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Prostate Cancer

ARAMIS Trial: Darolutamide in High-Risk Nonmetastatic Prostate Cancer

THE INVESTIGATIONAL androgen receptor inhibitor darolutamide significantly improved metastasis-free survival in men with high-risk nonmetastatic castration-resistant prostate cancer vs placebo in the large phase III ARAMIS trial.1 Men treated with darolutamide had a median metastasis-free survival...

Kidney Cancer
Bladder Cancer
Prostate Cancer
Hepatobiliary Cancer

Conference Highlights From the 2019 Gastrointestinal and Genitourinary Cancers Symposiums

THIS YEAR saw a huge turnout and a large number of scientific abstracts presented at both the 2019 Gastrointestinal (GI) Cancers Symposium, held on January 17–19, and the 2019 Genitourinary (GU) Cancers Symposium, held on February 14–16, both in San Francisco. The GU Cancers Symposium attracted...

prostate cancer

Risk of Subsequent Primary Cancers After Carbon Ion Radiotherapy for Localized Prostate Cancer

In a Japanese retrospective study reported in The Lancet Oncology, Mohamad et al found that carbon ion radiotherapy was associated with a lower risk of subsequent primary cancers compared with photon radiotherapy in patients with localized prostate cancer. The study included data on 1,455 patients ...

Prostate Cancer

ASCO Endorses Active Surveillance Guideline for Low-Risk Prostate Cancer

ASCO ENDORSES and reinforces the evidence-based American Urological Association (AUA), American Society for Radiation Oncology (ASTRO), and the Society of Urologic Oncology (SUO) Guideline published in 2018 in the Journal of Urology. ASCO’s endorsement of a guideline on clinically localized...

Prostate Cancer

Prostatectomy vs Watchful Waiting: Clinical Dilemma Centers on Aggressive vs Indolent Disease

THE MANAGEMENT of localized prostate cancer remains controversial. Although the widespread use of prostate-specific antigen (PSA) testing has resulted in a dramatic increase in the diagnosis and treatment of prostate cancer, many men do not benefit from intervention because the disease is either...

Prostate Cancer

Radical Prostatectomy or Watchful Waiting: 29-Year Follow-up of Scandinavian Trial

AS REPORTED in The New England Journal of Medicine by Anna Bill-Axelson, MD, PhD, Lars Holmberg, MD, PhD, both of Uppsala University Hospital, and and colleagues, the 29-year follow-up of the Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) trial has shown that radical prostatectomy is...

Prostate Cancer

Expert Point of View: Emmanuel S. Antonarakis, MD

EMMANUEL S. ANTONARAKIS, MD, Associate Professor of Oncology, Johns Hopkins University, Baltimore, commented on the state of current knowledge about poly (ADP-ribose) polymerase (PARP) inhibitors in prostate cancer. “PARP inhibitors are definitely making inroads in the management of patients with...

Prostate Cancer

PARP Inhibitors Moving Ahead in Prostate Cancer

MULTIPLE POLY (ADP-ribose) polymerase (PARP) inhibitors are under study in metastatic prostate cancer and no clear winner has emerged yet. Some studies suggest that the best use of PARP inhibitors may be in patients whose cancers harbor DNA-repair defects and BRCA1/2 mutations, but other data...

prostate cancer

Addition of Docetaxel to Androgen Suppression and Radiotherapy for Localized High-Risk Prostate Cancer

As reported in the Journal of Clinical Oncology by Rosenthal et al, the phase III NRG Oncology RTOG 0521 trial showed that the addition of docetaxel to androgen suppression and radiotherapy improved overall and disease-free survival as well as the distant metastasis rate in patients with high-risk...

prostate cancer

Focal Laser Ablation in Prostate Cancer

Researchers have shown that selectively destroying cancerous prostate tissue may be as effective as complete prostate removal or radiation therapy, while preserving more sexual and urinary function than these other treatments. The study was published by Wasler et al in the Journal of Vascular and...

