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prostate cancer

Sumanta K. Pal, MD, on Prostate Cancer: Impact of the Microbiome on Immune Therapy

Sumanta K. Pal, MD, of City of Hope, discusses the ways in which the composition of the gut microbiome may impact the outcome of immune therapy. Methods such as fecal microbiome transplant hold promise as a means of augmenting the effect of treatment and, according to Dr. Pal, potentially resensitizing patients to therapies.

Prostate Cancer

Actinium-225–PSMA Radioligand Therapy for Prostate Cancer

In a retrospective study (WARMTH Act) reported in The Lancet Oncology, Sathekge et al found that actinium-225–prostate-specific membrane antigen (PSMA) radioligand therapy showed activity in patients with metastatic castration-resistant prostate cancer.   Study Details The study consisted of 448...

prostate cancer

Umang Swami, MD, on Prostate Cancer: Differences in Genomic, Transcriptomic, and Immune Landscape Based on Site of Metastasis

Umang Swami, MD, of Huntsman Cancer Institute at the University of Utah, describes the molecular and immunologic mechanisms of metastatic tropism in advanced prostate cancer, data that may facilitate future drug development. In patients with metastatic disease, specific sites are associated with differential overall survival, but the biological reasons have not been fully explored (Abstract 21).

Prostate Cancer
Supportive Care

Annual Increases in Cardiorespiratory Fitness May Help Reduce Risk of Prostate Cancer

An increase in annual cardiorespiratory fitness may be linked to a lower risk of developing prostate cancer, according to a recent study published by Bolam et al in the British Journal of Sports Medicine. Background There are relatively few known risk factors for prostate cancer. Although research...

prostate cancer

Maha H.A. Hussain, MD, on Prostate Cancer: New Data on Abiraterone and Prednisone Plus Olaparib

Maha H.A. Hussain, MD, of the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, discusses phase II findings from the BRCAAway trial. This study showed that in patients with metastatic castration-resistant prostate cancer with BRCA1/2 or ATM alterations, abiraterone and prednisone plus olaparib was well tolerated and resulted in a longer progression-free survival than either agent alone or sequentially.

Prostate Cancer
Genomics/Genetics

Is HRR Testing Underused in Patients With Prostate Cancer?

Despite being recommended in prostate cancer guidelines, homologous recombinant repair (HRR) mutation analysis is widely underused in patients with prostate cancer, according to real-world data presented at the 2024 ASCO Genitourinary Cancers Symposium (Abstract 210). A major implication of these...

prostate cancer

Neeraj Agarwal, MD, on Prostate Cancer: Phase III Trial Update on Cabozantinib, Atezolizumab, and Hormonal Therapy

Neeraj Agarwal, MD, of Huntsman Cancer Institute at the University of Utah, discusses results of the CONTACT-2 trial, which showed cabozantinib plus atezolizumab improved radiographic progression–free survival of patients with metastatic castration-resistant prostate cancer vs a second novel hormonal therapy (NHT) in patients who had experienced disease progression on a prior NHT and have extrapelvic nodal or visceral disease. The benefits were more pronounced in patients with liver metastasis and in those who previously received docetaxel (Abstract 18).

Prostate Cancer

More Intensified Salvage Regimen for Prostate Cancer Does Not Impair Health-Related Quality of Life

In patients with biochemically recurrent prostate cancer after radical prostatectomy, a more intensified regimen of abiraterone acetate/prednisone plus apalutamide improved outcomes and did not lead to decrements in specific domains of health-related quality of life (HRQoL) vs treatment with...

Prostate Cancer

Cabozantinib and Atezolizumab in Metastatic Castration-Resistant Prostate Cancer

Patients with metastatic castration-resistant prostate cancer with extrapelvic nodal or visceral metastasis who were treated with the combination of cabozantinib plus atezolizumab had significantly improved time to disease progression compared with those who were treated with hormonal therapy. This ...

Prostate Cancer

Use of Enzalutamide in Nonmetastatic Castration-Sensitive Prostate Cancer With Biochemical Recurrence

On November 16, 2023, the androgen receptor inhibitor enzalutamide was approved for use in patients with nonmetastatic castration-sensitive prostate cancer with biochemical recurrence at high risk for metastasis.1 Supporting Efficacy Data Approval was based on the EMBARK trial (ClinicalTrials.gov...

