Evolving Brachytherapy Boost in Prostate Cancer in the Era of Hypofractionation - International Journal of Radiation Oncology, Biology, Physics

Evolving Brachytherapy Boost in Prostate Cancer in the Era of Hypofractionation - International Journal of Radiation Oncology, Biology, Physics: Radiation therapy (RT) for localized prostate cancer (PCa) has seen a rapid evolution
of options to now include conventional fractionation, moderate and ultra-hypofractionation,
and brachytherapy (BT) ± supplemental external beam RT (EBRT), in conjunction with
risk-based use of androgen deprivation therapy (ADT). This variety gives wide latitude
to physicians and patients to select modalities best suited to their preferences,
resources, and medical context while achieving largely equitable end results.

Thursday, September 24, 2020

Dr. Shore on the Objective of the HERO Trial in Advanced Prostate Cancer - YouTube

Dr. Shore on the Objective of the HERO Trial in Advanced Prostate Cancer - YouTube: Neal D. Shore, MD, FACS, medical director of the Carolina Urologic Research Center, discusses the objective of the phase 3 HERO trial in advanced prostate ca...

Germlines 'Rich Source' of Prostate Cancer Info

Germlines 'Rich Source' of Prostate Cancer Info: New guidelines on germline testing are a rich source of information for clinicians. Lead author Dr Veda Giri discusses how they can best take advantage of them.

Detection and dynamics of circulating tumor cells in patients with high-risk prostate cancer treated with radiotherapy and hormones: a prospective phase II study | Radiation Oncology | Full Text

Detection and dynamics of circulating tumor cells in patients with high-risk prostate cancer treated with radiotherapy and hormones: a prospective phase II study | Radiation Oncology | Full Text: Circulating tumor cells (CTCs) are an established prognostic marker in castration-resistant prostate cancer but have received little attention in localized high-risk disease. We studied the detection rate of CTCs in patients with high-risk prostate cancer before and after androgen deprivation therapy and radiotherapy to assess its value as a prognostic and monitoring marker. We performed a prospective analysis of CTCs in the peripheral blood of 65 treatment-naïve patients with high-risk prostate cancer. EpCAM-positive CTCs were enumerated using the CELLSEARCH system at 4 timepoints. A cut off of 0 vs ≥ 1 CTC/7.5 ml blood was defined as a threshold for negative versus positive CTCs status. CTCs were detected in 5/65 patients (7.5%) at diagnosis, 8/62 (12.9%) following neoadjuvant androgen deprivation and 11/59 (18.6%) at the end of radiotherapy, with a median CTC count/7.5 ml of 1 (range, 1–136). Only 1 patient presented a positive CTC result 9 months after radiotherapy. Positive CTC status (at any timepoint) was not significantly associated with any clinical or pathologic factors. However, when we analyzed variations in CTC patterns following treatment, we observed a significant as

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 AndreÅŸanu, MD, Center for Uronephrology and Renal Transplantation, Fundeni Clinical Institute, 258 Fundeni Avenue, 2nd District, 022328 Bucharest, Romania.

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

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

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.

Thursday, April 30, 2020

Profiling prostate biology | Science

Profiling prostate biology | Science: Molecular profiling of heterogeneous cell populations at the single-cell level using single-cell RNA sequencing (scRNA-seq) has provided refined cell type–specific gene expression signatures and allowed the discovery of rare cell types. Applying such an approach in the context of anatomy and pathology informs disease mechanisms. A requirement for androgen is a cardinal feature in the development and maintenance of normal prostate and for the maintenance of prostate adenocarcinoma ([ 1 ][1]). On page 497 of this issue, Karthaus et al. ([ 2 ][2]) provide an in-depth characterization of prostatic cellular heterogeneity and address mechanisms of androgen independence in regenerating mouse prostates. They identify an adaptive stemlike phenotype in a large population of secretory epithelial cells undergoing androgen-dependent regeneration, uncovering an unappreciated plasticity in these differentiated cells, which has implications for prostate cancer therapy.