prostate cancer

James L. Mohler, MD, on Managing Prostate Cancer: NCCN Guidelines Updates

James L. Mohler, MD, of the Roswell Park Comprehensive Cancer Center, discusses updated recommendations in prostate cancer: more specificity for family history and genomic sequencing, as well as the evolving uses of androgen-deprivation therapy.

prostate cancer

AR-V7 Assay Findings and Outcomes With Hormone Therapy in High-Risk Castration-Resistant Prostate Cancer

In the PROPHECY study, reported in the Journal of Clinical Oncology, Armstrong et al found that positive findings on 2 assays for circulating tumor cell (CTC) androgen receptor splice variant 7 (AR-V7) were associated with poorer outcomes for abiraterone and enzalutamide therapy in men with...

Prostate Cancer

Docetaxel Plus Androgen-Deprivation Therapy After Primary Local Therapy in High-Risk Prostate Cancer

In a French phase III trial reported in JAMA Oncology, Stéphane Oudard, MD, PhD, of Hôpital Européen Georges Pompidou, and colleagues found that the addition of docetaxel to androgen-deprivation therapy (ADT) did not improve prostate-specific antigen (PSA) progression-free survival in men with...

Prostate Cancer

Patient-Reported Outcomes With Enzalutamide Treatment in Nonmetastatic Castration-Resistant Prostate Cancer

As reported by Bertrand Tombal, MD, of the Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, and colleagues in The Lancet Oncology, treatment with enzalutamide was associated with clinically meaningful delays in pain progression, symptom worsening, and deterioration in...

prostate cancer

EAU 2019: Testosterone Replacement Therapy May Slow Recurrence in Low-Risk Prostate Cancer

Researchers have shown that testosterone replacement may slow the recurrence of prostate cancer in low-risk patients. Findings from the study were presented by Towe et al at the European Association of Urology (EAU) 2019 Congress (Abstract 646). Practitioners have long regarded testosterone as a...

prostate cancer
immunotherapy

Viral Vector–Based Immunotherapy in Metastatic Castration-Resistant Prostate Cancer

In a phase III trial reported in the Journal of Clinical Oncology, Gulley et al found that PROSTVAC, a viral vector-based immunotherapy, did not improve overall survival or 6-month event-free survival vs placebo in patients with asymptomatic or minimally symptomatic metastatic castration-resistant...

prostate cancer

Intense Neoadjuvant Androgen Deprivation Before Prostatectomy in Locally Advanced Prostate Cancer

In a phase II trial reported in the Journal of Clinical Oncology, McKay et al found a trend toward improved pathologic response or minimal residual disease with the addition of neoadjuvant abiraterone and prednisone to enzalutamide and leuprolide prior to radical prostatectomy in patients with...

prostate cancer

Prevalence of Adverse Germline Genetic Variants in Prostate Cancer

In a study reported in JAMA Oncology by Nicolosi et al, it was found that 17% of men with prostate cancer had likely deleterious germline genetic variants, and that many of these men would not have been considered candidates for genetic testing. Study Details The study involved data from 3,607...

Prostate Cancer

ARAMIS Trial Reports Darolutamide Improves Outcomes in High-Risk Nonmetastatic Prostate Cancer

Darolutamide—an investigational androgen receptor inhibitor—significantly improved metastasis-free survival in men with high-risk nonmetastatic castration-resistant prostate cancer vs placebo in the large phase III ARAMIS trial.1 Men treated with darolutamide had a median metastasis-free survival...

Prostate Cancer

Radioligand Therapy Achieves Responses in Metastatic Prostate Cancer

In a prospective, single-center, single-arm phase II trial reported at the 2019 Genitourinary Cancers Symposium, a novel approach using a tumor-specific radioligand therapy that binds to prostate-specific membrane antigen (PSMA) (lutetium-177 PSMA-617 -[LuPSMA]) achieved responses in a majority of...

prostate cancer
issues in oncology

AACR 2019: Does Treatment With Abiraterone Acetate Benefit Patients With Advanced Prostate Cancer and Preexisting Cardiovascular Disease?