Prostate Cancer
Issues in Oncology

Factors Influencing Selection of Active Surveillance for Low-Risk Prostate Cancer

Investigators may have uncovered some of the factors associated with the selection of active surveillance over surgery or radiation therapy in patients with low-risk prostate cancer, according to a recent study published by Xu et al in Cancer. Background Guidelines for low-risk prostate cancer that ...

Prostate Cancer
Neuroendocrine Tumors

Novel Blood Test May Help Distinguish Neuroendocrine Prostate Cancer From Other Subtypes

A novel blood test may accurately detect neuroendocrine prostate cancer and differentiate it from castration-resistant prostate adenocarcinoma, according to a recent study published by Franceschini et al in Cancer Discovery. Background Approximately 10% to 15% of patients with metastatic prostate...

prostate cancer

Rana R. McKay, MD, on Mutated Prostate Cancer, PARP Inhibition, and Radical Prostatectomy

Rana R. McKay, MD, of the University of California, San Diego, discusses phase II findings from the Neptune study of neoadjuvant olaparib plus androgen-deprivation therapy followed by radical prostatectomy in patients with intermediate-risk or high-risk prostate cancer marked by germline or somatic BRCA1/2 gene alterations. This population generally has inferior outcomes, and PARP inhibition has shown efficacy in these patients.

Prostate Cancer

LuPSMA: Another Treatment Option for Metastatic Castration-Resistant Prostate Cancer

The use of lutetium-177–labeled PSMA-617 (LuPSMA) improved radiographic progression–free survival by 57% in men with metastatic castration-resistant prostate cancer who experienced disease progression on an androgen receptor (AR) pathway inhibitor compared with changing to a new AR pathway...

Prostate Cancer

Overall Survival With LuPSMA vs Cabazitaxel in Previously Treated Patients With Metastatic Castration-Resistant Prostate Cancer

As reported in The Lancet Oncology by Michael S. Hofman, MBBS, and colleagues, overall survival results from the Australian phase II TheraP trial showed no difference with lutetium-177–labeled PSMA-617 (LuPSMA) vs cabazitaxel in patients with metastatic castration-resistant prostate cancer and...

prostate cancer

Stephen J. Freedland, MD, on Managing Prostate Cancer in Transgender Women

Stephen J. Freedland, MD, of Cedars-Sinai Medical Center, discusses the incidence of prostate cancer in transgender women. Although the rates of disease appear lower than in cisgender men, Dr. Freedland notes the risk is not as limited as case reports may suggest. He also discusses interpreting PSA values and rises in PSA for patients on gender-affirming hormone therapies.

prostate cancer

Samson W. Fine, MD, on Clinical Significance of Atypical Small Acinar and Intraductal Proliferations in the Prostate

Samson W. Fine, MD, of Memorial Sloan Kettering Cancer Center, discusses the evolving spectrum of atypical intraductal proliferations in the prostate, from high-grade prostatic intraepithelial neoplasia to intraductal carcinoma. He describes several clinical challenges, including: assessment and terminology of cribriform architecture; pathologic reporting in various biopsy scenarios; and association with genetic findings.

prostate cancer
genomics/genetics

William J. Catalona, MD, on Genetic Testing in Prostate Cancer: Expert Review

William J. Catalona, MD, of Northwestern University Feinberg School of Medicine, reviews the genetic landscape in prostate cancer, including BRCA2 and ATM, two important mutations for aggressive disease; the clinical implications of germline testing such as guiding screening and disease management, as well as identifying patients at high risk for aggressive prostate cancer; and the role of somatic testing, especially in advanced disease.

Prostate Cancer
Issues in Oncology

Black Men With Advanced Prostate Cancer May Be Less Likely to Receive Treatment

Investigators have found that Black men diagnosed with more advanced stages of prostate cancer may be significantly less likely to be prescribed novel hormone therapy compared with men from other racial and ethnic groups, according to a recent study published by Martin et al in JAMA Network Open....