Prostate epithelium consists of three primary cell types: luminal cells, an underlying layer of basal cells, and rare neuropeptide-secreting neuroendocrine cells. Luminal cells express the androgen receptor (AR) transcription facto

Axumin-based PET/CT scans and detection of recurrent prostate cancer | THE "NEW" PROSTATE CANCER INFOLINK

Axumin-based PET/CT scans and detection of recurrent prostate cancer | THE "NEW" PROSTATE CANCER INFOLINK: A new report from a relatively small, single-institution study has provided additional information about the utility of [18F]fluciclovine (Axumin) PET/CT scans in the detection of recurrent prostat…

Major trial shows breast cancer drug can hit prostate cancer Achilles heel -- ScienceDaily

Major trial shows breast cancer drug can hit prostate cancer Achilles heel -- ScienceDaily: A drug already licensed for the treatment of breast and ovarian cancers is more effective than targeted hormone therapy at keeping cancer in check in some men with advanced prostate cancer, a major clinical trial reports. Olaparib, a pill lacking the side effects of chemotherapy, can target an Achilles heel in prostate cancers with a weakness in their ability to repair damaged DNA.

'Bold' Prostate Cancer Trial Enrolls 'Very, Very Quickly'

'Bold' Prostate Cancer Trial Enrolls 'Very, Very Quickly': For men with early prostate cancer on active surveillance, can the immunotherapy sipuleucel-T (Provenge) reduce grade progression?

Wednesday, April 29, 2020

More negative data for checkpoint inhibition in treatment of mCRPC | THE "NEW" PROSTATE CANCER INFOLINK

More negative data for checkpoint inhibition in treatment of mCRPC | THE "NEW" PROSTATE CANCER INFOLINK: Alas … once again we hear that the combination of  androgen receptor blockade (with enzalutamide/Xtandi) + a checkpoint inhibitor (the PD-L1 inhibitor atezolizumab/Tecentriq) has had no clini…

Breast cancer drug slows prostate cancer progression in major trial

Breast cancer drug slows prostate cancer progression in major trial: Scientists are reporting some promising findings from a large prostate cancer trial, where patients were administered a drug typically used to treat breast cancer. The drug proved more effective than standard hormone treatments at applying the brakes to the disease, with the scientists hopeful it…

It's a Bust: Adding Immunotherapy No Benefit in mCRPC

It's a Bust: Adding Immunotherapy No Benefit in mCRPC: The immune checkpoint inhibitor atezolizumab was added to standard treatment with enzalutamide in men with metatastic castration-resistant prostate cancer.

Olaparib for Metastatic Castration-Resistant Prostate Cancer | NEJM

Olaparib for Metastatic Castration-Resistant Prostate Cancer | NEJM: Original Article from The New England Journal of Medicine — Olaparib for Metastatic Castration-Resistant Prostate Cancer

Tuesday, April 28, 2020

Loss of a negative feedback loop between IRF8 and AR promotes prostate cancer growth and enzalutamide resistance | Cancer Research

Loss of a negative feedback loop between IRF8 and AR promotes prostate cancer growth and enzalutamide resistance | Cancer Research: In incurable castration-resistant prostate cancer (CRPC), resistance to the novel androgen receptor (AR) antagonist enzalutamide (ENZ) is driven mainly by AR overexpression. Here we report that the expression of interferon regulatory factor 8 (IRF8) is increased in primary prostate cancer (PCa) but decreased in CRPC compared to normal prostate tissue. Decreased expression of IRF8 positively associated with CRPC progression and ENZ resistance. IRF8 interacted with AR and promoted its degradation via activation of the ubiquitin/proteasome systems. Epigenetic knockdown of IRF8 promoted AR-mediated PCa progression and ENZ resistance in vitro and in vivo. Furthermore, IFNα increased expression of IRF8 and improved the efficacy of ENZ in CRPC by targeting the IRF8-AR axis. We also provide preliminary evidence for the efficacy of IFNα with hormonotherapy in a clinical study. Collectively, this study identifies IRF8 both as a tumor suppressor in PCa pathogenesis and a potential alternative therapeutic option to overcome ENZ resistance.