Patients with advanced prostate cancer who had preexisting cardiovascular disease had a higher risk of mortality in the 6 months after starting abiraterone acetate treatment compared with those who had no preexisting cardiovascular disease, according to data presented by Lu-Yao et al at a presscast ...

prostate cancer

Addition of Radium-223 to Abiraterone Acetate and Prednisone or Prednisolone in Metastatic Castration-Resistant Prostate Cancer

In the phase III ERA 223 trial reported in The Lancet Oncology, Smith et al found that the addition of radium-223 to abiraterone acetate and prednisone or prednisolone did not improve symptomatic skeletal event-free survival and was associated with increased risk of fracture in patients with...

prostate cancer

Addition of Docetaxel to Hormone Therapy in High-Risk Prostate Cancer With Rising PSA Levels

In a French phase III trial reported in JAMA Oncology, Oudard et al found that the addition of docetaxel to androgen-deprivation therapy (ADT) did not improve prostate-specific antigen (PSA) progression-free survival in men with high-risk prostate cancer with rising PSA after primary local therapy. ...

prostate cancer
symptom management

Patient-Reported Outcomes With Enzalutamide in PROSPER Trial

As reported by Tombal et al in The Lancet Oncology, treatment with enzalutamide was associated with clinically meaningful delays in pain progression, symptom worsening, and deterioration in functional status vs placebo in the phase III PROSPER trial in nonmetastatic, castration-resistant prostate...

prostate cancer
issues in oncology

Hospitalizations in Patients With Prostate Cancer on Medicare

In a retrospective analysis reported in the Journal of Oncology Practice, Parikh et al found that more than one-quarter of hospitalizations in Medicare patients with prostate cancer were potentially avoidable. Study Details The study involved 99 evaluable patients in the Mount Sinai Health System ...

prostate cancer
immunotherapy

Sumit K. Subudhi, MD, PhD, on Prostate Cancer: Results From the CheckMate 650 Trial on Nivolumab and Ipilimumab

Sumit K. Subudhi, MD, PhD, of The University of Texas MD Anderson Cancer Center, discusses the initial results from a phase II study of nivolumab plus ipilimumab in the treatment of metastatic castration-resistant prostate cancer (Abstract 142).

prostate cancer

Howard I. Scher, MD, on Prostate Cancer: Circulating Tumor Cells as a Surrogate Endpoint for Survival

Howard I. Scher, MD, of Memorial Sloan Kettering Cancer Center, discusses circulating tumor cell number as a transitional surrogate endpoint for survival in phase II trials on metastatic castration-resistant prostate cancer (Abstract 143).

prostate cancer
symptom management

Silke Gillessen, MD, on Prostate Cancer: Results From the REDUSE Trial on Denosumab

Silke Gillessen, MD, of Cantonal Hospital St. Gallen, discusses data from a phase III study on the incidence of hypocalcemia in patients with castration-resistant prostate cancer treated with denosumab. The trial was designed to assess prevention of symptomatic skeletal events with denosumab administered every 4 weeks vs every 12 weeks (Abstract 139).

prostate cancer

Karim Fizazi, MD, PhD, on Prostate Cancer: Results From the ARAMIS Trial on Darolutamide

Karim Fizazi, MD, PhD, of the University of Paris-Sud and Gustave Roussy, discusses study findings on the efficacy and safety of darolutamide in men with nonmetastatic castration-resistant prostate cancer (Abstract 140).

prostate cancer

Nicholas J. van As, MD, on Prostate Cancer: Results From the PACE-B Trial Comparing Radiotherapy Techniques

Nicholas J. van As, MD, of The Royal Marsden NHS Foundation Trust, discusses an analysis of acute toxicity in the PACE-B study, which compared stereotactic body radiotherapy with conventionally fractionated or moderately hypofractionated external-beam radiotherapy for localized prostate cancer (Abstract 1).

