).

Prostate Cancer

Novel PSMA-Targeted Radiotherapy Improves Radiographic Progression-Free and Overall Survival in Metastatic Prostate Cancer

Lutetium-177–PSMA-617 (Lu-177–PSMA-617)—an investigational radioligand therapy—significantly improved radiographic progression-free survival and overall survival when added to standard of care compared with standard of care alone for men with metastatic castration-resistant prostate cancer whose...

prostate cancer

Michael J. Morris, MD, on Prostate Cancer: LuPSMA in the Metastatic Setting

Michael J. Morris, MD, of Memorial Sloan Kettering Cancer Center, discusses phase III results of the VISION study, which showed that lutetium-177–PSMA-617 (LuPSMA), a targeted radioligand therapy, plus standard-of-care treatment improves radiographic progression-free survival and extends overall survival compared with standard of care alone in men with metastatic castration-resistant prostate cancer (Abstract LBA4).

Prostate Cancer

FDA Approves Piflufolastat F-18 Injection, a PSMA PET Imaging Agent, for the Detection of Metastatic or Recurrent Prostate Cancer

On May 27, the U.S. Food and Drug Administration (FDA) approved piflufolastat F-18 injection (Pylarify), an F-18–labeled prostate-specific membrane antigen (PSMA)-targeted positron-emission tomography (PET) imaging agent, to identify suspected metastasis or recurrence of prostate cancer. This is...

Leukemia
Prostate Cancer

Cancer Has Taught Me to Live With Purpose

I have had two life-threatening cancers over the past 3 decades and can say without equivocation that there is never a good time to get cancer. My first cancer diagnosis happened in 1992, just weeks after I had accepted the position of Chief Executive Officer of Hughes Electronics. The job meant a...

Prostate Cancer

Fluciclovine F-18 PET/CT vs Conventional Imaging Alone in Guiding Postsurgery Salvage Radiotherapy for Prostate Cancer

In a single-institution phase II/III trial (EMPIRE-1) reported in The Lancet, Ashesh B. Jani, MD, and colleagues found that use of fluciclovine F-18 positron-emission tomography/computed tomography (PET/CT) in addition to conventional imaging to guide postprostatectomy salvage radiotherapy was...

Prostate Cancer

2021 Genitourinary Cancers Symposium: Advancements in the Care of Older Adults With Prostate Cancer

The 2021 Genitourinary (GU) Cancers Symposium was held in a virtual format on February 11–13 and featured the latest developments in the understanding and treatment of genitourinary cancers. The impact of prostate cancer therapies on outcomes in older adults continues to be a growing area of...

Prostate Cancer

Increased PSA Screening Linked to Lower Risk of Advanced Prostate Cancer at Diagnosis and Death From the Disease in Younger Black Patients

Younger Black men undergoing frequent prostate-specific antigen (PSA) screening appear to have both a lower risk of metastasis at the time of prostate cancer diagnosis and of fatal disease, according to data from an observational study by Qiao et al presented at a presscast in advance of the 2021...

Prostate Cancer

Apalutamide in Metastatic Castration-Sensitive Prostate Cancer: Final Overall Survival Analysis of the TITAN Trial

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

Prostate Cancer
Issues in Oncology

Prospective Study Explores Prostate Cancer and Treatment Outcomes By Race

A study designed to enroll an equal number of Black and White men with advanced prostate cancer confirmed key findings that have been evident in retrospective analyses and suggest potential new avenues for treating Black patients who disproportionately die of the disease. Researchers at Duke Cancer ...

Prostate Cancer

Variations in Testing and Treatment Across Medical Specialties for Men Initiating Active Surveillance for Prostate Cancer

In a study reported in JCO Oncology Practice, Lai et al found that although the majority of men who have initiated active surveillance for prostate cancer are followed by urologists, some are managed by physicians in other specialties, and that testing and subsequent treatment patterns vary across...

Issues in Oncology
Bladder Cancer
Prostate Cancer

YouTube Videos on Bladder Cancer: Study Focuses on Quality of Content

Social media platforms are valuable tools for educating patients about serious health topics, but they can also spread false and biased information with potentially harmful results, according to recent research published by Stacy Loeb, MD, MSc, and colleagues in European Urology. Researchers...

Breast Cancer
Lung Cancer
Prostate Cancer

Safety of Stereotactic Body Radiotherapy for Patients With Multiple Metastases

In the phase I NRG-BR001 trial reported in JAMA Oncology, Chmura et al found that stereotactic body radiotherapy (SBRT) could be used safely to treat multiple metastases in patients with breast, lung, and prostate cancers.   Study Details The trial was conducted within a consortium of North...

Kidney Cancer
Bladder Cancer
Prostate Cancer
Immunotherapy

Genitourinary Oncology Highlights 2020–2021 Almanac

Landmark changes in the treatment of genitourinary cancers have occurred over the past year, as summarized in this year’s Genitourinary Oncology Almanac from The ASCO Post. Starting with our area of focus, metastatic renal cell carcinoma, the saga continues with two more positive phase III trials...