Using 2 Prostate Biopsy Techniques Optimizes Cancer Diagnosis | Oncology | JAMA | JAMA Network

Using 2 Prostate Biopsy Techniques Optimizes Cancer Diagnosis | Oncology | JAMA | JAMA Network: Combining a traditional biopsy with a magnetic resonance imaging (MRI)–targeted biopsy more accurately diagnoses clinically significant prostate cancer than either technique alone, according to a recent study by National Institutes of Health (NIH) researchers.

New radiation therapies keep advanced prostate cancer in check - Harvard Health Blog - Harvard Health Publishing

New radiation therapies keep advanced prostate cancer in check - Harvard Health Blog - Harvard Health Publishing: Treatments for prostate cancer are always evolving, and now research is pointing to new ways of treating a cancer that has just begun to spread, or metastasize, after initial surgery or radiation. Doctors usually give hormonal therapies in these cases to block testosterone, which is a hormone that makes the cancer grow faster. But newer …

Monday, April 27, 2020

Olaparib in treatment of men with mCRPC and selected HRR gene mutations | THE "NEW" PROSTATE CANCER INFOLINK

Olaparib in treatment of men with mCRPC and selected HRR gene mutations | THE "NEW" PROSTATE CANCER INFOLINK: According to a media release issued by AstraZeneca and Merck on Friday evening, olaparib (Lynparza) has shown “a statistically significant and clinically meaningful improvement in … ove…

Prostate cancer death rates predicted to fall this year by 9.5% on the 2015 figure, research shows | Daily Mail Online

Prostate cancer death rates predicted to fall this year by 9.5% on the 2015 figure, research shows | Daily Mail Online: Prostate death rates are expected to fall this year because of better diagnosis and treatment, research suggests. British death rates will be 9.5 per cent lower for 2020 than in 2015, according to a study.

Friday, April 24, 2020

[Targeted molecular therapy and immunotherapy for prostate cancer].

[Targeted molecular therapy and immunotherapy for prostate cancer].: For decades, the treatment of advanced prostate cancer was mainly based on the manipulation of the androgen receptor-controlled proliferation pathway. Chemotherapy only played an additional important role with the advent of taxanes.

Active Surveillance for Low-Risk Prostate Cancer - Laurence Klotz and Peter Carroll

Active Surveillance for Low-Risk Prostate Cancer - Laurence Klotz and Peter Carroll: localized prostate cancer and active surveillance, , Matthew Cooperberg, Laurence Klotz, Peter Carroll, evolution of management for low-risk prostate cancer, T1a prostate cancer, mpMRI and genomic testing.

Prostate Cancer Wishes From a Patient's Perspective Presentation - Robin Millman

Prostate Cancer Wishes From a Patient's Perspective Presentation - Robin Millman: prostate cancer patient's perspective, prostate cancer awareness, improved utilization of active surveillance, side effects of metastatic prostate cancer therapies,

Thursday, April 23, 2020

Alas … PPV not good for PI-RADS at all | THE "NEW" PROSTATE CANCER INFOLINK

Alas … PPV not good for PI-RADS at all | THE "NEW" PROSTATE CANCER INFOLINK: For the past few years, some of us have been quietly concerned about the true value of MRI scans and the accuracy of PI-RADS scores in evaluation of a patient’s risk for the presence of clini…

Wednesday, April 22, 2020

Focal therapy for localized prostate cancer: the “state of the art” | THE "NEW" PROSTATE CANCER INFOLINK

Focal therapy for localized prostate cancer: the “state of the art” | THE "NEW" PROSTATE CANCER INFOLINK: In a report on the UroToday web site, John Fortin, a prostate cancer patient who chose to have focal therapy himself a while ago, has reported on information presented at the 12th International Sym…

Will the FDA approve an oral LHRH agonist for treatment of prostate cancer? | THE "NEW" PROSTATE CANCER INFOLINK

Will the FDA approve an oral LHRH agonist for treatment of prostate cancer? | THE "NEW" PROSTATE CANCER INFOLINK: According to a media release issued yesterday, Myovant Sciences (an Australian company, based in Brisbane) has submitted a New Drug Application (NDA) for approval of its oral LHRH agonist, relugoli…

Worth the cost? A closer look at the da Vinci robot’s impact on prostate cancer surgery

Worth the cost? A closer look at the da Vinci robot’s impact on prostate cancer surgery: The da Vinci robotic system has become the ubiquitous method for prostate removal, but its cost and long-term outcomes for patients are raising questions.

