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Metastasis to bone is the hallmark of prostate cancer and a major source of disease-related morbidity and mortality. In addition to prostate cancer cells, other major players in the vicious interactive cycle of prostate cancer bone metastasis are osteoblasts, osteoclasts, and mineralized bone...
In a trial (ALSYMPCA trial) reported in The New England Journal of Medicine, Chris Parker, MD, from Royal Marsden Hospital in Surrey, UK, and colleagues compared the alpha emitter radium-223 dichloride (Xofigo) with best standard of care in men with castration-resistant prostate cancer and bone...
Cancer cells are known to have short telomeres, but just how short they are from cancer cell to cancer cell may be a determining factor in a prostate cancer patient’s prognosis, according to a study1 led by scientists at Johns Hopkins. “Doctors are looking for new ways to accurately predict...
All medical care should seek to achieve one or more of three goals: to relieve suffering, to prevent future suffering, or to prolong life. Care for cancer is no exception, and minimizing suffering from cancer and prolonging life has primarily resulted from advances in treatment. Although there are...
In the Prostate Cancer Prevention Trial (PCPT), initially reported in 2003, finasteride significantly reduced the risk of prostate cancer by 24.8% but was associated with a relative 26.9% increase in risk of high-grade disease compared with placebo. In a study reported in The New England Journal of ...
The therapeutic landscape for the treatment of castration-resistant prostate cancer has changed dramatically in the past 4 years, as five new agents affecting different aspects of the malignant process were proven to prolong life. The results are a great benefit to patients, but at the same time...
An interim analysis of the COU-AA-302 phase III trial in asymptomatic or mildly symptomatic chemotherapy-naive men with metastatic castration-resistant prostate cancer showed that the addition of abiraterone (Zytiga) to prednisone significantly delayed radiographic progression and improved overall...
The seminal study by Wang and colleagues reported in the Journal of the National Cancer Institute1 and reviewed in this issue of The ASCO Post suggests a potential new therapeutic option in the treatment of advanced prostate cancer. The authors draw attention to the reliance of cancer cells on...
L-type amino acid transporters (LATs) uptake neutral amino acids including L-leucine into cells, stimulating mTOR complex 1 (mTORC1) signaling and protein synthesis. LAT1 and LAT3 are overexpressed at different stages of prostate cancer and are involved in increasing nutrients and stimulating cell...
This issue of The ASCO Post launches a Clinical Trials Resource Guide to increase awareness of NCI-funded phase I, II, and III clinical studies for your patients with advanced cancer. All of the studies are listed on the National Institutes of Health website at ClinicalTrials.gov. The clinical...
Ornish et al at the University of California in San Francisco and the Preventive Medicine Research Institute in Sausalito, California, performed a 5-year study1 including 35 men on active surveillance (10 in a lifestyle-intervention group and 25 in a control group) with low-risk prostate cancer....
Short telomere length in peripheral blood mononuclear cells is associated with aging and age-related diseases such as cancer, stroke, vascular dementia, cardiovascular disease, obesity, osteoporosis, and diabetes. Telomere attrition is considered a potential mechanism in triggering the chromosomal...
Long-term follow-up of the ALSYMPCA trial showed that radium Ra 223 dichloride (Xofigo) is extremely safe and active in men with castration-resistant prostate cancer and bone metastases. A snapshot of safety data from about 1.5 years after patients’ final radium-223 injection shows minimal...
Encouraging results of the large phase III PREVAIL trial represent another positive milestone for men with metastatic castration-resistant prostate cancer. Enzalutamide (Xtandi) improved overall survival by 29% and reduced the risk of radiographic progression of disease by 81% in men who had not...
“Dietary intake of lycopene was associated with reduced risk of lethal prostate cancer and with a lesser degree of angiogenesis in the tumor,” Ke Zu, MD, of Harvard School of Public Health, Boston, and colleagues concluded after reviewing dietary information and total and lethal prostate cancer...
In a recent study, reviewed in this issue of The ASCO Post, Li et al present data from two long- term prospective studies—the Physicians Health Study (PHS, from 1982 to 1998), and the Health Professionals’ Follow-up Study (HPFS, from 1986 to 2010)—both of which suggest a strong association between...
