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Prostate Cancer

Updated Information on Prostate Cancer Drugs: Enzalutamide, Orteronel, and Cixutumumab

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 ...

Prostate Cancer

AR-V7 Predicts Resistance to Enzalutamide and Abiraterone in Men With Castration-Resistant Prostate Cancer

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

Prostate Cancer Biomarkers: Improvement in Predicting Clinically Significant Disease

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...

Prostate Cancer

‘Reasonable’ to Advise Men Who Have Had Vasectomies That They Have a Small Increased Risk for Lethal Prostate Cancers

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...

Prostate Cancer

Mutations in IGF Pathway Genes Associated With Prostate Cancer Mortality

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...

Prostate Cancer

Low-Risk Prostate Cancer and Principles of Active Surveillance

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...

Prostate Cancer

Active Surveillance in Low-Risk Prostate Cancer: When Will We Pay It More Than Just Lip Service?

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...

Prostate Cancer

Minority of Older Patients With Low-Risk Prostate Cancer Managed by Observation, Rates Vary Widely Among Urologists and Radiation Oncologists

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...

Prostate Cancer

College of American Pathologists Publishes Recommendations for Prostate Cancer Active Surveillance

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 ...

Prostate Cancer

Enzalutamide and the Landscape of Castration-Resistant Prostate Cancer: Integrating New Indications With Existing Agents

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...

Prostate Cancer

PREVAIL Trial: Enzalutamide Before Chemotherapy Prolongs Survival in Metastatic Prostate Cancer

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...

Prostate Cancer

BET Bromodomain Inhibition Highly Active in Castration-Resistant Prostate Cancer

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...

Prostate Cancer

September Is Prostate Cancer Awareness Month

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...

Prostate Cancer

Systematic Model Identifies Factors Associated With Adherence in Prostate Cancer Prevention Trial

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...

prostate cancer

Drew Pinsky, MD, Elected to Prostate Cancer Foundation Board of Directors

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...

Prostate Cancer

PSA—It Just Keeps Getting Better, So Why Should It Stand Alone?

The updated results of the European Randomised Study of Screening for Prostate Cancer (ERSPC)—reported in The Lancet by Fritz H. Schröder, MD, of Erasmus University Medical Center, and colleagues1 and reviewed in this issue of The ASCO Post—show a continued decline, as predicted,2 in the number...

Prostate Cancer

European Researchers at 13-Year Follow-up: Increased Absolute Benefit of PSA Screening in Prostate Cancer Mortality, but Time for Population-Based Screening Has Not Arrived

The 13-year follow-up of the European Randomized Study of Screening for Prostate Cancer ­(ERSPC), reported by Fritz H. Schröder, MD, PhD, Professor Emeritus of Urology at Erasmus University Medical Center, Rotterdam, the Netherlands, and colleagues in The Lancet, showed that prostate-specific...

Prostate Cancer

Studies Help Refine Management of Prostate Cancer

Several studies reported at this year’s ASCO Annual Meeting address gray areas in the management of prostate cancer, according to Evan Y. Yu, MD, Associate Professor at the University of Washington and the Seattle Cancer Care Alliance. “In prostate cancer, probably the most excitement has happened...

Breast Cancer
Colorectal Cancer
Gynecologic Cancers
Prostate Cancer

Overscreening for Prostate, Breast, Colorectal, and Cervical Cancer Can Raise Costs and Harm Patients

Analyses of data from 27,404 people aged 65 and older participating in the National Health Interview Survey (NHIS) from 2000 through 2010 suggest that overscreening for prostate, breast, cervical, and colorectal cancer screening “is common in both men and women, which not only increases health care ...

Prostate Cancer

Moderate Form of Male Pattern Baldness Associated With Increased Risk of Aggressive Prostate Cancer

Men with moderate pattern baldness on the front and the crown of the head at age 45 had a 40% increased risk, compared to men with no baldness at that age, of developing prostate cancer later in life, according to a study led by researchers from the National Cancer Institute (NCI) and published in...

