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Prostate Cancer

Progress in Defining Molecular Signature for Aggressive Androgen-Indifferent Prostate Cancer

Prostate cancer has lagged behind breast cancer in the identification of predictive and prognostic biomarkers, but the field is catching up. Researchers have identified a molecular signature that can distinguish aggressive prostate cancer that is androgen-indifferent and will have a better response ...

Kidney Cancer
Prostate Cancer
Cost of Care

Next-Generation Genitourinary Oncology: Keeping One’s Powder Dry

There is a new yin-yang of management in genitourinary oncology, with the balance of opposing power focused among cancer cells, kinase inhibition, and lymphocyte function, representing a shift in the fashions of treatment somewhat away from chemotherapy. This linear progress has been complicated...

Prostate Cancer

Potential Surrogate for All-Cause Mortality Risk in Localized Prostate Cancer

In a study reported in JAMA Oncology, Trevor J. Royce, MD, of Harvard Radiation Oncology Program, Brigham and Women’s Hospital, and colleagues found that a prostate-specific antigen (PSA) nadir > 0.5 ng/mL may be a dominant risk factor for all-cause mortality after radiation therapy and...

Prostate Cancer

Expert Point of View: Joseph Greer, PhD

“These data are consistent with other studies we have conducted in advanced lung cancer, in which we similarly found that one-third of patients believed that their metastatic lung cancer was curable. These patients ostensibly already had conversations with their oncologists about their prognosis...

Prostate Cancer

Aligning Patient Expectations With Treatment Goals in the Metastatic Setting

More than one-third of men with incurable metastatic prostate cancer mistakenly believe that their cancer may be curable, according to a survey of patient expectations at an academic cancer center. “This study is part of a larger survey of treatment decision-making among men with metastatic...

Prostate Cancer

Expert Point of View: Susan F. Slovin, MD, PhD

Formal discussant for the presentation of SWOG S9921 results, Susan F. Slovin, MD, PhD, a medical oncologist at Memorial Sloan Kettering Cancer Center, New York, said there were some important points to understand about this “vintage” trial.  “The trial was designed 20 years ago, and the view is...

Prostate Cancer

No Benefit From Older Standard-of-Care Drug in Adjuvant Chemotherapy for High-Risk Prostate Cancer, but Newer Trials Feasible

An older trial designed to evaluate the benefits of adjuvant therapy following radical prostatectomy in patients with high-risk prostate cancer showed no difference in overall or disease-free survival between 2 years of androgen-deprivation therapy and 2 years of androgen-deprivation therapy plus...

breast cancer
prostate cancer
issues in oncology

Diana D. Jeffery, PhD, on Mental Health Comorbidities: Predictors of Cost and Utilization

Diana D. Jeffery, PhD, of the Defense Health Agency, discusses the need to screen for mental health comorbidities, including depression, anxiety, adjustment disorders, substance use disorders, and persistent mental illnesses, as shown in a study of breast and prostate cancer patients (Abstract 18).

breast cancer
prostate cancer
supportive care

ASCO Quality Care 2017: Mental Health Conditions Contribute to Care-Related Costs, Hospital Visits in Breast and Prostate Cancers

A new analysis of data from the U.S. Military Health System found that mood and adjustment disorders such as anxiety and depression were strong predictors of the annual number of outpatient visits, hospital admissions, and number of days in the hospital for patients with breast and prostate...

prostate cancer

Guru Sonpavde, MD, on Prostate Cancer: Targeting DNA Alterations

Guru Sonpavde, MD, of the UAB Comprehensive Cancer Center, discusses his study on circulating tumor DNA alterations in metastatic castration-resistant prostate cancer and the therapeutic direction the data suggest. (Abstract 149)

prostate cancer

Paul L. Nguyen, MD, on Prostate Cancer: Active Surveillance

Paul L. Nguyen, MD, of the Dana-Farber Cancer Institute, summarizes a session he co-chaired, which included discussion of Canadian vs U.S. guidelines; ProtecT; genomic and hereditary tests; and imaging to guide active surveillance. (General Session 1)

prostate cancer

Paul L. Nguyen, MD, on Predicting Metastasis and Mortality

Paul L. Nguyen, MD, of the Dana-Farber Cancer Institute, discuses an evaluation of the Decipher prostate cancer classifier to predict metastasis and disease-specific mortality from genomic analysis of diagnostic needle biopsy specimens. (Abstract 4)

prostate cancer

Joshua M. Lang, MD, on Prostate Cancer: Best of the Journals

Joshua M. Lang, MD, of the University of Wisconsin Carbone Cancer Center, discusses genomic alterations in DNA damage–repair pathways––more common in patients with prostate cancer than previously recognized–– and clinical trials with PARP inhibitors.

