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Prostate Cancer
Genomics/Genetics

Two New Studies Find Aggressive Prostate Cancer May Be Linked to Ancestral Heritage

Two studies published simultaneously by Jaratlerdsiri et al in Nature and Gong et al in Genome Medicine have identified genetic signatures explaining ethnic differences in the severity of prostate cancer, particularly in sub-Saharan Africa. Through genetic sequencing of prostate cancer tumors from...

Prostate Cancer

Success Story in Prostate Cancer for Many Men

“I now think of prostate cancer as a story of success for many men, given the advancements in both research and treatment options over the past decade,” Behfar Ehdaie, MD, MPH, told The ASCO Post. Dr. Ehdaie is lead author of a study that found MRI-guided focused ultrasound focal therapy is safe...

Prostate Cancer

MRI-Guided Ultrasound Focal Therapy May Delay or Avoid Prostatectomy or Radiotherapy in Patients With Intermediate-Risk Prostate Cancer

MRI-guided focused ultrasound focal therapy produced “a high degree of success” and “a low rate of genitourinary adverse events” when used to treat select patients with intermediate-grade prostate cancer, Behfar Ehdaie, MD, MPH, and colleagues reported in The Lancet Oncology.1 Dr. Ehdaie is...

Prostate Cancer

Surviving Advanced Prostate Cancer Has Made Me a More Empathetic Physician

My diagnosis of terminal prostate cancer 3 years ago was filled with irony. As an interventional radiologist, I have treated hundreds of patients with advanced prostate cancer, and I knew my prognosis wasn’t good. After experiencing some of the common symptoms of the cancer, including voiding...

Prostate Cancer

Long-Term Benefit of Radiotherapy Confirmed in Advanced Prostate Cancer: STAMPEDE Trial Follow-up

Radiotherapy to the prostate in addition to standard treatment may improve survival for some men with advanced prostate cancer without detriment to quality of life, long-term study results from the STAMPEDE trial confirmed. These findings were published by Chris C. Parker, MD, and colleagues in...

Prostate Cancer

GnRH Agonist Therapy for Prostate Cancer and Cardiovascular Disease Risk in Men With Type 2 Diabetes

In a Swedish population-based cohort study reported in JAMA Network Open, Lin et al found that men with type 2 diabetes receiving gonadotropin-releasing hormone (GnRH) agonists for prostate cancer were more likely to have an increased risk for developing cardiovascular disease compared with those...

Prostate Cancer

PSA Screening and Prostate Cancer Mortality Among Black and White Veterans

In a study reported in JAMA Oncology, Sherer et al found that prostate-specific antigen (PSA) screening was associated with reduced prostate cancer mortality among both non-Hispanic Black and non-Hispanic White U.S. veterans who developed prostate cancer. Annual vs some screening was associated...

Prostate Cancer

FDA Approves Darolutamide for Metastatic Hormone-Sensitive Prostate Cancer

On August 5, 2022, the U.S. Food and Drug Administration approved darolutamide (Nubeqa) tablets in combination with docetaxel for adult patients with metastatic hormone-sensitive prostate cancer. The evaluation of efficacy was based on ARASENS (ClinicalTrials.gov identifier NCT02799602), a...

Prostate Cancer

Second Primary Cancer Risk After Primary Radiotherapy vs Surgery or Other Treatment in Veterans With Localized Prostate Cancer

In a retrospective cohort study reported in JAMA Network Open, Bagshaw et al found that the risk of a second primary cancer at more than 1 year from diagnosis was significantly greater among U.S. veterans with localized prostate cancer who received primary radiotherapy vs those who received surgery ...

Prostate Cancer

Media Emphasis on Urinary Symptoms May Delay Diagnosis of Early Prostate Cancer

According to Cancer Research UK, over 52,000 men are diagnosed with prostate cancer each year in the UK, and there are more than 12,000 deaths. Over three-quarters (78%) of men diagnosed with the disease survive for over 10 years, but this proportion has barely changed over the past decade in the...

Prostate Cancer

Expert Point of View: Susan Slovin, MD, PhD

Invited discussant Susan Slovin, MD, PhD, of Memorial Sloan Kettering Cancer Center, New York, pointed out there are no relevant serum biomarkers for disease progression and the challenges of interpreting response in metastatic castration-resistant prostate cancer. “We should have more definitive...