Prostate Cancer

Primary Androgen Deprivation Does Not Improve Long-Term Survival in Older Patients With Localized Prostate Cancer

Primary androgen-deprivation therapy has been widely used in localized prostate cancer, despite the absence of definitive evidence of benefit in early-stage disease. In a large population-based cohort study reported in JAMA Internal Medicine, Grace L. Lu-Yao, MPH, PhD, of Rutgers Cancer Institute...

Prostate Cancer

Enzalutamide in Metastatic Castration-Resistant Prostate Cancer

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.   On September 10, 2014, the androgen receptor inhibitor...

Prostate Cancer

Duration of Androgen-Deprivation Therapy for Patients With High-Risk Prostate Cancer

Optimal duration of androgen-deprivation therapy as part of primary therapy for prostate cancer continues to be an important question. Two well-conducted studies reported recently at the 56th Annual Meeting of the American Society for Radiation Oncology ­(ASTRO) provide data that can help inform...

Prostate Cancer

Androgen, Estrogen, and Stem Cell Markers Help Predict Recurrence and Survival in Metastatic Prostate Cancer

In a study reported in Clinical Cancer Research, Fujimura and colleagues developed and tested models to predict prostate-specific antigen (PSA) recurrence and cancer-specific survival in patients with treatment-naive prostate cancer and bone metastases using mRNA expression of genes involved in...

Prostate Cancer

Radiotherapy Should Be Added to Hormone Therapy in Node-Positive Prostate Cancer

Node-positive prostate cancer has typically been excluded from clinical trials, leaving oncologists with little evidence to guide management for this group of patients. A study presented at the European Society for Medical Oncology (ESMO) 2014 Congress sheds light on this issue, providing the...

prostate cancer

Peter Carroll, MD, MPH, Receives Grant for Early Detection of Prostate Cancer

The ZERO Cancer Research Fund has awarded the Jim Lafferty Memorial Research Grant in the amount of $45,000 to Peter Carroll, MD, MPH, of the University of California San Francisco, for the purpose of researching new and improved methods for early detection of prostate cancer. The grant is part of...

Prostate Cancer

Genomic Score Predicts Aggressiveness of Prostate Cancer in Biopsy Specimens

A prospectively designed study establishes the17-gene Oncotype DX prostate cancer test as a robust and independent predictor of the aggressiveness of prostate cancer based on a patient’s diagnostic specimen. Tumor aggressiveness, as measured by the test’s Genomic Prostate Score, was similar in...

Prostate Cancer

ASCO Endorses AUA/ASTRO Guideline on Adjuvant and Salvage Radiotherapy After Prostatectomy

ASCO has issued an endorsement of the American Urological Association (AUA)/American Society for Radiation Oncology (ASTRO) guideline on the use of adjuvant and salvage radiotherapy after prostatectomy, which was based on a systematic review of medical literature. The ASCO endorsement was published ...

Prostate Cancer

From ‘Clinical Judgment’ to Evidence-Based Medicine: Thoughts on the  ASCO/CCO Guideline in Metastatic Castration-Resistant Prostate Cancer

We are witnessing unprecedented progress in the development of therapy for patients with metastatic castration-resistant prostate cancer. The U.S. Food and Drug Administration (FDA) has issued 13 approvals since 1996 for agents that have demonstrated an impact on overall survival, pain, or...

Prostate Cancer

Systemic Therapy in Men With Metastatic Castration-Resistant Prostate Cancer: ASCO/CCO Clinical Practice Guideline

The ASCO Clinical Practice Guidelines Committee and the Cancer Care Ontario (CCO) program in evidence-based care have released a clinical practice guideline on systemic therapy in men with metastatic castration-resistant prostate cancer. The guideline was published in the Journal of Clinical...

