FORMAL DISCUSSANT Robert G. Bristow, MD, PhD, of the Manchester Cancer Research Centre, Manchester, United Kingdom, called this trial “an exemplar.” “Radiation to the prostate should be considered standard of care in the setting of hormone-sensitive low-metastatic burden. The treatment is well...
MEN WITH newly diagnosed metastatic prostate cancer do not typically receive treatment to the primary tumor with radiation or surgery. A new analysis of the STAMPEDE trial found that radiation administered to the prostate can improve overall survival in men with newly diagnosed metastatic prostate...
In a study reported in JAMA Oncology, Howard I. Scher, MD, of the Genitourinary Oncology Service, Memorial Sloan Kettering Cancer, and colleagues found that the presence of nuclear-localized androgen receptor splice variant 7 (AR-V7) protein in circulating tumor cells may predict better survival...
In an Australian phase III trial reported in The Lancet Oncology, Suzanne K. Chambers, PhD, of the Menzies Health Institute Queensland, Griffith University, Gold Coast, and colleagues found similar functional outcomes at 2 years with robot-assisted laparoscopic prostatectomy and open radical...
In a study published by Mark A. Preston, MD, MPH, and colleagues in European Urology, researchers demonstrated that a baseline prostate-specific antigen (PSA) level obtained from black men between 40 and 60 years old may predict the future development of prostate cancer for years after testing....
Three prominent medical societies have issued a new clinical guideline for physicians treating men with early-stage prostate cancer using external-beam radiation therapy (EBRT). Adoption of the guideline could make treatment shorter and more convenient for many patients with prostate cancer....
The first report of a large international clinical trial shows that, for men who show signs of prostate cancer after surgical removal of their prostates, extending radiation therapy to the pelvic lymph nodes combined with adding short-term androgen-deprivation therapy (ADT) to standard treatment...
In long-term follow-up of the phase III NRG/RTOG 9413 study reported in The Lancet Oncology by Roach et al, neoadjuvant hormonal therapy (NHT) plus whole-pelvic radiotherapy (WPRT) and prostate-only radiotherapy (PORT) plus adjuvant hormonal therapy (AHT) were associated with the highest rates of...
Howard M. Sandler, MD, of Cedars-Sinai Medical Center, summarizes a session he moderated that included discussion of an ASTRO, ASCO, and AUA guideline; indications and dose fractionation; treatment volumes; and the use of IGRT and IMRT (Panel 03).
Daniel E. Spratt, MD, of the University of Michigan, discusses a large-scale gene-expression analysis and meta-analysis of RTOG trials on androgen receptor activity and radiotherapeutic sensitivity in African American men with prostate cancer (Abstract 4).
Howard M. Sandler, MD, of Cedars-Sinai Medical Center, discusses a session on data from several long-term studies on localized disease, including optimal sequencing of radiation and androgen-deprivation therapy; the efficacy and toxicity of SBRT; conventional vs hypofractionated radiation therapy; and dose escalation (Scientific Symposium 08).
Alan Pollack, MD, of the University of Miami, discusses study findings on short-term androgen-deprivation therapy with or without pelvic lymph node treatment added to prostate bed–only salvage radiotherapy (Abstract LBA5).
A new analysis of genetic data from a large prospective registry and clinical data from several randomized trials indicates that African American patients may have comparatively higher cure rates when treated with radiation therapy than Caucasian patients. The study, which is the first report...
Nicholas D. James, PhD, MBBS, of University Hospitals Birmingham NHS Trust, discusses study findings on treating metastatic castration-sensitive prostate cancer, including results on radiotherapy and abiraterone (Abstract LBA5_PR).
Radiotherapy to the prostate improved overall survival in men newly diagnosed with metastatic prostate cancer who have a low metastatic disease burden, but not in those with higher burden of disease, according to results from a preplanned analysis of a large comparison study reported by Parker et...
The Prostate Cancer Foundation (PCF) recently released the results of its first national public awareness report about risks, actions, and attitudes toward prostate cancer in the PCF 3P Report 2018: Public Perception of Prostate Cancer. Each year, even though more than three million men in...