Prostate Cancer
Genomics/Genetics

Outcomes With Olaparib in BRCA-Mutated Metastatic Castration-Resistant Prostate Cancer in the PROfound Trial

In an analysis of the phase III PROfound trial reported in the Journal of Clinical Oncology, Joaquin Mateo, MD, PhD, and colleagues found that olaparib improved outcomes vs abiraterone or enzalutamide among the subgroup of patients with metastatic castration-resistant prostate cancer who had...

Prostate Cancer

Metastatic Castration-Resistant Prostate Cancer: Efficacy of Anti-PSMA Antibody With Alpha Emitter

In a phase I study reported in the Journal of Clinical Oncology, Scott T. Tagawa, MD, MS, FASCO, FACP, and colleagues determined the recommended phase II dose and described preliminary activity of actinium-225–J591—an anti–prostate-specific membrane antigen (PSMA) monoclonal antibody (J591)...

Prostate Cancer

PROpel Trial: Olaparib Plus Abiraterone in Metastatic Castration-Resistant Prostate Cancer Unselected for HRR Mutation Status

As reported in The Lancet Oncology by Fred Saad, MD, of the Centre Hospitalier de l’Université de Montréal, and colleagues, the final prespecified overall survival analysis of the phase III PROpel trial has shown no significant benefit with the addition of first-line olaparib to abiraterone in...

Prostate Cancer

FDA Approves Enzalutamide for Nonmetastatic Castration-Sensitive Prostate Cancer With Biochemical Recurrence

On November 16, the U.S. Food and Drug Administration (FDA) approved the androgen receptor inhibitor enzalutamide (Xtandi) for patients with nonmetastatic castration-sensitive prostate cancer with biochemical recurrence at high risk for metastasis. EMBARK Trial Efficacy was evaluated in EMBARK...

Prostate Cancer
Genomics/Genetics

Researchers Identify Novel Genetic Variants Predictive of Prostate Cancer Risk and Severity

Researchers have compiled a comprehensive list of genetic variants that may be associated with the risk of developing prostate cancer, according to a recent study published by Wang et al in Nature Genetics. The new findings included major increases in representation among patients from racial and...

Prostate Cancer
Issues in Oncology

Comparing the Accuracy of Initial Staging Methods in Prostate Cancer

Bone scans may overstage prostate cancer at initial staging compared with prostate-specific membrane antigen (PSMA) positron-emission tomography (PET), according to a recent study published by Hope et al in The Journal of Nuclear Medicine. Background PSMA PET is known to be more accurate than...

Prostate Cancer

Metastatic Castration-Resistant Prostate Cancer: Single-Dose LuPSMA Plus Maintenance Pembrolizumab

In a single-institution phase I dose-expansion trial reported in The Lancet Oncology, Aggarwal et al found that a single dose of lutetium-177–PSMA-617 (LuPSMA) followed by pembrolizumab maintenance was associated with activity in patients with metastatic castration-resistant prostate cancer. Study...

Prostate Cancer

Race, PSA Level, and Risk of Prostate Cancer

Black men in the United States are more likely to develop prostate cancer than White men, and after diagnosis, they’re more likely to have advanced disease and to die of the disease than White men. Although it would seem that earlier prostate‐specific antigen (PSA) screening would reduce the risk...

Prostate Cancer

PACE Trials Support Stereotactic Body Radiotherapy for Some Patients With Localized Prostate Cancer

Prostate cancer treatment just got a major boost from the PACE trials, which may have established a new standard of care in low- and favorable intermediate-risk disease, according to data presented at the 2023 American Society for Radiation Oncology (ASTRO) Annual Meeting.1 The results of the phase ...

Prostate Cancer

Enzalutamide With or Without Leuprolide and Leuprolide Alone in Biochemically Recurrent Prostate Cancer

In the phase III EMBARK trial reported in The New England Journal of Medicine, Stephen J. Freedland, MD, and colleagues found that enzalutamide/leuprolide and enzalutamide alone improved metastasis-free survival vs leuprolide alone in patients with high-risk biochemical recurrence of prostate...