Prostate Cancer

Physical Activity Improves Survival for Men With Localized Prostate Cancer

Among a large group of men with localized prostate cancer, those who engaged in higher levels of physical activity had lower rates of overall mortality and lower rates of prostate cancer-specific mortality, according to a study published in Cancer Epidemiology, Biomarkers & Prevention.1 “Our...

Prostate Cancer

'Bipolar' Androgen Therapy in Castration-Resistant Prostate Cancer

Resistance to castrating therapy and androgen deprivation therapy in prostate cancer is due in part to adaptive upregulation of androgen receptor levels by castration-resistant prostate cancer cells in the setting of prolonged exposure to a low-testosterone environment. In a study reported in...

Prostate Cancer

Active Surveillance in Intermediate-Risk Prostate Cancer Called Into Question

A study presented at the 2015 Genitourinary Cancers Symposium calls into question the use of active surveillance in patients with intermediate-risk prostate cancer. Patients with intermediate-risk prostate cancer managed with active surveillance had almost a four times higher risk of prostate...

Prostate Cancer

Selenium Supplements After Diagnosis of Nonmetastatic Prostate Cancer May Raise Prostate Cancer Mortality Risk

“Selenium supplementation of 140 or more μg/d after diagnosis of nonmetastatic prostate cancer may increase risk of prostate cancer mortality,” according to a prospective study following 4,459 men initially diagnosed with nonmetastatic prostate cancer in the Health Professionals Follow-up Study...

Prostate Cancer

High-Dose Radiotherapy Provides Meaningful Improvements in Localized Prostate Cancer—But Not Increased Survival Yet

High-dose radiotherapy failed to improve overall survival at 7 years compared with standard-dose radiotherapy in men with stage II localized prostate cancer. However, the high-dose schedule had several advantages, including improved rates of local tumor control and distant metastasis, according to...

Prostate Cancer

No Survival Benefit Reported With Docetaxel Added to Hormone Therapy in Metastatic Prostate Cancer

Docetaxel added to androgen-deprivation therapy did not improve overall survival over androgen-deprivation therapy alone in hormone-naive metastatic prostate cancer, according to an updated analysis of the GETUG-AFU 15 trial presented at the 2015 Genitourinary Cancers Symposium.1 In a retrospective ...

Prostate Cancer

Intensified Immunotherapy Encouraging in Chemotherapy-Naive Metastatic Prostate Cancer

Emerging evidence suggests that immunotherapy may play an important role in treating prostate cancer. In particular, preliminary results have shown that combining a new vaccine with ipilimumab ­(Yervoy) boosts overall survival in men with castration-resistant prostate cancer.1 A study comparing...

Prostate Cancer

Targeted MR/Ultrasound Fusion–Guided Biopsy Increased Detection of  High-Risk Prostate Cancer

Among men undergoing biopsy for suspected prostate cancer, targeted magnetic resonance (MR)/ultrasound fusion–guided biopsy was associated with an increased rate of detection of high-risk prostate cancer and a decreased rate of detection of low-risk prostate cancer than was standard...

Prostate Cancer

Cabozantinib Fails to Improve Survival in Metastatic Castration-Resistant Prostate Cancer

Final results of the phase III, randomized double-blind, controlled COMET-1 trial were disappointing. Although the oral tyrosine kinase inhibitor cabozantinib (Cometriq) improved several secondary endpoints compared with prednisone, including bone scan response and progression-free survival, the...

Prostate Cancer

Evidence Mounts for Clinical Utility of AR-V7 in Treatment Selection for Advanced Prostate Cancer

The search is on in prostate cancer to identify predictive and prognostic biologic and genomic markers that go beyond traditional ones. Several groups are working in this area. One marker that has received much attention is a splice abnormality in the androgen receptor (AR) called AR-V7. Two...