prostate cancer

Karim Fizazi, MD, PhD, on Prostate Cancer: Results From the LATITUDE Trial on Abiraterone Acetate Plus Prednisone

Karim Fizazi, MD, PhD, of the University of Paris-Sud and Gustave Roussy, discusses final phase III findings on men with newly diagnosed, high-risk, metastatic, castration-naive prostate cancer who were treated with abiraterone acetate plus prednisone added to androgen-deprivation therapy (Abstract 141).

prostate cancer

2019 GU Cancers Symposium: ARAMIS: Darolutamide in Nonmetastatic, Castration-Resistant Prostate Cancer

In the phase III ARAMIS trial reported by Fizazi et al at the 2019 Genitourinary Cancers Symposium (Abstract 140) and simultaneously published in The New England Journal of Medicine, researchers found that the androgen receptor antagonist darolutamide significantly prolonged metastasis-free...

prostate cancer
immunotherapy

2019 GU Cancers Symposium: CheckMate 650: Nivolumab and Ipilimumab in Metastatic, Castration-Resistant Prostate Cancer

Some patients with metastatic prostate cancer respond to a combination of immune checkpoint inhibitors after treatment with hormonal therapy and chemotherapy has not been successful in treating their disease, according to early results from the phase II CheckMate 650...

prostate cancer
issues in oncology

2019 GU Cancers Symposium: Study Evaluates Survival by Race in Metastatic Castration-Resistant Prostate Cancer

A large, retrospective study analyzing 5 years of data from the Veterans Health Administration (VHA) found that African American men with chemotherapy-naive, metastatic, castration-resistant prostate cancer who were treated with abiraterone acetate or enzalutamide lived 20% longer compared with...

prostate cancer

2019 GU Cancers Symposium: Small Trial of LuPSMA in PSMA-Positive, Metastatic, Castration-Resistant Prostate Cancer

A single-arm, phase II trial in men with prostate-specific membrane antigen (PSMA)-positive, metastatic, castration-resistant prostate cancer that progressed despite standard therapies found that a majority of men treated with a novel, targeted radiation therapy called lutetium-177 PSMA-617...

prostate cancer

Quality of Life in Men Living With Advanced and Localized Prostate Cancer

In a population-based study reported in The Lancet Oncology, Downing et al found little difference in health-related quality of life (HRQOL) between men with advanced vs localized prostate cancer. Sexual function problems were common among all patients—and often not addressed—and use of ...

prostate cancer

Long-Term Effects of Finasteride vs Placebo on Prostate Cancer Mortality

In a letter to the editor of The New England Journal of Medicine, Goodman et al reported a long-term follow-up of the Prostate Cancer Prevention Trial indicating that finasteride treatment was not associated with an increased risk of death from prostate cancer. Study Details As previously...

solid tumors
prostate cancer

Common Markers of Tumor Hypoxia Found Across Cancer Types

Unlike healthy tissues, tumors thrive in low-oxygen environments, often acquiring the ability to resist treatment and spread to other sites in the body. Despite being a well-known cause of therapy resistance and metastasis, the impact of hypoxia on tumor cells is poorly understood. Researchers have ...

prostate cancer

Germline DNA Repair Mutations and Outcomes in Metastatic Castration-Resistant Prostate Cancer

A subset of patients with aggressive prostate cancer are carriers of germline BRCA2 mutations, which are also linked to hereditary breast cancer, ovarian cancer, and pancreatic cancer. Study findings also showed family members of patients with prostate cancer who carry BRCA2 and DNA-repair...

prostate cancer

Overall Survival of Black vs White Men Receiving Docetaxel Regimens for Metastatic Castration-Resistant Prostate Cancer

In an analysis reported in the Journal of Clinical Oncology, Halabi et al found that overall survival was improved for black men vs white men receiving regimens containing docetaxel and prednisone for metastatic castration-resistant prostate cancer. As noted by the investigators, several studies...