History of severe acne, which is a surrogate for high androgen activity, has been associated with increased risk of prostate cancer, and recent data suggest that severe teenage acne is a risk factor for melanoma. Such findings suggest a role of androgens in etiology for both prostate cancer and...
The 10th Genitourinary Cancers Symposium, sponsored by ASCO, the American Society for Radiation Oncology, and the Society of Urologic Oncology, was held January 29–February 1, 2014, in San Francisco. The more than 630 abstracts presented addressed essential research in genitourinary malignancies,...
Ipilimumab (Yervoy) failed to meet the primary endpoint of improving overall survival in the randomized, phase III CA184-043 trial. However, the immunotherapy did improve progression-free survival and prostate-specific antigen (PSA) response compared with placebo in postdocetaxel metastatic...
The 2014 Genitourinary Cancers Symposium, held in San Francisco from January 29 to February 1, brought together more than 3,100 participants from around the world involved in the care of patients with genitourinary malignancies. The abstract presentations and plenary discussions offered the latest...
Extended follow-up in the Scandinavian Prostate Cancer Group Study Number 4 (SPCG4), reported recently in The New England Journal of Medicine,1 found that men with early-stage prostate cancer, particularly those under 65 years old, who were treated with radical prostatectomy had increased survival...
Specialist bias, in which specialists recommend the therapy that they are capable of delivering, is thought to influence the treatment of patients with localized prostate cancer and to contribute to overtreatment of men with limited life expectancy,” Ayal A. Aizer, MD, MPH, and colleagues, from the ...
The recent study by Nam et al in The Lancet Oncology—reviewed in this issue of The ASCO Post—provides a fresh perspective on complications other than incontinence or erectile dysfunction that commonly arise after primary treatment of localized prostate cancer.1 The authors conducted a...
Men with newly diagnosed localized prostate cancer face a decision between prostatectomy and radiotherapy, treatments deemed similarly effective but with well-established trade-offs in terms of treatment-related morbidity. Numerous clinical trials and other prospective studies, from both academic...
Studies of complications of surgery or radiotherapy for prostate cancer generally focus on incontinence and erectile dysfunction. In a population-based cohort study reported in The Lancet Oncology, Robert Nam, MD, MSc, FRCS(C), Professor of Surgery, Sunnybrook Health Sciences Centre, University of...
Physicians at MedStar Georgetown University Hospital and Georgetown University Medical Center, Washington, DC, are studying the safety and effectiveness of prostate artery embolization in men with enlarged prostate glands and urinary obstruction. According to the National Institutes of Health,...
Daily use of tadalafil (Cialis) did not improve erectile function compared to placebo or prevent erectile dysfunction among men undergoing radiotherapy for prostate cancer, according to results of a stratified, placebo-controlled, double-blind, parallel-group study with 1:1 randomization at 76...
A retrospective analysis of patients with prostate cancer receiving primary treatment with either stereotactic body radiation therapy or intensity-modulated radiation therapy found that those receiving stereotactic body radiotherapy had greater rates of genitourinary toxicity during 2-year...
I have spent my career working with urologists. Over a long period of time, I have concluded that they are fine and interesting people who work hard, live well, support interesting hobbies, generally take good care of their families, and are very enjoyable company at parties. The recent discussion...
The long-term benefits of radical prostatectomy vs watchful waiting in men with localized prostate cancer has remained a debated issue. As reported in The New England Journal of Medicine by Anna Bill-Axelson, MD, of Uppsala University Hospital, and colleagues, additional long-term follow-up in the...
A simple blood test may be able to identify men with castration-resistant prostate cancer who will not respond to enzalutamide (Xtandi). The presence of the splice variant androgen receptor (AR) V7 in circulating tumor cells identified men who were unlikely to respond to enzalutamide and whose...
At the 19th Annual Conference of the National Comprehensive Cancer Network (NCCN), held recently in Hollywood, Florida, NCCN Panel members presented updates for several tumor types, briefly summarized here. For a more complete description of all updates, visit www.nccn.org. Breast Cancer Guidelines ...
Results from three studies published recently in European Urology indicate that the 17-gene Oncotype DX Genomic Prostate Score is a significant predictor of disease aggressiveness at the time of diagnosis before intervention with radiation or surgery.1 The test provides precise and individualized...
In men with prostate cancer and a prostate-specific antigen (PSA)-only recurrence after curative surgery or radiation, delaying androgen deprivation therapy for at least 2 years or until clinical progression (ie, new symptoms, metastasis by imaging techniques or short PSA doubling time) did not...