Monday, April 20, 2020

Surrogate endpoints for overall survival for patients with metastatic hormone-sensitive prostate cancer in the CHAARTED trial | Prostate Cancer and Prostatic Diseases

Surrogate endpoints for overall survival for patients with metastatic hormone-sensitive prostate cancer in the CHAARTED trial | Prostate Cancer and Prostatic Diseases: Metastasis-free survival has been shown to be a robust surrogate for overall survival (OS) in men with nonmetastatic prostate cancer (PC). However, this surrogate only holds true for a select subset of patients, and leaves those trials analyzing metastatic disease at a disadvantage. We aimed to identify the best surrogate for predicting OS in patients with metastatic hormone-sensitive PC. We analyzed data from the Chemohormonal Therapy versus Androgen Ablation Randomized Trial for Extensive Disease trial in which patients were randomly assigned to receive either androgen deprivation therapy (ADT) or ADT plus docetaxel. PSA response, progression and development of castration-resistant PC (CRPC) within 6 and 12 months were investigated as potential OS surrogates, in accordance with the Prentice Criteria. The proportion the of treatment effect (PTE) was calculated for each surrogate and used to identify the best one. Data from 790 patients were considered: 393 (49.7%) men received ADT alone, while 397 (50.3%) received combination therapy. Four intermediate clinical endpoints met the criteria for surrogacy: progression within 6 months (HR: 5.70; 95%CI: 4.26, 7.64; p < 0.001) and 12 mon

Sunday, April 19, 2020

‘Smart toilet’ monitors for signs of disease | News Center | Stanford Medicine

‘Smart toilet’ monitors for signs of disease | News Center | Stanford Medicine: A disease-detecting “precision health” toilet can sense multiple signs of illness through automated urine and stool analysis, a new Stanford study reports.

New ‘Toolbox’ for Urological Cancer Detection | University of Turku

New ‘Toolbox’ for Urological Cancer Detection | University of Turku: Researchers from Ghent University, Belgium, together with researchers from the University of Turku, Finland, have developed a new method for biomarker discovery of urological cancers. The method enables timely diagnosis and treatment of cancer. Urological cancers include e.g. prostate, bladder and kidney cancers.

Reconsidering Prostate Cancer Mortality — The Future of PSA Screening | NEJM

Reconsidering Prostate Cancer Mortality — The Future of PSA Screening | NEJM: Medicine and Society from The New England Journal of Medicine — Reconsidering Prostate Cancer Mortality — The Future of PSA Screening

New 'toolbox' for urological cancer detection -- ScienceDaily

New 'toolbox' for urological cancer detection -- ScienceDaily: Researchers have developed a new method for biomarker discovery of urological cancers. The method enables timely diagnosis and treatment of cancer. Urological cancers include e.g. prostate, bladder and kidney cancers.

Thursday, April 16, 2020

Judd W. Moul, MD, FACS, on Triaging Patients with Prostate Cancer | Cancer Network

Judd W. Moul, MD, FACS, on Triaging Patients with Prostate Cancer | Cancer Network: The prostate cancer expert discussed guidelines that he and his colleagues culminated for triaging patients with prostate cancer during the COVID-19 pandemic.

Reconsidering Prostate Cancer Mortality — The Future of PSA Screening | NEJM

Reconsidering Prostate Cancer Mortality — The Future of PSA Screening | NEJM: Medicine and Society
Reconsidering Prostate Cancer Mortality — The Future of PSA Screening
List of authors.

