The STAMPEDE clinical trial of nearly 2,000 men shows that adding abiraterone acetate (Zytiga) to a standard initial treatment regimen for high-risk, advanced prostate cancer lowers the relative risk of death by 37%. The 3-year survival rate was 76% with standard therapy alone vs 83% with standard...
As reported by Zhao et al in JAMA Oncology, luminal B prostate cancers carry a worse overall prognosis than luminal A and basal-like cancers, but luminal B tumors respond better to postoperative androgen-deprivation therapy. Study Details In the study, the PAM50 classifier was used to subtype...
As the subtleties of metastatic prostate cancer become increasingly recognized, treatment should evolve accordingly, said Jessica M. Clement, MD, Assistant Professor of Medicine at the University of Connecticut Health System and Neag Cancer Center, Farmington. Of particular interest to Dr. Clement ...
On April 25, ASCO issued a provisional clinical opinion on the use of second-line hormonal therapy for men with castration-resistant prostate cancer who have not yet received chemotherapy. The recommendations of this provisional clinical opinion were informed by evidence from a systematic review of ...
Active surveillance in men under 60, use of telemedicine in the management of prostate cancer, and physicians' personal prostate cancer screening preferences were all highlighted at the 2017 Annual Scientific Meeting of the American Urological Association (AUA). Active Surveillance for Low-Risk...
New results presented at the 2017 American Urological Association (AUA) Annual Meeting from a large, community-based, multicenter clinical validation study conducted at Kaiser Permanente confirmed that the Oncotype DX Genomic Prostate Score (GPS) test is a strong independent predictor of prostate...
Data presented at the 2017 Annual Scientific Meeting of the American Urological Association (AUA) showed new findings related to the impact of certain genetic mutations on the risk and development of prostate cancer, in particular metastatic disease. Male BRCA Mutations An analysis by Mano et al...
Treating prostate cancer with a single, high dose of radiation delivered precisely to the site of the tumor results in good quality of life and fewer trips to the hospital, with adverse side effects that are no worse than if the radiation treatment had been given in several lower doses. These...
As reported by Katherine S. Virgo, PhD, MBA, of Emory University, and colleagues in the Journal of Clinical Oncology, ASCO has issued a provisional clinical opinion on second-line hormonal therapy for chemotherapy-naive castration-resistant prostate cancer. The provisional clinical opinion applies...
Declines in prostate-specific antigen (PSA) testing that came after changes in government screening guidelines have abated in recent years, according to a new study. In JAMA Internal Medicine, American Cancer Society (ACS) investigators led by Stacy A. Fedewa, PhD, wrote that about 1 in 3 men aged...
Prostate cancer has lagged behind breast cancer in the identification of predictive and prognostic biomarkers, but the field is catching up. Researchers have identified a molecular signature that can distinguish aggressive prostate cancer that is androgen-indifferent and will have a better response ...
There is a new yin-yang of management in genitourinary oncology, with the balance of opposing power focused among cancer cells, kinase inhibition, and lymphocyte function, representing a shift in the fashions of treatment somewhat away from chemotherapy. This linear progress has been complicated...
A new analysis of patients who have undergone treatment for prostate cancer shows a connection between androgen-deprivation therapy and dementia, according to researchers from the Perelman School of Medicine at the University of Pennsylvania. Previous studies from Penn have shown men who undergo...
An individual patient-level meta-analysis has shown that the Decipher® (GenomeDx) genomic classifier is capable of distinguishing risk groups for metastatic disease after radical prostatectomy for prostate cancer. The study was reported by Spratt and colleagues in the Journal of Clinical...
On April 11, the U.S. Preventive Services Task Force (USPSTF) posted for public comment a draft recommendation statement and three draft evidence reviews on screening for prostate cancer. Through this draft recommendation, the Task Force is providing clinicians and their patients with...
The American Society of Clinical Oncology (ASCO) and Cancer Care Ontario today issued a joint clinical practice guideline update on brachytherapy for patients with prostate cancer. The update provides evidence-based recommendations for different patient risk groups and specifies the most effective...
Hypofractionated radiotherapy was noninferior to standard radiotherapy in biochemical-clinical failure disease-free survival in men with localized prostate cancer, according to a study reported by Catton et al in the Journal of Clinical Oncology. Study Details In the trial, 1,206 patients with...
