Sunday, May 31, 2020
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Thursday, May 28, 2020
Tuesday, May 26, 2020
Treatment of the primary in metastatic prostate cancer : Current Opinion in Urology
Treatment of the primary in metastatic prostate cancer : Current Opinion in Urology: garding the optimal treatment of the primary in patients diagnosed with metastatic prostate cancer.
Recent findings
Multimodal treatments offer the best chance for survival for these patients, but the optimal strategy lacks consensus. Using retrospective studies as an argument, recent articles sustain the clinical and oncological benefits of local therapies in hormone-naïve metastatic prostate cancer, represented by radical prostatectomy or radiotherapy. Through these procedures, local control of disease can be achieved, thus avoiding potential complications and further surgical interventions. Even if the current results are not evenly relevant, the treatment of the primary along with metastasis-directed therapy could improve survival and even cure-selected patients.
Summary
This article emphasizes important aspects regarding a feasible management of mPCa, with possible impact on subsequent guidelines. The expected results from ongoing trials may provide another perspective in treatment of these cases.
Correspondence to Andrei Andreşanu, MD, Center for Uronephrology and Renal Transplantation, Fundeni Clinical Institute, 258 Fundeni Avenue, 2nd District, 022328 Bucharest, Romania.
Recent findings
Multimodal treatments offer the best chance for survival for these patients, but the optimal strategy lacks consensus. Using retrospective studies as an argument, recent articles sustain the clinical and oncological benefits of local therapies in hormone-naïve metastatic prostate cancer, represented by radical prostatectomy or radiotherapy. Through these procedures, local control of disease can be achieved, thus avoiding potential complications and further surgical interventions. Even if the current results are not evenly relevant, the treatment of the primary along with metastasis-directed therapy could improve survival and even cure-selected patients.
Summary
This article emphasizes important aspects regarding a feasible management of mPCa, with possible impact on subsequent guidelines. The expected results from ongoing trials may provide another perspective in treatment of these cases.
Correspondence to Andrei Andreşanu, MD, Center for Uronephrology and Renal Transplantation, Fundeni Clinical Institute, 258 Fundeni Avenue, 2nd District, 022328 Bucharest, Romania.
Monday, May 25, 2020
Advanced Prostate Cancer Cases Continue to Rise in U.S. | MedPage Today
Advanced Prostate Cancer Cases Continue to Rise in U.S. | MedPage Today: Lasting effect of USPSTF's 2012 recommendation against PSA testing
RT Plus ADT Tops Brachytherapy Boost for Prostate Cancer | MedPage Today
RT Plus ADT Tops Brachytherapy Boost for Prostate Cancer | MedPage Today: Meta-analysis may help decision making, but direct comparisons still lacking
Friday, May 22, 2020
Thursday, May 21, 2020
Wednesday, May 20, 2020
Tuesday, May 19, 2020
Monday, May 18, 2020
Sunday, May 17, 2020
Saturday, May 16, 2020
Wednesday, May 13, 2020
Concurrent or layered treatment with radium-223 and enzalutamide or abiraterone/prednisone: real-world clinical outcomes in patients with metastatic castration-resistant prostate cancer | Prostate Cancer and Prostatic Diseases
Concurrent or layered treatment with radium-223 and enzalutamide or abiraterone/prednisone: real-world clinical outcomes in patients with metastatic castration-resistant prostate cancer | Prostate Cancer and Prostatic Diseases: In this study, we evaluated real-world data on radium-223 plus abiraterone/prednisone or enzalutamide. Previously, the ERA 223 trial (NCT02043678) demonstrated increased fracture risk with concurrent treatment with radium-223 and abiraterone plus prednisone/prednisolone in patients with metastatic castration-resistant prostate cancer (mCRPC). We used the Flatiron Health database to perform a retrospective study of patients with mCRPC treated with radium-223. Treatment with radium-223 plus abiraterone/prednisone or enzalutamide was defined as concurrent if both drugs started within 30 days of one another, or layered when the second drug started ≥30 days after the first. The index date was defined as the day of the first radium-223 dose. Outcome measures included symptomatic skeletal events (SSEs), overall survival (OS), and patterns of treatments received. Of the 625 patients treated with radium-223, 22% received it together with abiraterone/prednisone and 27% with enzalutamide. When these agents were combined, they were often initiated in a layered fashion (73% layered, 23% concurrent). Prior or concomitant bone health agents (BHAs) were received by 67% and 55% of patients, respect
Time to Reassess Active Surveillance Risks in Prostate Ca? | MedPage Today
Time to Reassess Active Surveillance Risks in Prostate Ca? | MedPage Today: Update from ProtecT trial suggests small survival edge for upfront treatment
PET-CT Improved High-risk Prostate Cancer Staging in Trial | Oncology | JAMA | JAMA Network
PET-CT Improved High-risk Prostate Cancer Staging in Trial | Oncology | JAMA | JAMA Network: In a recent phase 3 trial, a novel imaging technique that identifies prostate-specific membrane antigen (PSMA) on tumor cells was more accurate than the scans typically used to stage high-risk prostate cancer before surgery or radiotherapy. The crossover study compared a combination of PSMA positron...