prostate cancer

L. Michael Glodé, MD, on Prostate Cancer: Results From SWOG S9921

L. Michael Glodé, MD, of the University of Colorado Cancer Center, discusses study findings on adjuvant androgen deprivation vs mitoxantrone plus prednisone plus ADT in high-risk prostate cancer patients following radical prostatectomy. (Abstract 2)

prostate cancer

Charles G. Drake, MD, PhD, on Prostate Cancer and Immunology: Expert Perspective

Charles G. Drake, MD, PhD, of Columbia University Medical Center, summarizes his keynote lecture on immunotherapy as a new frontier in prostate cancer and its synergistic use with traditional treatments.

prostate cancer

Joshua Armenia, PhD, on Prostate Cancer: Recent Discoveries

Joshua Armenia, PhD, of Memorial Sloan Kettering Cancer Center, discusses new information that is changing the understanding of prostate cancer, including the identification of a new subclass, which represents 21% of cases, and the discovery of recurrently mutated cancer pathways not previously implicated in prostate cancer (Abstract 131).

Prostate Cancer

On the Horizon: New Tools for Prostate Cancer

The field of prostate cancer is being energized by discoveries in genetics, novel imaging techniques, and the potential of checkpoint inhibitors in the treatment of prostate cancer. Not all of these advances are currently clinically actionable, but all have the potential to change clinical...

Prostate Cancer

24-Gene Predictor of Response to Postoperative Radiotherapy in Prostate Cancer

In a matched retrospective analysis reported in The Lancet Oncology, Zhao et al identified and validated a 24-gene predictor of response to postoperative radiotherapy in prostate cancer. Felix Y. Feng, MD, of the University of California, San Francisco, is the corresponding author of The Lancet...

Prostate Cancer
Issues in Oncology

A Gleason 6 Tumor: Is It Cancer, and Should It Be Treated?

The diagnosis and treatment of prostate cancer have long been a source of controversy among the oncology community, the political sector, and patient advocacy groups. Most notably, the decision to biopsy a man’s prostate gland rests largely on his prostate-specific antigen (PSA) test numbers, the...

Prostate Cancer

Long-Term Effects of Finasteride in Patients From the Prostate Cancer Prevention Trial

In the Prostate Cancer Prevention Trial finasteride was found to reduce the risk of low-grade prostate cancer but to have no effect on overall survival. Results of the trial, in which 18,880 men were randomized to receive finasteride or placebo for 7 years, were reported in 2003. In a recent study...

Issues in Oncology
Lung Cancer
Gastrointestinal Cancer
Prostate Cancer
Colorectal Cancer

At ESMO 2016, Many Phase III Trials Fail to Meet Primary Endpoints

The 2016 European Society for Medical Oncology (ESMO) Congress revealed many important positive findings from key trials in a number of tumor types, but many highly anticipated phase III trials in advanced disease failed to meet their primary endpoints. The ASCO Post has summarized several of these ...

prostate cancer
sarcoma

Link Between Molecular Mechanisms in Prostate Cancer and Ewing Sarcoma Found

Medical researchers at Indiana University (IU) Bloomington have found evidence for a link between prostate cancer, which affects millions of men aged 50 and older, and Ewing's sarcoma, a rare form of cancer that affects children and young adults. The results of the study, reported by Kedage et al...

Prostate Cancer

Similar Functional Outcomes With Robot-Assisted Laparoscopic and Open Radical Retropubic Prostatectomy

Robot-assisted laparoscopic prostatectomy and open radical retropubic prostatectomy yielded similar domain-specific quality-of-life or pathologic outcomes at 12 weeks in men with newly diagnosed, clinically localized prostate cancer, according to the results of a randomized phase III trial reported ...

Prostate Cancer

Prognostic and Predictive Molecular Subtypes of Prostate Cancer Identified

Members of the oncology community have long complained that prostate cancer lags behind breast cancer regarding biomarkers for prognosis and treatment, but the good news is that this gap is narrowing. In the largest study of its kind to date, presented at the 58th Annual Meeting of the American...

Prostate Cancer

Safety of Extreme Hypofractionation Reassuring in Intermediate-Risk Prostate Cancer

Giving patients larger fractions of radiation over shorter periods (ie, hypofractionation) is gaining ground in several types of cancers. This approach is attractive for patients’ convenience, shortening treatment and travel times, and also for resource utilization. Several studies have shown that ...

prostate cancer

Christopher J. Sweeney, MBBS, on Prostate Cancer: CHAARTED Trial Follow-up

Christopher J. Sweeney, MBBS, of the Dana-Farber Cancer Institute, discusses how long-term study results showed no survival benefit in men with ogliometastatic prostate cancer. (Abstract 720PD)

prostate cancer

Christopher J. Sweeney, MBBS, on Localized Prostate Cancer: Metastasis-Free Survival as a Surrogate for Overall Survival

Christopher J. Sweeney, MBBS, of the Dana-Farber Cancer Institute, discusses how this early clinical endpoint will accelerate the development of new therapies for localized intermediate and high-risk prostate cancer. (Abstract 717O)

Prostate Cancer

Surgery and Radiation ProtecT Against Progression/Metastasis vs Active Monitoring in Prostate Cancer, but at What Cost?