H. Gilbert Welch, M.D., M.P.H., and Peter C. Albertsen, M.D.

Article
Figures/Media

Metrics

23 References

From its peak in the early 1990s, U.S. mortality due to prostate cancer has decreased from 39 per 100,000 men to 19 per 100,000 men — essentially by half. Although everyone agrees that this reduction is good news, there is considerable disagreement about why it happened. The controversy has profound implications for the future of prostate-specific antigen (PSA) screening.
Figure 1. Prostate Cancer Mortality in the United States, 1950–2016.

A long-term perspective on trends in cancer-specific mortality among patients with three common causes of cancer-related deaths since 1950 is provided in Figure 1A. The substantial rise and fall in the largest component of cancer-related mortality, lung cancer mortality, reflects the rise and fall in rates of cigarette smoking decades earlier. In contrast, breast cancer mortality was remarkably stable until 1990 and then began to fall. Prostate cancer mortality was similarly stable until 1970 and als

Wednesday, April 15, 2020

Clinical and genomic characterization of Low PSA Secretors: a unique subset of metastatic castration resistant prostate cancer | Prostate Cancer and Prostatic Diseases

Clinical and genomic characterization of Low PSA Secretors: a unique subset of metastatic castration resistant prostate cancer | Prostate Cancer and Prostatic Diseases: Metastatic disease burden out of proportion to serum PSA has been used as a marker of aggressive phenotype prostate cancer but is not well defined as a distinct subgroup. We sought to prospectively characterize the molecular features and clinical outcomes of Low PSA Secretors. Eligible metastatic castration resistant prostate cancer (mCRPC) patients without prior small cell histology underwent metastatic tumor biopsy with molecular characterization. Low PSA secretion was defined as serum PSA < 2, 5, or 10 ng/mL plus >5 metastases with radiographic progression at study entry. Clinical and molecular features were compared between low PSA vs. normal secretors in a post-hoc fashion. 183 patients were enrolled, including 15 (8%) identified as Low PSA Secretors using optimal PSA cut point of 5 ng/mL. Biopsies from Low PSA Secretors demonstrated higher t-SCNC and RB1 loss and lower AR transcriptional signature scores compared with normal secretors. Genomic loss of RB1 and/or TP53 was more common in Low PSA Secretors (80% vs. 41%). Overall survival (OS) was shorter in Low PSA Secretors (median OS = 26.7 vs. 46.0 months, hazard ratio = 2.465 (95% CI: 0.982–6.183). Progression-free survival

Monday, April 13, 2020

Mathematical model predicts patient outcomes to adaptive therapy -- ScienceDaily

Mathematical model predicts patient outcomes to adaptive therapy -- ScienceDaily: Researchers provide a closer look at a mathematical model and data showing that individual patient alterations in the prostate-specific antigen (PSA) biomarker early in cancer treatment can predict outcomes to later treatment cycles of adaptive therapy.

Tuesday, April 7, 2020

Patients of Metastatic Prostate Cancer Could Benefit from Immunotherapy Treatment | Cancer Network

Patients of Metastatic Prostate Cancer Could Benefit from Immunotherapy Treatment | Cancer Network: A recent study found that a group of patients with metastatic castration-resistant prostate cancer responded positively to treatment with ipilimumab, prolonging survival after treatment in the “favorable” cohort.

Cancer scientists aim to use protein power to stop tumor growth -- ScienceDaily

Cancer scientists aim to use protein power to stop tumor growth -- ScienceDaily: Scientists have created a new therapy option that may help halt tumor growth in certain cancers such as prostate, which is among the most common types of cancer in men.

Monday, April 6, 2020

Managing Treatment for Patients with Prostate Cancer During the COVID-19 Pandemic | Cancer Network

Managing Treatment for Patients with Prostate Cancer During the COVID-19 Pandemic | Cancer Network: An international team of researchers created a framework of recommendations to help patients and healthcare professionals make decisions regarding radiation treatment for patients with prostate cancer during the COVID-19 pandemic.

Friday, April 3, 2020

A Mobile App for Cancer Thrivers During the Coronavirus Pandemic — Cancer ABCs

A Mobile App for Cancer Thrivers During the Coronavirus Pandemic — Cancer ABCs: Today, our partners at Stand Up To Cancer announced an initiative that will both help scientists understand the emerging coronavirus pandemic and ensure the needs of cancer patients and survivors are being included as the research goes forward.