Adding docetaxel to standard androgen ablation therapy (ie, testosterone suppression) extended survival by more than 1 year in men with newly diagnosed metastatic hormone-sensitive prostate cancer in the phase III E3805 trial, funded by the National Institutes of Health. As reported at the ASCO...
Three separate studies of treatments for prostate cancer reported at the 2014 ASCO Annual Meeting in Chicago showed excellent, intermediate, and disappointing results. An update of the previously reported PREVAIL trial (see March 1 issue of The ASCO Post, page 1) was overwhelmingly positive for the ...
Androgen receptor (AR) splice variant 7 (V7) appears to be a new biomarker for response and disease progression in patients treated with enzalutamide (Xtandi) or abiraterone (Zytiga). The presence of AR-V7 in circulating tumor cells predicted resistance to both drugs in men with metastatic...
Prostate cancer will be diagnosed in 233,000 American men in 2014. It is one of the leading causes of death by a cancer (killing ~29,500 men annually).1 Hundreds of thousands of men undergo prostate biopsies each year, most for either benign disease or for a cancer that will never lead to their...
Long-term results from the Health Professionals Follow-up Health Study have shown a 20% increased risk of advanced prostate cancer and a 19% increased risk of lethal prostate cancer among men who had vasectomies.1 According to the study’s lead author, Mohummad Minhaj Siddiqui, MD, it is...
In a study reported in the Journal of the National Cancer Institute, Cao and colleagues identified mutations in insulin-like growth factor (IGF) pathway genes that were significantly associated with mortality in prostate cancer. Analysis of 530 single nucleotide polymorphisms (SNPs) in 26 IGF...
For specific diseases, many physicians tend to recommend interventions and therapies with which they are most comfortable and familiar. It is not surprising that urologists and radiation oncologists did so in the study reported by Hoffman and colleagues in JAMA Internal Medicine and reviewed in...
Active surveillance is well established as an appropriate management option for men with low-risk prostate cancer and particularly for those over 65 years of age. Its legitimacy is now enshrined within National Comprehensive Cancer Network guidelines, in the American Society for Radiation Oncology...
Most older men with low-risk prostate cancer receive upfront treatment, despite the absence of a clear survival benefit and potential for morbidity. In a retrospective cohort study reported in JAMA Internal Medicine, Karen E. Hoffman, MD, MHSc, MPH, of The University of Texas MD Anderson Cancer...
Recommendations from the United States Preventive Services Task Force and randomized trials have drawn attention to overtreatment of localized, low-risk prostate cancer. PSA screening and changing consensus on PSA testing practices are among the many factors that contribute to the overdiagnosis and ...
The androgen receptor axis is a validated target for the treatment of castration-resistant prostate cancer. Several perturbations in this pathway are postulated to lead to androgen-independent growth, including androgen receptor mutation and amplification as well as the autocrine production of...
The androgen-receptor inhibitor enzalutamide (Xtandi) has been shown to prolong survival in men with metastatic castration-resistant prostate cancer with progressive disease after chemotherapy. In the phase III PREVAIL trial reported in The New England Journal of Medicine, Tomasz M. Beer, MD, of...
Progression to castration-resistant prostate cancer after androgen ablation therapy is primarily due to deregulated androgen receptor signaling. Treatment with agents that target such signaling, such as abiraterone (Zytiga) and enzalutamide (Xtandi), has been successful. However, durable response...
In recognition of September as Prostate Cancer Awareness Month, The ASCO Post is pleased to share the following reminders, adapted in part from the American Cancer Society: Prostate cancer is the second most common cancer among men, behind skin cancer, and it affects one in seven men in his...
Healthy men participating in the Prostate Cancer Prevention Trial who actively participate in all steps of the clinical trial are most likely to undergo an end-of-study biopsy, according to a study published in Cancer Epidemiology, Biomarkers and Prevention.1 The Prostate Cancer Prevention Trial...
The Prostate Cancer Foundation has announced that Drew Pinsky, MD, has been elected to the Foundation’s Board of Directors. Dr. Pinsky, a cancer survivor, is a Practicing Physician and a Member of the Staff of Huntington Memorial Hospital in Pasadena, California. He is also Assistant Clinical...