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FOR DECADES, the status of metastatic prostate cancer trials was not particularly exciting. With an absence of high-impact novel agents, the focus of cancer trial groups was on the improvement of standard care. Well-crafted, large trials of hormonal therapy demonstrated the utility of combined...
University of California, Los Angeles (UCLA) researchers have discovered that a combination of high doses of radiotherapy and hormonal therapy provides the best chance of decreasing the mortality rate in men with aggressive prostate cancer. The findings, published by Kishan et al in JAMA, also...
As reported by Smith et al in The New England Journal of Medicine, the phase III SPARTAN trial has shown that the androgen receptor inhibitor apalutamide (Erleada) produces significant improvement in metastasis-free survival and time to symptomatic progression vs placebo among men with...
ON FEBRUARY 7, 2018, the U.S. Food and Drug Administration (FDA) approved abiraterone acetate (Zytiga) tablets in combination with prednisone for metastatic high-risk castration-sensitive prostate cancer. The FDA initially approved abiraterone acetate with prednisone in 2011 for patients with...
“To what extent do treatments for prostate cancer impact sexual functioning? To a great extent,” Christian Nelson, PhD, Chief, Psychiatry Service, Memorial Sloan Kettering Cancer Center, New York, told participants at the 11th Annual Oncofertility Consortium Conference in Chicago.1 Most men with...
Analysis of long-term survival outcomes in the phase III CHAARTED trial showed a survival advantage with the addition of docetaxel to androgen-deprivation therapy (ADT) in patients with hormone-sensitive metastatic prostate cancer, although no advantage was observed among patients with low-volume...
The U.S. Food and Drug Administration (FDA) today approved apalutamide (Erleada) for the treatment of patients with prostate cancer that has not spread, but that continues to grow despite treatment with hormone therapy. This is the first FDA-approved treatment for nonmetastatic,...
Eric J. Small, MD, of the University of California, San Francisco, discusses phase III findings on apalutamide vs placebo in patients with nonmetastatic castration-resistant prostate cancer (Abstract 161).
Paul L. Nguyen, MD, of the Dana-Farber Cancer Institute, summarizes a session he chaired on prostate cancer, which included discussion of daily vs weekly image-guided radiotherapy; a biomarker to predict biochemical failure and metastasis; a comparison of abiraterone or enzalutamide activity; and the impact of 18F-fluciclovine PET/CT on clinical management choices for men with biochemically recurrent disease (Abstracts 4, 5, 164, 165).
Fatima Karzai, MD, of the National Institutes of Health, discusses phase II findings on olaparib and durvalumab in metastatic castration-resistant prostate cancer in an unselected population (Abstract 163).
Nicholas D. James, MBBS, PhD, of University Hospitals Birmingham NHS Foundation Trust, discusses study findings on the addition of docetaxel to first-line hormone therapy in prostate cancer, an analysis focusing on cost-effectiveness and long-term and quality-adjusted survival (Abstract 162).
Maha Hussain, MD, of Northwestern University, discusses phase III findings on enzalutamide in men with nonmetastatic castration-resistant prostate cancer (Abstract 3).
Robert G. Bristow, MD, PhD, of Manchester Cancer Research Centre, discusses germline and somatic mutations; new ways to generate biomarkers that may describe tumor complexity; and how, in the future, this information may help triage patients with aggressive prostate tumors to intensified treatments.
Results from the phase III PROSPER trial in patients with nonmetastatic castration-resistant prostate cancer were presented by Hussain et al at the 2018 Genitourinary Cancers Symposium (Abstract 3). The results show that the use of enzalutamide (Xtandi) plus androgen-deprivation therapy (ADT)...
On February 7, 2018, the U.S. Food and Drug Administration (FDA) approved abiraterone acetate (Zytiga) tablets in combination with prednisone for metastatic high-risk castration-sensitive prostate cancer. The FDA initially approved abiraterone acetate with prednisone in 2011 for patients with...
Using nuclear medicine, German researchers may have found a way to accurately differentiate cancerous tissue from healthy tissue in prostate cancer patients. The research is highlighted in findings published by Rahbar et al in The Journal of Nuclear Medicine. These new findings demonstrate that...