Prostate Cancer

LuPSMA Improves Progression-Free Survival vs Cabazitaxel in PSMA-Positive Metastatic Castration-Resistant Prostate Cancer

Lutetium-177–labeled PSMA-617 (LuPSMA; lutetium Lu 177 vipivotide tetraxetan) achieved longer progression-free survival with fewer toxicities compared with cabazitaxel in patients with prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer whose disease...

Prostate Cancer

EAU22: Trial Shows New Imaging Technology May Be Less Accurate Than MRI in Detecting Prostate Cancer

A team of researchers in Australia and New Zealand reported that magnetic resonance imaging (MRI) scans may be able to detect prostate cancer more accurately than the newer, prostate-specific membrane antigen (PSMA) positron-emission tomography/computed tomography (PET/CT) scanning technique. The...

Prostate Cancer

Addition of Enzalutamide to Active Surveillance in Low- or Intermediate-Risk Localized Prostate Cancer

As reported in JAMA Oncology by Neal D. Shore, MD, FACS, and colleagues, the phase II ENACT trial has shown a reduced risk of disease progression with the addition of enzalutamide to active surveillance in patients with low- or intermediate-risk localized prostate cancer. Study Details In the...

Prostate Cancer

EAU22: New Research Supports Risk-Based Prostate Cancer Screening

Data from the world’s largest prostate cancer screening study provides further evidence to support the introduction of a targeted screening program for the disease, said researchers. In 2009, the European Randomised Study of Screening for Prostate Cancer (ERSPC) showed that screening can reduce...

Prostate Cancer

EAU22: Study Finds Gut Microbes Differ in Patients With Prostate Cancer vs Those With Benign Biopsy Results

Researchers have found a significant difference in the gut microbiota of patients with prostate cancer compared with those who have benign biopsies. Although the finding is an association, it could partly explain the relationship between lifestyle effects and geographic differences in prostate...

Prostate Cancer

Is Focal Therapy With MRI-Guided Focused Ultrasound Safe and Effective for Grade Group 2 or 3 Prostate Cancer?

In a phase IIb study reported in The Lancet Oncology, Ehdaie et al found that focal ablation with magnetic resonance imaging (MRI)-guided focused ultrasound successfully treated a high proportion of patients with grade group 2 or 3 prostate cancer. As stated by the investigators, “Men with grade...

Prostate Cancer

Cabozantinib and Atezolizumab for Patients With Progressive Metastatic Castration-Resistant Prostate Cancer Post–Hormonal Therapy

As reported in The Lancet Oncology by Neeraj Agarwal, MD, and colleagues, findings in the expansion cohort of the phase Ib COSMIC-021 trial indicate activity of the combination of cabozantinib and atezolizumab in patients with metastatic castration-resistant prostate cancer whose disease progressed ...

Prostate Cancer

William Catalona, MD, on the Evolution of Views Regarding Active Surveillance in Men With Low-Risk Prostate Cancer

William Catalona, MD, Professor of Urology at Northwestern University’s Feinberg School of Medicine, and past Principal Investigator on the Northwestern-based prostate SPORE, explained the evolution of his views regarding active surveillance in men with low-risk prostate cancer. Although...

Prostate Cancer

Rates of Active Surveillance Rising Among Men With Low-Risk Prostate Cancer but Still Suboptimal

Most men with low-risk prostate tumors now opt for active surveillance, but overtreatment remains a problem, according to data presented during the 2022 American Urological Association (AUA) Annual Meeting.1 A retrospective analysis of more than 20,000 patients with low-risk prostate cancer showed...

Prostate Cancer

Potential Association of the 2012 USPSTF Grade D Recommendation Against PSA Screening With Changes in Prostate Cancer–Specific Mortality

In a study reported in JAMA Network Open, Burgess et al found that the 2012 U.S. Preventive Services Task Force (USPSTF) Grade D recommendation against prostate-specific antigen (PSA) screening for all men appeared to be associated with ending of a trend of annual reductions in prostate...

Prostate Cancer
Genomics/Genetics

Differences in Germline Variant Spectrum Between Black and White Men With Prostate Cancer

In a study presented at the 2022 ASCO Annual Meeting (Abstract 10502) and simultaneously published in JCO Precision Oncology, Veda N. Giri, MD, and colleagues found that Black men with prostate cancer exhibited a lower frequency and narrower spectrum of germline pathogenic or likely pathogenic...

prostate cancer
genomics/genetics

Neal D. Shore, MD, on Germline Genetic Testing and Its Impact on Prostate Cancer Clinical Decision-Making