prostate cancer
immunotherapy

MSI-H/dMMR Tumors in Prostate Cancer and Response to Immune Checkpoint Blockade

In a study reported in JAMA Oncology, Abida et al found that approximately 3% of patients with prostate cancer had microsatellite instability–high (MSI-H)/mismatch repair–deficient (dMMR) tumors and that some of these patients exhibited durable responses to treatment with immune...

prostate cancer
issues in oncology

Gleason 6 Score May Underestimate Prostate Cancer Mortality Risk in Black Men

Black men diagnosed with prostate cancer classified as low risk may actually have a more aggressive form of the disease that is more likely to be fatal than in nonblack men placed in the same prognostic category, according to results from a new study published as a research letter by Mahal et al in ...

prostate cancer

Time to Biochemical Failure as Surrogate Endpoint in Locally Advanced Prostate Cancer

As reported in the Journal of Clinical Oncology by Dignam et al, analysis of outcomes in the phase III NRG/RTOG 9202 trial indicates that the time interval to biochemical failure (IBF) could serve as a surrogate endpoint for clinical outcomes in patients receiving radiotherapy plus long-term...

prostate cancer

RADAR Trial: Short- vs Intermediate-Term Androgen Suppression and Zoledronic Acid in Locally Advanced Prostate Cancer

As reported by Denham et al in The Lancet Oncology, 10-year results of the phase III TROG 03.04 RADAR trial have shown that 18 months of androgen suppression plus radiotherapy is more effective than 6 months of androgen suppression plus radiotherapy in locally advanced prostate cancer, but no...

Issues in Oncology
Prostate Cancer
Geriatric Oncology

Overscreening for Prostate Cancer in Older Men Remains an Issue

Although most major cancer organizations agree on the guidelines for prostate cancer screening, there is still uneven application of the test, such as in the older patient population, resulting in overdiagnosis and waste in an already fiscally challenged health-care system. Researchers from the...

Prostate Cancer

Shedding Light on Mechanisms of Resistance to Treatment of Metastatic Castration-Resistant Prostate Cancer

ONE OF the pressing issues in metastatic castration-resistant prostate cancer is the development of resistance to therapies directed at the androgen receptor (AR), such as enzalutamide (Xtandi) and abiraterone acetate (Zytiga). Research is ongoing to identify mechanisms of resistance in the hope of ...

Prostate Cancer

Expert Point of View: Joaquin Mateo, MD, PhD

FORMAL DISCUSSANT Joaquin Mateo, MD, PhD, of the Prostate Cancer Translational Research Group, Vall d’Hebron Institute of Oncology, Barcelona, said that the TRITON2 findings were encouraging, although still preliminary. “We should interpret these results with caution, because this interim analysis ...

Prostate Cancer

PARP Inhibitor Active in BRCA1/2-Mutated Metastatic Castration-Resistant Prostate Cancer

THE SEARCH for biomarkers in prostate cancer has proved frustrating, partly due to the complexity of the disease and its heterogeneity. A preliminary analysis of a phase II (TRITON2) study suggests that rucaparib (Rubraca), a poly (ADP-ribose) polymerase (PARP) inhibitor, may be active in men with...

prostate cancer

Survival With Surgery vs Radiotherapy in Gleason Score 9–10 Prostate Cancer

In a cohort study reported in JAMA Oncology, Tilki et al found that patients with Gleason score 9–10 prostate cancer treated with multimodality therapy known as MaxRP (radical prostatectomy [RP] plus adjuvant external-beam radiotherapy [EBRT] with or without androgen-deprivation therapy...

prostate cancer
issues in oncology

Dissemination of Misleading Information on Prostate Cancer on Social Media

YouTube videos on prostate cancer often offer misleading or biased medical information that poses potential health risks to patients, an analysis of the social media platform published by Loeb et al in European Urology showed. For the latest analysis, researchers, which included social...

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