The ProtecT trial showing similar 10-year survival with active monitoring, surgery, or radiotherapy for prostate-specific antigen (PSA)-detected localized prostate cancer but a greater risk of disease progression/metastasis with monitoring was recently reported by Hamdy and colleagues and is...

Prostate Cancer

Risk of Metastasis With Active Monitoring in PSA-Detected Localized Prostate Cancer: The ProtectT Trial

The ProtecT study findings1 are provocative. Despite having a control arm of active monitoring with serial prostate-specific antigen (PSA) testing, as compared with watchful waiting in the prior randomized trials (ie, SPCG-42 and PIVOT3), and also enrolling men with more favorable-risk disease...

Prostate Cancer

Similar 10-Year Survival With Active Monitoring, Surgery, or Radiotherapy for PSA-Detected Clinically Localized Prostate Cancer

In the UK ProtecT trial reported in The New England Journal of Medicine, Freddie C. Hamdy, FRCS, FMedSci, of the University of Oxford, and colleagues found no significant differences in prostate cancer–specific or overall mortality among men with clinically localized prostate cancer detected by...

prostate cancer
issues in oncology

Study Reports No Association Between Vasectomy and Prostate Cancer Incidence or Mortality

In an analysis of the Cancer Prevention Study II (CPS-II) study cohort reported in the Journal of Clinical Oncology, Jacobs et al found no significant association between vasectomy and overall prostate cancer incidence or mortality. A recent prospective study had shown an association of vasectomy...

prostate cancer

Paul L. Nguyen, MD, on Prostate Cancer: High-Risk Disease, Brachytherapy, And Hormones

Paul L. Nguyen, MD, of the Dana-Farber Cancer Institute, summarizes a session he moderated, which included talks on local recurrence following brachytherapy, long-term PSA stability after the procedure, and androgen deprivation and high-dose radiotherapy. (Scientific Session 41)

prostate cancer

Bradley R. Prestidge, MD, on Prostate Cancer: Initial Findings of NRG Oncology/RTOG 0232

Bradley R. Prestidge, MD, of Bon Secours VA Health System, summarizes his plenary lecture on this phase III trial comparing combined external beam radiation and transperineal interstitial permanent brachytherapy with brachytherapy alone for selected patients with intermediate-risk prostate cancer. (Plenary Lecture 1, Presentation 7)

prostate cancer

Alan Pollack, MD, PhD, on Prostate Cancer: Postprostatectomy Radiotherapy

Alan Pollack, MD, PhD, of the University of Miami Health System, summarizes a session that included discussion of outcomes, dose response, oligometastatic disease, and gene predictor of response. (Presentations 228-235)

prostate cancer

Anders Widmark, MD, PhD, on Intermediate-Risk Prostate Cancer: Results From the HYPO-RT-PC Trial

Anders Widmark, MD, PhD, of the Umea University Hospital Oncology, discusses the early toxicity results from the phase III Scandinavian study on extreme hypofractionation vs conventionally fractionated radiotherapy for intermediate-risk prostate cancer. (Abstract LBA-5)

prostate cancer

Daniel Hamstra, MD, PhD, on Prostate Cancer: Decreasing Rectal Toxicity

Daniel A. Hamstra, MD, PhD, of Texas Oncology, discusses phase III findings on the use of an absorbable hydrogel spacer designed to decrease rectal toxicity and improve bowel quality of life for patients with prostate cancer. (Abstract LBA-6)

Prostate Cancer

Large Study Finds No Link Between Vasectomy and Prostate Cancer Risk

In a new study, men who underwent vasectomy did not have an increased risk of prostate cancer, nor were they more likely to die from prostate cancer than men who did not receive this procedure. According to the researchers, this is the largest prospective study of vasectomy and fatal prostate...

Prostate Cancer

Testosterone-Related Genetic Mutation Associated With Poorer Survival in Prostate Cancer

A collaborative Cleveland Clinic–Mayo Clinic team of researchers has shown for the first time that patients with advanced prostate cancer are more likely to die earlier of their disease if they carry a specific testosterone-related genetic abnormality. The findings, published by Hearn et al in The...