Neal D. Shore, MD, of the Carolina Urologic Research Center, discusses his study findings, showing that germline genetic testing influenced care for patients with prostate cancer. Men whose genetic test was positive for a pathogenic germline variant received more recommendations for changes to follow-up and treatment, and for testing and counseling of relatives, than did patients with negative or uncertain test results (Abstract 10500).  

prostate cancer

Alicia K. Morgans, MD, MPH, and Michael S. Hofman, MBBS, on Prostate Cancer: New Data on Lutetium-177–PSMA-617 (LuPSMA) vs Cabazitaxel

Alicia K. Morgans, MD, MPH, of Dana-Farber Cancer Institute, and Michael S. Hofman, MBBS, of Peter MacCallum Cancer Centre, University of Melbourne, discuss follow-up results on LuPSMA vs cabazitaxel in patients with metastatic castration-resistant prostate cancer progressing after docetaxel treatment. The findings suggest that LuPSMA is a suitable option for this population, with fewer adverse events, higher response rates, improved patient-reported outcomes, and similar overall survival compared with cabazitaxel (Abstract 5000).

prostate cancer

Alicia K. Morgans, MD, MPH, and Ian D. Davis, PhD, MBBS, on Prostate Cancer: Updated Overall Survival Outcomes With Enzalutamide

Alicia K. Morgans, MD, MPH, of Dana-Farber Cancer Institute, and Ian D. Davis, PhD, MBBS, of Monash University and Eastern Health, discuss the latest findings from ANZUP Cancer Trials Group’s ENZAMET cooperative group trial of enzalutamide in patients with metastatic hormone-sensitive prostate cancer. The results corroborate the benefit of enzalutamide with improved overall survival, and involve some exploratory subgroup analyses (Abstract LBA5004).

Prostate Cancer

AUA, ASTRO Release New Clinically Localized Prostate Cancer Guideline

Recently, the American Urological Association (AUA), in partnership with the American Society for Radiation Oncology (ASTRO), released the 2022 clinical practice guideline for the management of clinically localized prostate cancer. The guideline has been endorsed by the Society of Urologic Oncology ...

Prostate Cancer

Does Treatment With 5α-Reductase Inhibitors Impact the Risk of Dying of Prostate Cancer Among Men Without a Prior Diagnosis of the Disease?

In a Swedish study reported in JAMA Oncology, Björnebo et al found that longer use of 5α-reductase inhibitors (5-ARIs) for the treatment of benign prostatic hyperplasia was associated with a reduced risk of prostate cancer mortality among men without a prior diagnosis of prostate cancer. As stated...

Prostate Cancer
Symptom Management

Adverse Events Seen With Abiraterone or Enzalutamide Among Patients With Advanced Prostate Cancer

Men taking either of the two most common oral medications for advanced prostate cancer who had also undergone hormone therapy to treat their disease were at higher risk of serious metabolic or cardiovascular issues than patients who were receiving hormone therapy alone, according to findings...

Prostate Cancer

Addition of ADT and Pelvic Lymph Node Radiotherapy to Salvage Prostate Bed Radiotherapy After Prostatectomy

In a phase III trial (NRG Oncology/RTOG 0534 SPPORT) reported in The Lancet, Alan Pollack, MD, PhD, and colleagues found that both the addition of short-term androgen-deprivation therapy (ADT) and the addition of ADT and pelvic lymph node radiotherapy (PLNRT) to salvage prostate bed radiotherapy...

Prostate Cancer

Polygenic Score May Enable More Precise PSA Screening for Prostate Cancer

The use of a polygenic score incorporating variations in prostate-specific antigen (PSA) values that are not due to cancer may allow for more precise PSA screening, according to findings of a large genome-wide association study presented at the American Association for Cancer Research (AACR) Annual ...

Prostate Cancer

SWOG-1216: Orteronel vs Bicalutamide With ADT for Metastatic Hormone-Sensitive Prostate Cancer

As reported in the Journal of Clinical Oncology by Neeraj Agarwal, MD, and colleagues, the phase III SWOG-1216 trial showed no significant improvement in overall survival—the study’s primary endpoint—with orteronel plus androgen-deprivation therapy (ADT) vs bicalutamide plus ADT in patients with...