In a study published by Preston et al in European Urology, researchers demonstrated that a baseline prostate-specific antigen (PSA) level obtained from black men between 40 and 60 years old may predict the future development of prostate cancer for years after testing. The study builds on ...
The U.S. Food and Drug Administration (FDA) recently granted Breakthrough Therapy designation to rucaparib (Rubraca) monotherapy for the treatment of adult patients with BRCA1/2-mutated metastatic castration-resistant prostate cancer who have received at least one prior androgen...
IN EARLY 2018, abiraterone acetate tablets (Yonsa, Zytiga) in combination with prednisone was approved for the treatment of metastatic high-risk castration-sensitive prostate cancer.1,2 Supporting Efficacy Data APPROVAL WAS BASED on findings from the phase III LATITUDE trial, in which 1,199...
Although national guidelines recommend against prostate cancer screening in men age 70 and older, researchers from the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center estimate that screening for and treating prostate cancer in men in this age group costs Medicare more than ...
As reported in the Journal of Clinical Oncology by Justin E. Bekelman, MD, of the University of Pennsylvania Perelman School of Medicine, and colleagues, ASCO has endorsed the 2017 American Urological Association (AUA), American Society for Radiation Oncology (ASTRO), and Society of Urologic...
The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on prostate cancer. These trials are studying bone marrow transplant, gene therapy, checkpoint inhibitor treatment, radiation therapy techniques, antibody therapies, and...
Prostate-specific membrane antigen (PSMA) positron-emission tomography (PET) imaging has become a popular method for determining the stage of a patient’s prostate cancer. However, researchers have identified a pitfall in this imaging technique and are cautioning medical professionals to be...
A group of men with especially aggressive prostate cancer may respond unusually well to immunotherapy, according to a study published by Rodrigues et al in the Journal of Clinical Investigation. The research offers the possibility of effective treatment, with clinical trials already underway. An...
The Prostate Cancer Foundation (PCF) and the Movember Foundation recently announced four new Movember Foundation–PCF Challenge Award teams at some of the world’s leading academic research institutions will receive a total of $3.5 million to support cross-disciplinary pioneering research toward the...
A MAN in his early 70s sits in our office. His general health is good, and he is feeling well. Yet he is deeply worried. Four years ago, when his prostate-specific antigen (PSA) level rapidly increased after radical prostatectomy and subsequent radiation therapy, he was started on...
In a long-term follow-up of a phase III trial reported in the Journal of Clinical Oncology, Hoffman et al found that dose-escalated moderately hypofractionated intensity-modulated radiation therapy (HIMRT) improved disease control and reduced treatment duration vs conventionally fractionated IMRT...
The Institute for Clinical and Economic Review (ICER) has released an evidence report assessing the comparative clinical effectiveness and value of antiandrogen therapies for the treatment of nonmetastatic castration-resistant prostate cancer. The report focuses on three antiandrogen...
Compared with nondrinkers, men who consumed at least 7 drinks per week during adolescence (ages 15–19) had 3 times the odds of being diagnosed with clinically significant prostate cancer, according to results published by Michael et al in Cancer Prevention Research. “The prostate...
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On July 13, 2018, enzalutamide (Xtandi) was approved for...
The largest coordinated research effort to study biologic and nonbiologic factors associated with aggressive prostate cancer in African American men has begun. The $26.5 million study is called RESPOND, or Research on Prostate Cancer in Men of African Ancestry: Defining the Roles of Genetics, Tumor ...
WHAT IS THE best choice of treatment for a man with newly diagnosed metastatic castration-resistant prostate cancer after treatment with androgen-deprivation therapy—abiraterone acetate (Zytiga) plus prednisone, or enzalutamide (Xtandi)? Both drugs achieve similar cancer control in this setting,...
AS REPORTED in The New England Journal of Medicine by Maha Hussain, MD, of the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, and colleagues, the phase III PROSPER trial has shown a 71% reduction in the risk of metastasis or death with enzalutamide (Xtandi) vs placebo in men ...
The PLATO trial failed to show benefit of adding abiraterone (Zytiga)/prednisone to ongoing enzalutamide (Xtandi) vs abiraterone/prednisone in men with metastatic castration-resistant prostate cancer exhibiting rising prostate-specific antigen (PSA) during enzalutamide treatment. Results of the...