Saturday, May 9, 2020
Prostate-specific antigen dynamics predict individual responses to intermittent androgen deprivation | Nature Communications
Prostate-specific antigen dynamics predict individual responses to intermittent androgen deprivation | Nature Communications: Intermittent androgen deprivation therapy (IADT) is an attractive treatment for biochemically recurrent prostate cancer (PCa), whereby cycling treatment on and off can reduce cumulative dose and limit toxicities. We simulate prostate-specific antigen (PSA) dynamics, with enrichment of PCa stem-like cell (PCaSC) during treatment as a plausible mechanism of resistance evolution. Simulated PCaSC proliferation patterns correlate with longitudinal serum PSA measurements in 70 PCa patients. Learning dynamics from each treatment cycle in a leave-one-out study, model simulations predict patient-specific evolution of resistance with an overall accuracy of 89% (sensitivity = 73%, specificity = 91%). Previous studies have shown a benefit of concurrent therapies with ADT in both low- and high-volume metastatic hormone-sensitive PCa. Model simulations based on response dynamics from the first IADT cycle identify patients who would benefit from concurrent docetaxel, demonstrating the feasibility and potential value of adaptive clinical trials guided by patient-specific mathematical models of intratumoral evolutionary dynamics. Prostate specific antigen (PSA) is a biomarker for prostate cancer. H
Monday, May 4, 2020
APCCC 2019 Slides
APCCC 2019 Slides: UroToday - GU OncToday brings coverage of the clinically relevant content needed to stay at the forefront of the dynamic field of GU oncology and urology.
Telomere-based risk models for the early diagnosis of clinically significant prostate cancer | Prostate Cancer and Prostatic Diseases
Telomere-based risk models for the early diagnosis of clinically significant prostate cancer | Prostate Cancer and Prostatic Diseases: The objective of this study was to explore telomere-associated variables (TAV) as complementary biomarkers in the early diagnosis of prostate cancer (PCa), analyzing their application in risk models for significant PCa (Gleason score > 6). As part of a larger prospective longitudinal study of patients with suspicion of PCa undergoing prostate biopsy according to clinical practice, a subgroup of patients (n = 401) with PSA 3–10 ng/ml and no prior biopsies was used to evaluate the contribution of TAV to discern non-significant PCa from significant PCa. The cohort was randomly split for training (2/3) and validation (1/3) of the models. High-throughput quantitative fluorescence in-situ hybridization was used to evaluate TAV in peripheral blood mononucleated cells. Models were generated following principal component analysis and random forest and their utility as risk predictors was evaluated by analyzing their predictive capacity and accuracy, summarized by ROC curves, and their clinical benefit with decision curves analysis. The median age of the patients was 63 years, with a median PSA of 5 ng/ml and a percentage of PCa diagnosis of 40.6% and significant PCa of 19.2%. Two TAV-based
PARP inhibitors as a new therapeutic option in metastatic prostate cancer: a systematic review | Prostate Cancer and Prostatic Diseases
PARP inhibitors as a new therapeutic option in metastatic prostate cancer: a systematic review | Prostate Cancer and Prostatic Diseases: A great number of DNA-damage repair (DDR) pathways have been recognized to be frequently dysregulated in advanced stages of prostate cancer. DNA-repair defects in prostate cancer represents a clinically relevant disease subset. Tumors whose ability to repair double-strand DNA breaks by homologous recombination is compromised, are highly sensitive to blockade of the repair of DNA single-strand breaks via the inhibition of the enzyme poly(ADP) ribose polymerase (PARP). A systematic review of the literature has been conducted in January 2020 using PubMed Medline database in line with the recommendations from the PRISMA guidelines. The following string terms were used for searching clinical trial articles: castration resistant OR castrate resistance OR castration refractory AND prostate cancer AND PARP OR poly(ADP-ribose) polymerase inhibitor OR DNA-repair OR homologous recombination repair. On-going clinical trials with olaparib, niraparib, talazoparib, veliparib, and rucaparib in mCRPC were searched on the clinicalTrials.gov website. From this research 176 articles were identified. After title screening and abstract reading, five papers and four abstract were considered for the syste
Friday, May 1, 2020
Mathematical Model Predicts Outcomes in Prostate Cancer Therapy | Cancer Network
Mathematical Model Predicts Outcomes in Prostate Cancer Therapy | Cancer Network: The model was able to use data from each treatment cycle to estimate intratumor subpopulations and accurately predict the outcomes in each subsequent cycle.
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