Prostate Cancer

Overall Survival in the ARCHES Trial: Addition of Enzalutamide to ADT for Metastatic Hormone-Sensitive Prostate Cancer

As reported in the Journal of Clinical Oncology by Andrew J. Armstrong, MD, ScM, and colleagues, the final overall survival analysis of the phase III ARCHES trial showed a significant benefit with the addition of enzalutamide to androgen-deprivation therapy (ADT) in patients with metastatic...

prostate cancer

Matthew R. Smith, PhD, MD, on Prostate Cancer: Phase III Data on Darolutamide, Androgen Deprivation, and Docetaxel

Matthew R. Smith, PhD, MD, of Massachusetts General Hospital Cancer Center, discusses overall survival findings from the ARASENS trial, which assessed the efficacy of the androgen receptor inhibitor darolutamide vs placebo in combination with androgen-deprivation therapy and docetaxel for patients with metastatic hormone-sensitive prostate cancer (Abstract 13).

gynecologic cancers
breast cancer
pancreatic cancer
prostate cancer
genomics/genetics

Timothy A. Yap, MBBS, PhD, on Ovarian, Breast, Pancreatic, and Prostate Cancers With Genetic Mutations: A First-in-Human Trial of AZD5305

Timothy A. Yap, MBBS, PhD, of The University of Texas MD Anderson Cancer Center, discusses results from the PETRA study, a first-in-class, first-in-human trial of the next-generation PARP1-selective inhibitor AZD5305 in patients with BRCA1/2, PALB2, or RAD51C/D mutations in advanced or metastatic ovarian cancer, HER2-negative breast cancer, pancreatic, or prostate cancer. Target engagement was demonstrated across all dose levels, and antitumor activity was observed in selected tumor and molecular subtypes.

prostate cancer

PSMA-Targeted Radioligand Therapy for Metastatic Castration-Resistant Prostate Cancer

In this video, Drs. Celestia (Tia) Higano, Julie Graff, and Neal Shore discuss the role of prostate-specific membrane antigen (PSMA)-targeted radioligand therapy in the treatment of metastatic castration-resistant prostate cancer. The patient is an 81-year-old man with 13-year history of prostate cancer who had received multiple prior lines of treatment for his metastatic disease, but no prior taxane. After his PSA rose again, he opted to travel abroad for lutetium (Lu-177) PSMA therapy, since he was not eligible for trials in the United States. The faculty discuss the VISION trial and the current and future role of PSMA-targeted radioligand therapy in prostate cancer. Editor’s Note: This video was filmed prior to the FDA approval of Lu-177 PSMA radioligand therapy on March 23, 2022.

prostate cancer
genomics/genetics

First-Line Therapy for BRCA2-Mutated Metastatic Castration-Resistant Prostate Cancer

This is Part 3 of Updates in Prostate Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Celestia (Tia) Higano, Julie Graff, and Neal Shore discuss the first-line therapy for BRCA2-mutated metastatic castration-resistant prostate cancer. The patient is a 69-year-old man with new castration-resistant prostate cancer who was previously treated with androgen-deprivation therapy plus docetaxel for metastatic hormone-sensitive prostate cancer and has a known BRCA2 mutation. The faculty discuss their choices for first-line therapy for this patient, reviewing the current NCCN recommendations, the role of PARP inhibitors, and recent data from the PROpel and MAGNITUDE trials.

prostate cancer

Doublet or Triplet Androgen-Deprivation Therapy Options for Metastatic Prostate Cancer

This is Part 2 of Updates in Prostate Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Celestia (Tia) Higano, Julie Graff, and Neal Shore discuss doublet and triplet androgen-deprivation therapy options for metastatic prostate cancer. The patient is a 71-year-old man with metastatic prostate cancer, a PSA of 275, and a positive bone scan, who has begun to receive androgen-deprivation therapy. The faculty discuss what, if any, additional therapy they might add to this patient’s treatment regimen, weighing the current doublet and triplet combination options for metastatic hormone-sensitive prostate cancer. They review the results of the recent PEACE-1 and ARASENS trials and emphasize the importance of assessing bone mineral density and of encouraging genetic counseling for these patients.

prostate cancer

Elderly Patient With Metastatic Hormone-Sensitive Prostate Cancer

This is Part 1 of Updates in Prostate Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. �In this video, Drs. Celestia (Tia) Higano, Julie Graff, and Neal Shore discuss the management of metastatic hormone-sensitive prostate cancer in elderly patients. The patient is a fit 88-year-old man with a history of localized prostate cancer who was originally treated with stereotactic body radiation therapy and is reluctant to start androgen-deprivation therapy for his metastatic disease due to the potential side effects. The faculty discuss the importance of counseling patients about side effects of treatment and when to consider androgen-deprivation therapy rather than metastasis-directed therapy alone, reviewing the results of the phase III HERO trial.

