Prostate Cancer

With no significant difference between intermittent and continuous androgen-deprivation therapy, patients with prostate cancer may experience an improvement in their quality of life with the former.

While still in its early stages, integrative genomic testing could be the future for personalizing therapy for patients with castration-resistant prostate cancer (CRPC), according to Tomasz M. Beer, MD, FACP.

While the US Preventive Services Task Force (USPSTF) has issued recommendations against routine PSA-based screening for prostate cancer, E. David Crawford, MD, feels as though this is a step in the wrong direction.

Cooperberg says the likelihood of a patient for staying on active surveillance for 10 or 15 years is around 50%, though men who stay on active surveillance for between 6 months and 5 years generally see progression in their disease.

Oliver Sartor, MD, medical director, Tulane Cancer Center, discusses how radium-223 dichloride became deemed safe in patients with bone-metastatic castration-resistant prostate cancer (CRPC). The treatment was tested in an open-label phase I/II trial where patients were given 6 additional doses of radium-223 on top of their original 6-dose regimen.

Single-dose fosaprepitant dimeglumine (Emend for injection) in combination with antiemetic agents has been approved by the FDA for the preventing

Matthew Cooperberg, MD genitourinary cancer specialist, University of California San Francisco (UCSF), discusses the varying management techniques for both low- and high-risk prostate cancers, including radiation therapy, surgery, hormonal therapy, and active surveillance.

​Daniel Hamstra, MD, PhD, radiation oncologist, Texas Center for Proton Therapy, Texas Oncology, discusses the benefits of shorter radiotherapy treatment sessions for patients with prostate cancer.

Matthew Cooperberg, MD, genitourinary cancer specialist, University of California San Francisco, discusses the appropriateness of a more aggressive approach to men with high-risk prostate cancer. Cooperberg says currently, men will normally respond to surgery followed by adjuvant radiotherapy, as well as systemic therapy.

​Tomasz M. Beer, MD, FACP, deputy director, Knight Cancer Institute, Oregon Health and Science University, discusses the potential for genomic tests to result in new treatments.

Retreatment with radium-223 dichloride (Xofigo) after initial therapy and progression was deemed safe in patients with bone-metastatic castration-resistant prostate cancer (CRPC), according to a recent prospective, open-label phase I/II trial.

A recent paper concluded that docetaxel added to standard of care should be considered the new standard of care for men with hormone-sensitive metastatic prostate cancer.

The FDA has granted olaparib (Lynparza), a first-in-class oral PARP inhibitor, breakthrough therapy designation for patients with BRCA1/2 or ATM-mutated metastatic castration-resistant prostate cancer (mCRPC).

Treatment initiation for hormone-sensitive metastatic prostate cancer should include the addition of docetaxel to androgen deprivation therapy (ADT) as standard of care.

Beer says that while BRCA is normally associated with breast cancer, the gene is found in up to 20% of advanced prostate cancers. He says of this 20% patient population, roughly half inherit the BRCA gene and the other half acquire it.

Kibel cited both the STAMPEDE and CHAARTED trials, which showed the efficacy of docetaxel plus androgen deprivation therapy (ADT) in metastatic prostate cancer.

Hamstra says that shorter regimens of radiotherapy for men whose prostates remained in tact post-surgery proved to be noninferior when compared to longer regimens. He adds that these shorter regimens are more convenient for patients, as well as more cost effective.

Adding celecoxib and zoledronic acid to standard treatment extended survival in men with metastatic prostate cancer commencing first-line hormone therapy, according to updated data from the STAMPEDE trial.

Hypofractionated radiotherapy and standard radiation therapy demonstrated similar toxicities and neither prevented PSA increases or disease recurrences for men with intermediate-risk prostate cancer better than the other, according to data from the phase III randomized CHHiP trial reported at the 2016 GU Cancers Symposium.

Second-line treatment with atezolizumab (MPDL3280A) resulted in a median overall survival (OS) of 11.4 months in patients with locally advanced or metastatic urothelial carcinoma (mUC) and who showcased high PD-L1 levels.

A post hoc analysis of the phase III COU-AA-302 clinical trial suggests docetaxel can produce antitumor activity as the first subsequent therapy following disease progression with abiraterone acetate in men with chemotherapy-naive, metastatic castration-resistant prostate cancer.

A current estimation shows that roughly 25% of metastatic castration-resistant prostate cancers (mCRPC) contain alterations in DNA repair genes. These would normally code for proteins to correct errors arising when cells duplicate their DNA before cell division.

Sartor says the test would lay out molecular data regarding a patient's malignancy and allow community oncologists to determine what would be the best course of treatment. He added that the hope for this study is to replace the "trial and error" method of treatment with something more concrete.

Aspirin, normally associated with heart health, may not extend to the reduction of risk in prostate cancer, according to the results of an observational study.

Resistance to androgen receptor therapies in patients with metastatic castration-resistant prostate cancer (mCRPC) has historically posed a challenge to clinicians. Now, a new blood test that analyzes circulating tumor cells (CTCs) could help overcoming these hurdles.

The FDA has approved a new treatment consisting of a non-alcohol formulation of docetaxel in patients with breast cancer, non-small cell lung cancer, prostate cancer, gastric adenocarcinoma, and head and neck cancer.

Urologists face a challenge in delineating the optimal sequence of treatment more and more as the goal for treating prostate cancer moves toward greater use of targeted therapies. While these treatment eradicate disease, urologists must minimize the risk of adverse events.

A new study from the University of California, Los Angeles shows that less than 5% of men who opt for active surveillance of their low-risk prostate cancer receive the proper amount of monitoring.

Living a healthier lifestyle could be a robust preventative measure against metastatic prostate cancer. One new study suggests that leading a healthy lifestyle could reduce a man's chances of developing the cancer by up to 68%.

Recent studies suggest that RP may be a better initial treatment given many of these patients require multimodal therapy to manage their disease. The question about radiation versus surgery lies in the details, with treatment tailored to each patient.