Prostate Cancer
Genomics/Genetics

Effect of Genomic Prostate Score Testing on Choice of Active Surveillance in a Predominantly Black Patient Population

In the ENACT study, reported in the Journal of Clinical Oncology, Murphy et al found that use of the 12-gene Genomic Prostate Score (GPS) in a predominantly Black patient population with relatively low-risk prostate cancer tended to be associated with reduced selection of active...

Pancreatic Cancer
Hepatobiliary Cancer
Colorectal Cancer
Breast Cancer
Skin Cancer
Lung Cancer
Prostate Cancer
Issues in Oncology

Estimated Shifts in Cancer Incidence and Death Over Next 2 Decades

In the next 2 decades, rankings of incidence and death across cancer types in the United States will undergo important changes, according to new research published by Lola Rahib, PhD, and colleagues in JAMA Network Open. The study estimates that pancreatic cancer is on course to become the...

Prostate Cancer

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...

Prostate Cancer

Novel Decision-Making Tool for Androgen-Deprivation Therapy for Patients With Prostate Cancer

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...

Prostate Cancer
Genomics/Genetics

Mutations in CTCs May Predict Clinical Outcomes in Patients With Metastatic Castration-Resistant Prostate Cancer

Various genetic alterations in circulating tumor cells (CTCs) were associated with clinical outcomes and resistance to hormone therapy in patients with metastatic castration-resistant prostate cancer, according to research published by Gupta et al in Molecular Cancer Research. Although only a...

Colorectal Cancer
Breast Cancer
Prostate Cancer

Does Consumption of Ultra-Processed Food and Drink Increase Colorectal Cancer Risk?

Consumption of ultra-processed food and drink could increase the risk of developing colorectal cancer. This was the conclusion of a large study published by Romaguera et al in Clinical Nutrition based on questionnaires about food behaviors completed by around 8,000 people in Spain. The study, the...

Prostate Cancer

Adding Apalutamide to Abiraterone/Prednisone Extends Radiographic Progression-Free but Not Overall Survival

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

Prostate Cancer

Comparing Radiotherapy Regimens 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 the phase III SAKK 09/10 trial presented at the 2021 Genitourinary Cancers...

Prostate Cancer

LuPSMA Outperforms Cabazitaxel for Metastatic Castration-Resistant Prostate Cancer in Phase II 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 TheraP phase II trial reported at the 2021...

Issues in Oncology
Prostate Cancer

Patient Refusal of Provider-Recommended Locoregional Treatment for Prostate Cancer: Sociodemographic Factors

In a study reported in JCO Oncology Practice, Dee et al found that the rate of refusal of provider-recommended locoregional treatment for localized prostate adenocarcinoma has increased over time, with Black and Asian men with intermediate- or higher-risk disease being more likely to refuse such...

prostate cancer

Sandy Srinivas, MD, on Managing Metastatic Castration-Resistant Prostate Cancer

Sandy Srinivas, MD, of Stanford Cancer Institute, discusses the increasing number of ways to deliver life-prolonging therapy to patients with advanced prostate cancer, including more accurate imaging techniques; PET tracers to help better detect, diagnose, and treat disease; PARP inhibitors for BRCA and other mutations; and new sequencing of drugs.

Prostate Cancer
Issues in Oncology

Can Treatment for Prostate Cancer Affect Smell and Taste?

One in six men being treated for advanced prostate cancer reported experiencing a reduced sense of smell and taste, according to a study published by Alonzi et al in the journal Supportive Care in Cancer. The study authors noted that a reduced sense of smell and taste among some patients with...

Prostate Cancer

Meta-analysis of Intermediate Clinical Endpoints as Surrogates for Overall Survival in Localized Prostate Cancer

In a meta-analysis reported in The Lancet Oncology, Gharzai et al found that commonly used intermediate clinical endpoints in clinical trials in localized prostate cancer do not correlate well with overall survival, apart from metastasis-free survival—supporting the establishment of metastasis-free ...

Prostate Cancer

ASCO Guideline Update Offers Four Standards of Care for Noncastrate Advanced, Recurrent, or Metastatic Prostate Cancer

A recent ASCO guideline update, prompted by data from several phase III randomized controlled trials, summarizes the evidence supporting the best initial treatment options for the management of noncastrate advanced, recurrent, or metastatic prostate cancer. The hope is that the guideline will help...

Prostate Cancer

Cardiovascular Events With Transdermal Estradiol vs LHRH Agonists for Androgen Suppression in Advanced Prostate Cancer

In an analysis from the UK phase II/III PATCH trial reported in The Lancet, Langley et al found no differences in cardiovascular event rates over long-term follow-up with the use of a transdermal estradiol patch vs luteinizing hormone-releasing hormone agonists (LHRHa) for androgen suppression in...

Prostate Cancer

Bipolar Androgen Therapy vs Enzalutamide in Asymptomatic Patients With Metastatic Castration-Resistant Prostate Cancer

In the phase II TRANSFORMER trial reported in the Journal of Clinical Oncology, Denmeade et al found no difference in progression-free survival with bipolar androgen therapy—defined as rapid cycling between high and low serum testosterone—vs enzalutamide in men with metastatic castration-resistant...

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...

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