Wednesday, April 1, 2020

Leveraging Digital Data to Inform and Improve Quality Cancer Care | Cancer Epidemiology, Biomarkers & Prevention

Leveraging Digital Data to Inform and Improve Quality Cancer Care | Cancer Epidemiology, Biomarkers & Prevention: Background: Efficient capture of routine clinical care and patient outcomes is needed at a population-level, as is evidence on important treatment-related side effects and their effect on well-being and clinical outcomes. The increasing availability of electronic health records (EHR) offers new opportunities to generate population-level patient-centered evidence on oncologic care that can better guide treatment decisions and patient-valued care.

Methods: This study includes patients seeking care at an academic medical center, 2008 to 2018. Digital data sources are combined to address missingness, inaccuracy, and noise common to EHR data. Clinical concepts were identified and extracted from EHR unstructured data using natural language processing (NLP) and machine/deep learning techniques. All models are trained, tested, and validated on independent data samples using standard metrics.

Results: We provide use cases for using EHR data to assess guideline adherence and quality measurements among patients with cancer. Pretreatment assessment was evaluated by guideline adherence and quality metrics for cancer staging metrics. Our studies in perioperative quality focused on medications

Monday, March 30, 2020

Radiation Treatment May Slow Disease Progression for Patients with Prostate Cancer | Cancer Network

Radiation Treatment May Slow Disease Progression for Patients with Prostate Cancer | Cancer Network: A recent study analyzed response to treatment of oligometastatic prostate cancer with stereotactic ablative radiotherapy and found improved oncologic outcomes among men.

Performance of clinicopathologic models in men with high risk localized prostate cancer: impact of a 22-gene genomic classifier | Prostate Cancer and Prostatic Diseases

Performance of clinicopathologic models in men with high risk localized prostate cancer: impact of a 22-gene genomic classifier | Prostate Cancer and Prostatic Diseases: Prostate cancer exhibits biological and clinical heterogeneity even within established clinico-pathologic risk groups. The Decipher genomic classifier (GC) is a validated method to further risk-stratify disease in patients with prostate cancer, but its performance solely within National Comprehensive Cancer Network (NCCN) high-risk disease has not been undertaken to date. A multi-institutional retrospective study of 405 men with high-risk prostate cancer who underwent primary treatment with radical prostatectomy (RP) or radiation therapy (RT) with androgen-deprivation therapy (ADT) at 11 centers from 1995 to 2005 was performed. Cox proportional hazards models were used to determine the hazard ratios (HR) for the development of metastatic disease based on clinico-pathologic variables, risk groups, and GC score. The area under the receiver operating characteristic curve (AUC) was determined for regression models without and with the GC score. Over a median follow-up of 82 months, 104 patients (26%) developed metastatic disease. On univariable analysis, increasing GC score was significantly associated with metastatic disease ([HR]: 1.34 per 0.1 unit increase, 95% confidence interval

Friday, March 27, 2020

Prostate-Specific Membrane Antigen PET/CT Suitable Imaging for Prostate Cancer | Cancer Network

Prostate-Specific Membrane Antigen PET/CT Suitable Imaging for Prostate Cancer | Cancer Network: Prostate-specific membrane antigen PET/CT was found to be a suitable replacement for conventional imaging in patients with prostate cancer, providing superior accuracy to the combined findings of CT and bone scanning.

Thursday, March 26, 2020

Cabazitaxel in Metastatic Prostate Cancer | NEJM

Cabazitaxel in Metastatic Prostate Cancer | NEJM: Correspondence from The New England Journal of Medicine — Cabazitaxel in Metastatic Prostate Cancer

Wednesday, March 25, 2020

1.5 T MR-guided and daily adapted SBRT for prostate cancer: feasibility, preliminary clinical tolerability, quality of life and patient-reported outcomes during treatment | Radiation Oncology | Full Text