A new analysis of the ongoing STAMPEDE clinical trial found that adding docetaxel to hormone therapy for advanced prostate cancer improves quality of life and lowers the need for subsequent therapy. Docetaxel was also found to be cost-effective. These findings will be presented by James et al at...
Findings from the phase III placebo-controlled SPARTAN trial suggest that apalutamide is an effective treatment for men with nonmetastatic castration-resistant prostate cancer who are at high risk for developing metastatic disease and for whom no approved treatments exist. Men who received...
Among men with prostate cancer who underwent radical prostatectomy, those who were obese had a higher risk of biochemical recurrence, according to data presented at the American Association for Cancer Research (AACR) Special Conference on Obesity and Cancer: Mechanisms Underlying Etiology and...
As reported by Chi et al in The Lancet Oncology, the addition of abiraterone and prednisone to androgen-deprivation therapy (ADT) in the phase III LATITUDE trial was associated with improved patient-reported outcomes in patients with newly diagnosed metastatic castration-naive prostate cancer. The...
James L. Gulley, MD, PhD, of the National Cancer Institute, discusses combined treatment approaches showing early evidence of clinical activity: agents such as vaccines or PARP inhibitors that can initiate an immune response, paired with agents such as checkpoint inhibitors that can facilitate the activity of tumor-directed immune cells.
FROM WILHELM RÖNTGEN’S groundbreaking discovery of x-rays in 1895, the history of radiotherapy has been rich with colorful paradigm-changing researchers and physicians who over the past century have transformed the field into one of the pillars of cancer treatment. One such trailblazer who...
The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, Channing Paller, MD, explores the role of pomegranate- and grape-based...
In a study reported in the Journal of Clinical Oncology, Heller et al identified two circulating tumor cell (CTC) markers that had high discriminatory ability for improved survival in metastatic castration-resistant prostate cancer. Study Details The study used individual patient data from 5...
In a study reported in the Journal of Clinical Oncology, Harshman et al found that a prostate-specific antigen (PSA) level ≤ 0.2 ng/mL at 7 months after the start of androgen-deprivation therapy (ADT) was significantly associated with longer overall survival in metastatic...
In a phase II trial (NCI 9012) reported in the Journal of Clinical Oncology, Hussain et al found no benefit of adding PARP1 inhibition with veliparib to abiraterone (Zytiga) plus prednisone in patients with metastatic castration-resistant prostate cancer. ETS fusion status was not predictive of...
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 who progressed on...
In a Belgian phase II study reported in the Journal of Clinical Oncology, Ost et al found that androgen deprivation therapy (ADT)-free survival was prolonged with metastasis-directed therapy vs surveillance in recurrent oligometastatic prostate cancer. Study Details Sixty-two patients with...
On September 14, 2017, the microtubule inhibitor cabazitaxel (Jevtana) was approved at the lower dose of 20 mg/m2 every 3 weeks in combination with prednisone for treatment of patients with metastatic castration-resistant prostate cancer previously treated with a docetaxel-containing regimen.1,2...
In a study reported in the Journal of Oncology Practice, Bickell et al found underuse of treatment for clinically significant prostate cancer was infrequent among white and black patients at two New York City hospitals, but black men accounted for nearly all such underuse of treatment. As noted by...
As reported in the Journal of Clinical Oncology, Spratt et al have developed an integrated clinical-genomic risk classifier for predicting distant metastasis in patients with localized prostate cancer. The classifier uses National Comprehensive Cancer Network® (NCCN) risk categories and risk...
Compared with the non-Hispanic white (NHW) population, the urban American Indian and Alaskan Native (AIAN) community was more likely to have lower survival rates following invasive prostate and breast cancer, according to a new study by Emerson et al in Cancer Research. “It’s been...
In a health-related quality-of-life study among patients in the phase III TOAD trial, immediate vs delayed androgen-deprivation therapy (ADT) was associated with early worsening of androgen-deprivation therapy–related symptoms but few other comparative adverse effects on functioning or quality of...
Among men diagnosed with prostate cancer, about one in two will receive androgen-deprivation therapy, which is associated with many potential adverse side effects, including significant bone loss and increased risk for low trauma or fragility fractures similar to those found in people with primary ...