Conventional wisdom suggests that a high level of the protein prostate-specific antigen (PSA) in men with prostate cancer means a poor prognosis. However, this may not always be the case in men with a particular subtype of prostate cancer, according to a new study from Weill Cornell Medicine and...
The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) has estimated that in developed countries, about 35% of breast cancers and 45% of colorectal cancers could be prevented with a better adherence to nutritional recommendations. A large prospective study evaluating...
In an Australian phase III trial reported in The Lancet Oncology, Coughlin et al found similar functional outcomes at 2 years with robot-assisted laparoscopic prostatectomy and open radical retropubic prostatectomy in men with newly diagnosed clinically localized prostate cancer. Study Details In ...
Prior to ASCO’s 2016 endorsement of the Cancer Care Ontario (CCO) guideline on active surveillance in the management of localized prostate cancer,1 most men—over 90%—diagnosed with low-risk localized disease were treated with active therapy.2 Today, about 50% of American men with low-risk disease...
EARLY IN 2018, abiraterone acetate tablets (Zytiga) in combination with prednisone were approved for the treatment of metastatic high-risk castration-sensitive prostate cancer.1,2 Supporting Efficacy Data APPROVAL WAS based on the findings of the phase III LATITUDE trial, in which 1,199 patients...
ON JULY 13, 2018, the U.S. Food and Drug Administration (FDA) approved enzalutamide (Xtandi) for patients with castration-resistant prostate cancer (CRPC). This approval broadens the indicated patient population to include patients with either nonmetastatic CRPC or metastatic CRPC. Enzalutamide was ...
In a phase II trial reported in JAMA Oncology, Autio et al found that prostate-specific membrane antigen (PSMA)–targeted docetaxel nanoparticle (BIND-014) treatment was active in patients with metastatic castration-resistant prostate cancer (mCRPC). Study Details In the multicenter trial,...
On July 13, 2018, the U.S. Food and Drug Administration (FDA) approved enzalutamide (Xtandi) for patients with castration-resistant prostate cancer (CRPC). This approval broadens the indicated patient population to include patients with either nonmetastatic CRPC or metastatic CRPC. Enzalutamide was ...
In a study reported in JAMA Oncology, Scher and colleagues found that the presence of nuclear-localized androgen receptor splice variant 7 (AR-V7) protein in circulating tumor cells (CTCs) may predict better survival with taxane therapy vs androgen receptor signaling (ARS) inhibitor treatment in...
As reported in The New England Journal of Medicine by Hussain et al, the phase III PROSPER trial has shown a 71% reduction in risk of metastasis or death with enzalutamide (Xtandi) vs placebo in men with nonmetastatic castration-resistant prostate cancer. Study Details In the double-blind trial,...
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Earlier this year, apalutamide (Erleada) was approved for ...
In a letter to the editor of The New England Journal of Medicine, Thomas J. Smith, MD, of Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, and colleagues described the successful use of oxybutynin to treat hot flashes in a patient receiving androgen-deprivation therapy (ADT) for ...
With the development of the prostate-specific antigen (PSA) test in the early 1990s, the urology community advocated for population screening of all men of a certain age, igniting a heated argument about the test’s clinical value vs potential harms that has not abated to this day. Moreover, from...
In a single-center phase II study reported in The Lancet Oncology, Teply et al found that bipolar androgen therapy can induce prostate-specific antigen (PSA) response and resensitization to enzalutamide (Xtandi) in men with metastatic castration-resistant prostate cancer whose disease progressed on ...
The ASCO updated guidelines on the treatment of metastatic non-castrate prostate cancer penned by Morris and his colleagues1 provide valuable information annotated to the strengths of evidence in recently reported prostate cancer studies. CHAARTED, GETUG-AFU 15, LATITUDE, and STAMPEDE have...
After about 70 years with no significant progress, the landscape for men with de novo metastatic prostate cancer has changed dramatically in the past 4 years, with statistically significant and highly clinically meaningful survival improvement reported from multiple phase III trials when...