1.5 T MR-guided and daily adapted SBRT for prostate cancer: feasibility, preliminary clinical tolerability, quality of life and patient-reported outcomes during treatment | Radiation Oncology | Full Text: Unity Elekta is a unique magnetic resonance (MR)-linac that conjugates a 1.5 Tesla MR unit with a 7 MV flattening filter free accelerator.A prospective observational study for the clinical use of Elekta Unity is currently ongoing in our department. Herein, we present our preliminary report on the feasibility, quality of life, and patient-reported outcomes measures (PROMs) for localized prostate cancer (PC) treated with stereotactic body radiotherapy (SBRT). The SBRT protocol consisted of a 35 Gy schedule delivered in 5 fractions within 2 weeks. Toxicity and quality of life (QoL) were assessed at baseline and after treatment using the Common Terminology Criteria for Adverse Events v5.0, International Prostatic Symptoms Score (IPSS), ICIQ-SF, IIEF-5, and EORTC-QLQ-C30 and PR-25 questionnaires. Between October 2019 and January 2020, 25 patients with localized PC were recruited. The median age was 68 years (range, 54–82); 4 were low risk, 11 favorable intermediate risk (IR) and 10 unfavorable IR. Median iPSA was 6.8 ng/ml (range, 1–19), and 9 of these patients (36%) received concurrent androgen deprivation therapy. Median prostate volume was 36 cc (range, 20–61); median baseline IPSS w

Tuesday, March 24, 2020

How Is Cancer Oncology Adapting to COVID-19? - MedicineNet Health News

How Is Cancer Oncology Adapting to COVID-19? - MedicineNet Health News: Responses to a number of issues facing cancer oncologists in the US and around the world from coronavirus COVID-19.

Bad news for Russia: US catches up with the Russian Vanguard

Bad news for Shoigu: America unexpectedly quickly catches up with the Russian Vanguard