As reported by Mason et al in the Journal of Clinical Oncology, long-term survival results of the UK-based, multiarm, multistage platform–design STAMPEDE trial showed no survival benefit with the addition of celecoxib or celecoxib plus zoledronic acid in men initiating long-term hormone...
In a study reported in JAMA Oncology, Trevor J. Royce, MD, of Harvard Radiation Oncology Program, Brigham and Women’s Hospital, and colleagues found that a prostate-specific antigen (PSA) nadir > 0.5 ng/mL may be a dominant risk factor for all-cause mortality after radiation therapy and...
“These data are consistent with other studies we have conducted in advanced lung cancer, in which we similarly found that one-third of patients believed that their metastatic lung cancer was curable. These patients ostensibly already had conversations with their oncologists about their prognosis...
More than one-third of men with incurable metastatic prostate cancer mistakenly believe that their cancer may be curable, according to a survey of patient expectations at an academic cancer center. “This study is part of a larger survey of treatment decision-making among men with metastatic...
In a Swedish study reported in the Journal of Clinical Oncology, Loeb et al found that use of testosterone replacement therapy was not associated with an increased risk of prostate cancer and was associated with a lower risk of aggressive cancer among men developing the disease. Study Details The ...
In the phase III SYNERGY trial reported in The Lancet Oncology, Chi et al found that the addition of the second-generation antisense oligonucleotide custirsen to docetaxel and prednisone did not improve overall survival in patients with metastatic castration-resistant prostate cancer. Custirsen...
In a large European cohort study reported in the Journal of Clinical Oncology, Smith Byrne et al found that vasectomy was not associated with an increased overall risk of prostate cancer or death from prostate cancer but appeared to increase the risk of lower-grade disease. Other studies have...
A genetically engineered mouse model developed by Blattner et al investigating the role of the gene Speckle Type BTB/POZ Protein, or SPOP, as a driver of prostate cancer has found that the mutation drives prostate neoplasia through coordinate deregulation of both P13K/mTOR and androgen receptor...
In a study reported in the Journal of Oncology Practice, Salloum et al found that use of nonindicated imaging for diagnostic staging of low-risk prostate cancer in a nonprofit integrated health-care system remained common but has decreased in frequency. As noted by the authors: “The overuse...
Formal discussant for the presentation of SWOG S9921 results, Susan F. Slovin, MD, PhD, a medical oncologist at Memorial Sloan Kettering Cancer Center, New York, said there were some important points to understand about this “vintage” trial. “The trial was designed 20 years ago, and the view is...
An older trial designed to evaluate the benefits of adjuvant therapy following radical prostatectomy in patients with high-risk prostate cancer showed no difference in overall or disease-free survival between 2 years of androgen-deprivation therapy and 2 years of androgen-deprivation therapy plus...
Diana D. Jeffery, PhD, of the Defense Health Agency, discusses the need to screen for mental health comorbidities, including depression, anxiety, adjustment disorders, substance use disorders, and persistent mental illnesses, as shown in a study of breast and prostate cancer patients (Abstract 18).
Results from a new prospective clinical trial indicate that high–dose rate (HDR) brachytherapy administered in a single 19-Gy treatment may be a safe and effective alternative to longer courses of HDR treatment for men with localized prostate cancer. The study was reported by Krauss et al in...
A new analysis of data from the U.S. Military Health System found that mood and adjustment disorders such as anxiety and depression were strong predictors of the annual number of outpatient visits, hospital admissions, and number of days in the hospital for patients with breast and prostate...
Scientists at the Sidney Kimmel Cancer Center at Thomas Jefferson University have developed a noninvasive technique to detect the presence of prostate cancer cells in patients' urine. The pilot study, led by Mathew L. Thakur, PhD, Director, Laboratories of Radiopharmaceutical Research and Molecular ...