Prostate Cancer

PSMAfore: Lutetium Lu-177 Vipivotide Tetraxetan in Metastatic Prostate Cancer

Data from the phase III PSMAfore trial were presented during a Presidential Symposium at the European Society for Medical Oncology (ESMO) Congress 2023 (Abstract LBA13). Results showed that the trial of lutetium Lu-177 vipivotide tetraxetan met its primary endpoint, with a clinically meaningful and ...

Prostate Cancer
Issues in Oncology

MRI Scans Could Predict Postradiation Urinary Side Effects in Patients With Prostate Cancer

Researchers have discovered that patients with longer prostatic urethras may have an increased risk of experiencing moderate and chronic urinary side effects after receiving radiation for prostate cancer, according to a recent study published by Lee et al in Academic Radiology. The new findings...

Prostate Cancer
Genomics/Genetics

Germline Variants and Risk of Aggressive Prostate Cancer

In a study reported in JAMA Oncology, Darst et al identified germline genetic variants that were associated with increased risk of aggressive vs nonaggressive prostate cancer. As stated by the investigators, “Germline gene panel testing is recommended for men with advanced prostate cancer or a...

Prostate Cancer

Addition of SBRT to Abiraterone Acetate in Oligometastatic Castrate-Resistant Prostate Cancer

In an Italian phase II trial (ARTO) reported in the Journal of Clinical Oncology, Francolini et al found that the addition of stereotactic body radiation therapy (SBRT) to first-line abiraterone acetate and prednisone resulted in a significantly higher rate of biochemical response among patients...

Prostate Cancer
Issues in Oncology

Precision Medicine Navigators May Increase Genomic Testing Rates Among Black Patients With Prostate Cancer

The presence of precision medicine navigators may increase the likelihood that patients with prostate cancer, especially Black patients, will receive genomic testing that may help predict the severity of their disease and guide treatment, according to findings presented by Allen et al at the 2023...

Prostate Cancer

SBRT vs Standard Radiotherapy for Localized Prostate Cancer: 5-Year Analysis of PACE B

People with intermediate-risk, localized prostate cancer may be treated as effectively using fewer and higher doses of radiation therapy delivered over five treatment sessions as they can with lower doses delivered over several weeks, a new phase III randomized trial suggested. The findings, which...

Prostate Cancer
Genomics/Genetics

Mutations in 11 Genes May Be Associated With Aggressive Prostate Cancer

Researchers have singled out mutations in 11 genes associated with aggressive types of prostate cancer, according to a novel study published by Darst et al in JAMA Oncology. The new findings may lead to improvements in diagnosis and treatment. Background Currently, oncologists use genetic tests to...

Prostate Cancer

Fixed-Dose Niraparib and Abiraterone Plus Prednisone in BRCA-Mutated Metastatic Castration-Resistant Prostate Cancer

On August 11, 2023, the fixed-dose combination of the PARP inhibitor niraparib and the CYP17 inhibitor abiraterone acetate plus prednisone was approved for patients with deleterious or suspected deleterious BRCA-mutated castration-resistant prostate cancer, as determined by a U.S. Food and Drug...

Prostate Cancer

Addition of Olaparib to Abiraterone in Metastatic Castration-Resistant Prostate Cancer: Overall Survival Results in the PROpel Trial

As reported by Fred Saad, MD, and colleagues in The Lancet Oncology, the final prespecified overall survival analysis of the phase III PROpel trial showed no significant benefit with the addition of first-line olaparib to abiraterone in patients with metastatic castration-resistant prostate cancer...

Prostate Cancer
Legislation

PSA Screening for HIM Act Introduced in Senate; Aims to Reduce Costs for Prostate Cancer Screening

Bipartisan legislation that may help to eliminate financial barriers to prostate cancer screening was introduced in the U.S. Senate. Sponsored by Senators Cory Booker (D-NJ) and John Boozman (R-AR), the Prostate-Specific Antigen Screening for High-Risk Insured Men (PSA Screening for HIM) Act would...

Prostate Cancer

Study Shows Exercise May Improve Sexual Function in Men With Prostate Cancer

It seems that exercise is good for almost everything, including prostate cancer. In fact, exercise had a positive effect on sexual function and enjoyment in men with prostate cancer, according to a recent study presented at the 2023 ASCO Breakthrough meeting by lead study author Daniel Galvão, PhD, ...