Prostate Cancer

Continuation of Docetaxel May Improve Survival in Metastatic Castration-Resistant Prostate Cancer

The number of docetaxel cycles completed was associated with improved overall survival among men with metastatic castration-resistant prostate cancer receiving docetaxel, prednisone, and lenalidomide (Revlimid) or docetaxel/prednisone, in the phase III Mainsail trial. de Morrée et al reported this ...

Bladder Cancer
Kidney Cancer
Prostate Cancer

Multitude of Mentors Help Shape an Illustrious Career in Oncology

Sumanta K. Pal, MD, has had a longer career in oncology than many other colleagues his age. Perhaps the reason for that may center on his starting college at the age 13 and medical school at the age of 17. Today this internationally recognized leader in genitourinary cancers is Assistant Professor ...

Prostate Cancer

Hypofractionated Radiotherapy for Localized Prostate Cancer: A New Standard of Care?

For at least the past quarter of a century, radiobiologists and radiation oncologists have debated the role of hypofractionation (fewer total fractions with a higher dose per fraction) for prostate cancer. The debate stems from the unique radiobiology of prostate cancer and the best means to...

Prostate Cancer

European Studies Compare Conventional vs Hypofractionated Radiotherapy for Localized Prostate Cancer

Two recent European phase III trials with different study designs focused on hypofractionated vs conventional radiotherapy in localized prostate cancer. Investigators in the CHHiP trial1 showed that the hypofractionated approach is noninferior to standard fractionation, with no increase in side...

Prostate Cancer

Hypofractionated Radiotherapy: Balancing Benefits vs Risks in Men With Localized Prostate Cancer

Radiation for prostate cancer typically requires 40 to 45 daily treatments, given over 8 to 9 weeks. Long fractionation schemes are chosen for most cancers, because they allow for tumor killing while reducing the potential for injury to normal tissue. However, the radiobiology of prostate cancer...

Prostate Cancer

Hypofractionated Radiotherapy Not Inferior to Conventional Radiotherapy in Low-Risk Prostate Cancer

In a phase III noninferiority trial (NRG Oncology RTOG 0415) reported in the Journal of Clinical Oncology, W. Robert Lee, MD, MS, Med, of Duke University Medical Center, and colleagues found that hypofractionated radiotherapy was not inferior to conventional radiotherapy in disease-free survival...

Prostate Cancer

Hypofractionation May Be Poised to Become New Standard of Care for Prostate Cancer

There has been an ongoing debate about which type of radiation therapy is preferable in the treatment of localized prostate cancer: hypofractionation (larger fractions given over 4–5 weeks) or conventional radiotherapy (given over 8–9 weeks). A new study presented at the 2016 ASCO Annual Meeting...

solid tumors
prostate cancer

No Survival Benefit for Cabozantinib Reported in Previously Treated Metastatic Castration-Resistant Prostate Cancer

Smith et al found no improvement in overall survival with cabozantinib (Cometriq) vs prednisone in patients with previously treated metastatic castration-resistant prostate cancer, in the phase III COMET-1 trial reported in the Journal of Clinical Oncology. Cabozantinib, which inhibits MET, VEGF...

Prostate Cancer

Novel Approach to PET/CT Imaging May Predict Location and Extent of Primary Prostate Cancer

With surgical removal at the front line of defense against prostate cancer, oncologists are considering prostate-specific molecular imaging at the point of initial biopsy and preoperative planning to root out the full extent of disease, researchers showed at the 2016 Annual Meeting of the Society...

Prostate Cancer

FDA Approves New Diagnostic Imaging Agent to Detect Recurrent Prostate Cancer

On May 27, the U.S. Food and Drug Administration (FDA) approved fluciclovine F-18 (Axumin), a radioactive diagnostic agent for injection. Fluciclovine F-18 is indicated for positron-emission tomography (PET) imaging in men with suspected prostate cancer recurrence based on elevated...

Prostate Cancer

Increased Survival and Toxicity With Docetaxel, No Benefit of Zoledronic Acid, When Added to First-Line Hormone Therapy in Prostate Cancer

As reported in The Lancet by Nicholas D. James, BSc, MBBS, PhD, of the University of Warwick, and colleagues, survival results of the STAMPEDE trial, which used a multiarm, multistage seamless phase II/III design, provide little evidence of benefit of zoledronic acid and showed increased survival ...

Prostate Cancer

Prostate Cancer: Opinions Vary on Gleason Scores and Surgery

Diagnosis and treatment of prostate cancer have been the source of heated debate for decades, most of which has centered on the clinical value of the prostate-specific antigen (PSA) test. In 2012, the U.S Preventive Services Task Force (USPSTF) gave the PSA test a D grade, which discourages many...

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