In a single-center analysis reported in JAMA Oncology, Hiten D. Patel, MD, MPH, of The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, and colleagues found that among men undergoing elective radical prostatectomy, those with low-volume intermediate-risk...
In a study reported in the Journal of the National Cancer Institute, Wyatt et al found high agreement between driver mutations in plasma circulating tumor DNA (ctDNA) and metastatic tissue biopsy in castration-resistant prostate cancer. Martin Gleave, MD, and Alexander Wyatt, DPhil, of Vancouver...
Establishing the way in which a genetic alteration called a TMPRSS2-ERG gene fusion forms in a prostate cancer, rather than the presence of the gene fusion itself, could help identify patients with prostate cancer with a low risk of spreading, which might determine the best course of treatment for...
As reported in JAMA Oncology by Almassi et al, extragonadal androgen ablation with the nonsteroidal CYP17A1 inhibitor ketoconazole improved outcome in men with metastatic castration-resistant prostate cancer according to the number of inherited HSD3B1 (1245C) alleles. HSD3B1 (1245C) is associated...
In a study reported in JAMA Oncology, Hearn et al found that the presence of the HSD3B1 (1245C) allele was associated with more rapid development of metastases in patients receiving androgen-deprivation therapy for biochemical recurrence after primary radiation therapy for localized prostate...
The phase III AFFINITY trial has shown no survival benefit with the addition of the antisense oligonucleotide custirsen to cabazitaxel (Jevtana)/prednisone in patients with metastatic prostate cancer previously treated with docetaxel. These findings were reported in The Lancet Oncology by Beer et...
DURING A DISCUSSION of Dr. Vale’s poster, Stéphane Oudard, MD, Professor of Oncology and Chief of the Oncology Clinical and Translational Research Unit at Georges Pompidou Hospital in Paris, France, said that although newer treatments have improved survival, there are still many challenges in...
FORMAL DISCUSSANT of the STAMPEDE trial, Cora Sternberg, MD, Chief of the Department of Medical Oncology, San Camillo Forlanini Hospital, Rome, commended the study design. “This multiarm, multistage design is very innovative. The investigators plan up to 10 trials over 20 years. The first results...
ABIRATERONE ACETATE (Zytiga) plus prednisone and docetaxel have moved up from the castrate-resistant metastatic setting to earlier in the course of disease as treatment of high-risk hormone-sensitive prostate cancer in men who are initiating androgen-deprivation therapy, based on level 1 evidence...
A Swedish population-based observational study has shown that comorbidity is a significant factor in other-cause but not prostate cancer–specific mortality after adjustment for patient, tumor, and treatment factors among men with prostate cancer. The findings were reported in the Journal of...
A systematic review and meta-analysis has found no association between vasectomy and high-grade, advanced, or fatal prostate cancer but a weak association with any prostate cancer. These findings were reported in JAMA Oncology by Bimal Bhindi et al. R. Jeffrey Karnes, MD, of the Mayo Clinic,...
William A. Hall, MD, of the Medical College of Wisconsin, discusses trial findings on androgen deprivation and radiation alone, compared with androgen deprivation, radiotherapy, and surgery in men with high-risk, nonmetastatic adenocarcinoma of the prostate (Abstract 15).
Gerard Morton, MD, of Sunnybrook Odette Cancer Centre, summarizes a session that included discussion of late toxicities of radiotherapy for locally recurrent prostate cancer; using chemotherapy instead of radiation in early-stage seminoma; radiotherapy vs surgery plus radiotherapy in Gleason score 9–10 prostate cancer; and an analysis of the IROCK study on kidney cancer (Abstracts 1, 1089, 282, 330).
Tamim Niazi, MDCM, of McGill University, discusses phase III study findings on hypofractionated, dose-escalation radiation therapy for high-risk adenocarcinoma of the prostate (Abstract 281).
A new study finds that immune response in prostate cancer may be able to forecast how patients will respond to radiation therapy, as well as their likelihood of disease recurrence and survival outcomes. The analysis of more than 9,000 prostate tumors also found evidence that programmed cell death...
Juanita Crook, MD, of the University of British Columbia, discusses late toxicity findings on transperineal ultrasound–guided brachytherapy for locally recurrent prostate cancer after external-beam radiation therapy (Abstract 1).