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The U.S. Department of Defense reported that a test launch of the STARS-4 missile equipped with a universal guided maneuvering planning hypersonic warhead, the Common-Hypersonic Glide Body (C-HGB), was carried out last Thursday from a Pacific missile firing range in Hawaii. The test results were recognized as successful - the C-HGB combat unit developed hypersonic speed and reached a predetermined point.
The tests were jointly conducted by the US Army and Navy with the participation of the United States Missile Defense Agency.
This was the second test in a row. The first took place on October 30, 2017 at the same rocket range.
The Pentagon report says nothing about the characteristics of the hypersonic unit. What is its speed and how much did it fly during the last test. It is only reported that the C-HGB has developed a speed exceeding the lower hypersonic boundary of 5 M. There is no data on how it is aimed at the target, what are its dynamic qualities when maneuvering at hypersonic speed, what is the height and relief of the flight. Instead of all this, a clearly disinformation photograph is offered, capturing a block that is four heads taller than a naval officer standing nearby.
The fact is that the C-HGB is a glider, an aircraft making a planning flight. And, therefore, its profile cannot in any way be symmetrical with respect to the center line. The photograph shows a typical aerial bomb, which is difficult to call even correctable.
Regarding the glider profile, we know something, for example, from the Russian combat planning hypersonic Avangard block, which at the end of last year were equipped with UR-100N UTTX silo-based ICBMs. In the future, this glider should be used in the passing test of the Sarmat ICBM. About the form of the "Vanguard" it is very approximately possible to say that it is "flattened," that is, using the lifting force of the wing, without which planning would not be possible.
The Russian glider develops a speed of 20 M. The power of a thermonuclear charge is from 800 ct to 2 Mt.
There is also a Chinese hypersonic glider DF-ZF, developing a speed of 10 M. Its development is close to completion. The device began to be tested in 2014. After only two years, all of his test flights completed successfully. And, according to experts, it can be adopted later this year.
Russia, on the other hand, has taken more than 30 years from the beginning of scientific research in a completely new field of creating vehicles flying at unbelievable speeds to obtaining workable samples. In the mid-80s, a topic with the code “4202” was opened in the Reutov NPO Mashinostroyenie (where the Zircon hypersonic anti-ship missile was also developed). Well, the mass production of gliders, which were named "Vanguard", began only in 2018. And all three decades (minus the period of scatter and vacillations due to the collapse of the Soviet Union), Reutov designers, with the support of scientists from academic institutions, created unique weapons. And then in the process of protracted trials brought him to mind.
The American designers of the planning block C-HGB from Dynetics Technical Solutions (DTS) did not start from scratch. They picked up the development of the block, which began in the mid-zero years with Sandia National Laboratories belonging to the US Department of Energy. Laboratories, two of them dealing with the problems of non-nuclear components for nuclear weapons, have created prototypes of the experimental hypersonic warhead Advanced Hypersonic Weapon (AHW). AHW has been tested twice - in 2011 and 2014.
In 2011, a speed of 8 M. was reached. Block, flying 3700 km, fell in the calculated area of ​​the ocean. The tests pursued limited goals - checking the thermal protection of the device, studying the aerodynamic characteristics of the flight, checking the achievement of long-range flight. Checks of maneuverability and controllability of the unit were not carried out. The second flight, in 2014, crashed. The missile, which was supposed to disperse AHW, got out of control in the fourth second, in connection with which the team was sent to destroy it.
By the way, there are images of the AHW block, which is completely different from the C-HGB photo provided by the Pentagon for open access.
And with such a not too solid baggage, DTS began to urgently bring the semi-finished product to the flight instance of the C-HGB, which is now being tested.
And the urgency is due to the fact that in the Pentagon after a demonstration by Russia during Putin’s appeal to the Federal Assembly of commercials with achievements in the field of the latest strategic weapons, great excitement began. Illusions shattered that the US victory in the Cold War was final and irrevocable.
US Under Secretary of Defense Michael Griffin literally began to bombard Congress with reports that both Russia and China had gone so far in creating hypersonic weapons that it really threatens America’s security. And he was able to knock out very serious money from the congressmen for conducting OCD on hypersound. The money was received, and several OCDs were immediately opened to create hypersonic missiles in the interests of all the arms of the United States - the Army, Navy, Air Force and ILC. The leading military-industrial complex corporations, Lockheed Martin, Raytheon and Boeing, seized on the contracts.
In this case, the C-HGB glider plays a very important role in these programs. They should be equipped with missiles created as part of the Long Range Hypersonic Weapon (LRHW) program - "Long Range Hypersonic Weapons." It will be a ground complex. However, it is planned to further adapt it for use on surface ships and submarines - this program is called Conventional Prompt Strike (CPS).
The LRHW project, whose main executor was Lockheed Martin Corporation, which has displaced DTS into the background, is advancing at a high speed. In 2021, it is planned to begin testing the entire complex “in a set”, that is, a new solid-fuel medium-range rocket AUR (All-Up-Round) equipped with a C-HGB glider. And in 2023, it is planned to deploy the first battery of hypersonic systems.
At the beginning of this year, thanks to the slide of the LRHW project that appeared on the Internet and was shown at a conference of the US Army's Accelerated Development and Critical Technologies Directorate, certain specifics appeared regarding the proposed capabilities of this complex.
The complex is located on a wheeled chassis similar to the chassis of the Patriot air defense system. The combat vehicle is equipped with two transport and launch containers with AUR missiles with C-HGB gliders. After launch, the rocket accelerates to a speed of 8-10 M a combat unit, which, having separated from the rocket, begins an independent flight with maneuvering and natural braking in the atmosphere. However, in the final section of the trajectory, the glider’s speed should exceed 5 M. According to experts, the glider’s flight range, taking into account the missile’s range, can reach 4-5 thousand km.
The readiness of the complex for the Navy is scheduled for 2028. It is intended primarily for the latest modification of the Virginia multipurpose submarines.
From the current situation in the United States with hypersonic weapons, two conclusions can be drawn. Two years ago, when the Americans had practically nothing even in the project, it seemed that they would be able to catch up with Russia in 8-10 years. However, it seems that their business is getting real - industrial - results much faster.
It is also clear that the US withdrawal from the INF Treaty was necessary to create medium-range missiles, which, in particular, will be used in LRHW ground complexes. And all the talk about the Russian Iskander was just a screen and a smokescreen.