Guru Sonpavde, MD, of the UAB Comprehensive Cancer Center, discusses his study on circulating tumor DNA alterations in metastatic castration-resistant prostate cancer and the therapeutic direction the data suggest. (Abstract 149)
Paul L. Nguyen, MD, of the Dana-Farber Cancer Institute, summarizes a session he co-chaired, which included discussion of Canadian vs U.S. guidelines; ProtecT; genomic and hereditary tests; and imaging to guide active surveillance. (General Session 1)
Paul L. Nguyen, MD, of the Dana-Farber Cancer Institute, discuses an evaluation of the Decipher prostate cancer classifier to predict metastasis and disease-specific mortality from genomic analysis of diagnostic needle biopsy specimens. (Abstract 4)
Joshua M. Lang, MD, of the University of Wisconsin Carbone Cancer Center, discusses genomic alterations in DNA damage–repair pathways––more common in patients with prostate cancer than previously recognized–– and clinical trials with PARP inhibitors.
L. Michael Glodé, MD, of the University of Colorado Cancer Center, discusses study findings on adjuvant androgen deprivation vs mitoxantrone plus prednisone plus ADT in high-risk prostate cancer patients following radical prostatectomy. (Abstract 2)
Charles G. Drake, MD, PhD, of Columbia University Medical Center, summarizes his keynote lecture on immunotherapy as a new frontier in prostate cancer and its synergistic use with traditional treatments.
Joshua Armenia, PhD, of Memorial Sloan Kettering Cancer Center, discusses new information that is changing the understanding of prostate cancer, including the identification of a new subclass, which represents 21% of cases, and the discovery of recurrently mutated cancer pathways not previously implicated in prostate cancer (Abstract 131).
Analysis of free-floating cancer DNA from blood samples has yielded leads for new prostate cancer treatment targets. Using a commercially available “liquid biopsy” test in patients with advanced prostate cancer, researchers found a number of genetic changes in cell-free, circulating...
A new method has been found for identifying therapeutic targets in cancers lacking specific key tumor suppressor genes. The process, which located a genetic site for the most common form of prostate cancer, has potential for developing precision therapy for other cancers, such as breast, brain, and ...
The field of prostate cancer is being energized by discoveries in genetics, novel imaging techniques, and the potential of checkpoint inhibitors in the treatment of prostate cancer. Not all of these advances are currently clinically actionable, but all have the potential to change clinical...
In a Danish study reported in The Lancet Oncology, Klemann et al found a low risk of prostate cancer–specific mortality in men with benign initial transrectal ultrasound-guided biopsy sets. The risk was particularly low among those with lower prostate-specific antigen (PSA) levels. Study...
As reported in The New England Journal of Medicine by Shipley et al in the NRG Oncology Radiation Therapy Oncology Group (RTOG), the final analysis of the phase III RTOG 9601 trial showed that the addition of antiandrogen therapy with bicalutamide to radiation therapy significantly improves overall ...
In the UK PROMIS study reported in The Lancet, Ahmed et al found that use of multiparametric magnetic resonance imaging (MP-MRI) might reduce the need for transrectal ultrasound (TRUS)-guided prostate biopsy and may improve detection of clinically significant prostate cancer. Study Details In the ...
In a study reported in JAMA Oncology, Royce et al found that a prostate-specific antigen (PSA) nadir > 0.5 ng/mL may be a dominant risk factor for all-cause mortality after radiation therapy and androgen-deprivation therapy in men with localized unfavorable-risk prostate cancer. Study Details...
In a matched retrospective analysis reported in The Lancet Oncology, Zhao et al identified and validated a 24-gene predictor of response to postoperative radiotherapy in prostate cancer. Felix Y. Feng, MD, of the University of California, San Francisco, is the corresponding author of The Lancet...
Scientists have been able to validate the recently proposed five-tiered system of Gleason grade grouping using population-based data. The study, led by Grace Lu-Yao, PhD, MPH, Associate Director for Population Science at the Sidney Kimmel Cancer Center at Thomas Jefferson University and Vice...
As some national guidelines now recommend against routine prostate cancer screening, the overall rate of men receiving treatment for the disease declined 42% between 2007 and 2012, a new study published by Borza et al in Health Affairs found. The decline reflects efforts to decrease overdiagnosis...
In a European phase III trial reported in The Lancet Oncology, Azzouzi et al found that padeliporfin vascular-targeted photodynamic therapy was associated with a reduced rate of disease progression vs active surveillance in men with low-risk prostate cancer. Study Details In the open-label trial, ...