Prostate Cancer

Androgen-Deprivation Therapy Added to Radiation Therapy Improves Disease Control in Intermediate-Risk Prostate Cancer

The addition of 6 months of androgen-deprivation therapy to radiation therapy as primary therapy for intermediate-risk prostate cancer improved biochemical control and disease-free survival but did not translate to an improvement in overall survival, in a phase III trial reported at the 2015...

Prostate Cancer

Widespread Use of Docetaxel Preceded Phase III Evidence of Usefulness in Patients With Metastatic Prostate Cancer

Docetaxel was being widely used by patients with metastatic prostate cancer before phase III evidence that it was more effective than the standard of care for patients with castration-resistant prostate cancer, according to an analysis of Medicare claims from before and after the trial results and...

Prostate Cancer

MAINSAIL Trial: Worse Outcomes With Addition of Lenalidomide to Docetaxel-Prednisone in Prostate Cancer

The combination of docetaxel plus prednisone has been a standard therapy in advanced prostate cancer since 2004.1 Since then, there have been multiple randomized phase III trials comparing this standard of care with additional drug therapy. None has demonstrated improvement in outcome. Lenalidomide ...

Prostate Cancer

Addition of Lenalidomide to Docetaxel-Prednisone Worsens Survival in Chemotherapy-Naive Metastatic Castration-Resistant Prostate Cancer

In the phase III MAINSAIL trial reported in The Lancet Oncology, Daniel P. Petrylak, MD, of Yale Cancer Center, New Haven, Connecticut, and colleagues found that the addition of lenalidomide (Revlimid) to docetaxel-prednisone in chemotherapy-naive men with metastatic castration-resistant prostate...

Prostate Cancer
Survivorship

Prostate Cancer Survivorship: Identifying Opportunities for Improvement

Prostate cancer survivors currently approach 3 million in number and comprise 43% of all male cancer survivors in the United States.1 These men face myriad unique oncologic, functional, emotional, and psychological issues that require evaluation and management throughout the survivorship phase of...

Prostate Cancer

ASCO Endorses American Cancer Society Prostate Cancer Survivorship Care Guidelines

As reported in the Journal of Clinical Oncology by Matthew J. Resnick, MD, of Vanderbilt University Medical Center, and colleagues, ASCO has endorsed the 2014 American Cancer Society Prostate Cancer Survivorship Care Guidelines.1,2 The ASCO endorsement panel was co-chaired by Dr. Resnick and David...

Prostate Cancer

Prostate Tumors With Genetic Abnormalities Respond to Olaparib

Olaparib (Lynparza) achieved encouraging response rates in men with metastatic prostate cancer, particularly those with mutations in genes involved in DNA repair (BRCA2 and ATM, most commonly).1 If validated, these results of the TOPARP-A trial will usher in the first drug targeted to somatic or...

Skin Cancer
Breast Cancer
Multiple Myeloma
Leukemia
Colorectal Cancer
Prostate Cancer
Pancreatic Cancer

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2015 Updates

For 2 decades, the NCCN Guidelines® have been recognized as the standard of cancer care in the United States, combining evidence, experience, and choice, so that multidisciplinary cancer treatment teams—including patients—are empowered to make informed decisions about cancer care,” said Robert W....

Prostate Cancer

Docetaxel Combined With Hormone Therapy Extends Survival in Advanced Prostate Cancer

Results from the STAMPEDE trial showed that the addition of docetaxel to standard hormone therapy improved overall survival by a median of 10 months over hormone therapy alone in men with newly diagnosed, advanced, hormone therapy–naive prostate cancer.1 The study also showed that zoledronic acid...

Prostate Cancer

Effect of ERG Gene Status on Progression-Free Survival With Abiraterone in Castration-Resistant Prostate Cancer

Gene fusions resulting in androgen receptor–modulated ERG gene overexpression can be found in up to 70% of patients with metastatic castration-resistant prostate cancer. In a study reported in Clinical Cancer Research, Attard and colleagues assessed the effect of ERG rearrangement on outcomes in...

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