Prostate Cancer
Issues in Oncology

SNMMI Provides New Consensus Statement on LuPSMA Therapy

The Society of Nuclear Medicine and Molecular Imaging (SNMMI) has provided standardized guidance on the selection and management of patients receiving lutetium-177–labeled PSMA-617 (LuPSMA) radionuclide therapy for metastatic castration-resistant prostate cancer, according to a new consensus...

Breast Cancer
Prostate Cancer
Lung Cancer
Issues in Oncology

How Guideline-Concordant Are Cancer Treatment Recommendations From ChatGPT?

Researchers have found that about one-third of treatment recommendations from the artificial intelligence (AI) model ChatGPT 3.5 were nonconcordant with the NCCN Clinical Practice Guidelines in Oncology® (NCCN Guidelines®), according to a recent study published by Chen et al in JAMA Oncology. The...

Prostate Cancer

Modified Citrus Pectin Treatment for Nonmetastatic Prostate Cancer

In the long-term treatment phase of an Israeli phase II study reported in the journal Nutrients, Keizman et al found that PectaSol modified citrus pectin (P-MCP) may be effective in patients with nonmetastatic, biochemically relapsed prostate cancer. As stated by the investigators, “[P-MCP] is a...

Prostate Cancer

Abiraterone Acetate With or Without Cabazitaxel in Metastatic Prostate Cancer

In a phase II trial reported in the Journal of Clinical Oncology, Slovin et al found that concomitant abiraterone acetate plus prednisone (AAP) and cabazitaxel appeared to produce better outcomes than AAP followed by cabazitaxel upon disease progression in patients with metastatic...

Prostate Cancer

Radiation Facility Volume and Survival in Very High–Risk Prostate Cancer Treated With Curative Radiation and Androgen-Deprivation Therapy

In a U.S. retrospective cohort study reported in JAMA Network Open, Sebastian et al found that treatment at a high-volume radiation facility was associated with improved overall survival among men with very high–risk prostate cancer receiving curative-intent radiotherapy with androgen-deprivation...

Prostate Cancer
Issues in Oncology

Four Novel Biomarkers May Help Detect Black Patients at Risk of Advanced Prostate Cancer

Researchers have identified a cell metabolism process found in male patients with West African ancestry who have diabetes and metastatic prostate cancer that could potentially lead to improved testing and treatments for Black patients with both diseases. The findings by Shuck et al were presented...

Prostate Cancer
Geriatric Oncology

PSMA PET/CT Imaging May Eliminate the Need for Preimaging Biopsy in Older Patients Undergoing Screening for Prostate Cancer

Prostate-specific membrane antigen positron-emission tomography/computed tomography (PSMA PET/CT) imaging may help physicians diagnose advanced disease and select the appropriate therapeutic interventions in patients aged 80 years or older with suspected prostate cancer, according to a recent study ...

Prostate Cancer
Genomics/Genetics

Rucaparib vs Physician’s Choice of Single-Agent Therapy in BRCA-Mutated Metastatic Castration-Resistant Prostate Cancer

As reported in The New England Journal of Medicine by Karim Fizazi, MD, PhD, of Gustave Roussy Institute, Paris-Saclay University, and colleagues, the phase III TRITON3 trial has shown significantly improved progression-free survival with rucaparib vs physician-selected single-agent therapy in the...

Prostate Cancer

Darolutamide Plus Androgen-Deprivation Therapy and Docetaxel in Metastatic Hormone-Sensitive Prostate Cancer

The addition of the androgen receptor inhibitor darolutamide to androgen-deprivation therapy and docetaxel reduced the risk of death by 30% compared with androgen-deprivation therapy plus docetaxel in patients with metastatic hormone-sensitive prostate cancer, according to a post hoc analysis of...

Prostate Cancer

PROpel Trial: Improvement in Progression-Free Survival With First-Line Olaparib Plus Abiraterone in Metastatic Prostate Cancer

The addition of the PARP (poly [ADP-ribose] polymerase) inhibitor olaparib to standard-of-care abiraterone in the first-line setting of metastatic castration-resistant prostate cancer achieved longer progression-free survival vs abiraterone alone, as demonstrated in the final results of the phase...

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