Prostate Cancer

High-Dose Radiotherapy With Short- vs Long-Term Androgen Deprivation in Localized Prostate Cancer

As reported in The Lancet Oncology by Zapatero et al, 10-year results of the Spanish phase III DART 01/05 trial did not support the 5-year findings of significantly improved biochemical disease–free, metastasis-free, and overall survival with long-term vs short-term androgen deprivation plus...

Prostate Cancer

Less Prostate Cancer Screening Reduces Overdiagnosis but May Miss Aggressive Cases

Over the past 15 years, public health authorities have downgraded recommendations for the prostate-specific antigen (PSA) test as a screening tool to reduce the overdiagnosis and overtreatment of men with low-grade prostate cancer. Researchers from Weill Cornell Medicine have found that while these ...

Prostate Cancer

PEACE-1 Trial: Addition of Abiraterone Plus Prednisone to ADT and Docetaxel in De Novo Metastatic Castration-Sensitive Prostate Cancer

As reported in The Lancet by Fizazi et al, the phase III PEACE-1 trial has shown that the addition of abiraterone and prednisone to androgen-deprivation therapy (ADT) and docetaxel improved radiographic progression-free survival and overall survival in patients with de novo metastatic...

Prostate Cancer

Accounting for Genetic Factors That Cause Normal Variations in PSA Levels May Improve the Accuracy of Prostate Cancer Detection

The accuracy of prostate-specific antigen (PSA) screening for prostate cancer could be improved by accounting for genetic factors that cause changes in PSA levels not associated with cancer, according to data presented by Kachuri et al during the American Association for Cancer Research (AACR)...

prostate cancer

Julio M. Pow-Sang, MD, on Nonmetastatic Prostate Cancer: Update on Best Management Practices

Julio M. Pow-Sang, MD, of Moffitt Cancer Center, discusses the treatment landscape for localized prostate cancer and its heterogeneity, the critical importance of stratifying risk to determining treatment options, and the continued improvement of therapy in the field.

Prostate Cancer

Expert Point of View: Elisabeth I. Heath, MD, FACP, and Oliver Sartor, MD

Formal discussant of the ARASENS trial, Elisabeth I. Heath, MD, FACP, Professor of Oncology and Associate Center Director, Translational Sciences, at Karmanos Cancer Institute in Detroit, commented on the changing paradigm in prostate cancer treatment. “The narrative is changing to triplet therapy, ...

Prostate Cancer

Study Reports Modest Gain in Progression-Free Survival With Continued Enzalutamide in Advanced Prostate Cancer

Enzalutamide is a common first-line choice for patients with metastatic castration-resistant prostate cancer, but response in some patients eventually wanes and then patients are switched to a different treatment. According to the phase IIIb PRESIDE trial, reported at the 2022 ASCO Genitourinary...

Prostate Cancer

First-Line Olaparib Plus Abiraterone Extends Radiographic Progression-Free Survival in Men With Metastatic Castration-Resistant Prostate Cancer

The PARP inhibitor olaparib in combination with abiraterone demonstrated a statistically significant and clinically meaningful improvement in radiographic progression-free survival vs current standard-of-care abiraterone as a first-line treatment for patients with metastatic castration-resistant...

prostate cancer

Xin Gao, MD, on Prostate Cancer: Early-Phase Results on Bavdegalutamide

Xin Gao, MD, of Massachusetts General Hospital, discusses phase I/II findings on bavdegalutamide, an androgen receptor protein degrader, which showed clinical activity in heavily pretreated patients with metastatic castration-resistant prostate cancer who received one to two prior novel hormonal agents.

Prostate Cancer

Triplet Combination Improves Overall Survival in Metastatic Hormone-Sensitive Prostate Cancer

Triplet therapy with the oral androgen receptor inhibitor darolutamide plus docetaxel plus androgen-deprivation therapy significantly improved overall survival in patients with metastatic hormone-sensitive prostate cancer vs docetaxel plus androgen-deprivation therapy, according to results of the...

Prostate Cancer

Observation vs Screening Spinal MRI in Patients With Castration-Resistant Prostate Cancer and Asymptomatic Spinal Metastases

As reported in The Lancet Oncology by David Dearnaley, FRCR, and colleagues, the phase III PROMPTS study has shown that a strategy of routine screening with spinal magnetic resonance imaging (MRI) and preemptive treatment to prevent clinical spinal cord compression is likely not warranted in...

Prostate Cancer

FDA Approves Radioligand for Metastatic Castration-Resistant Prostate Cancer

On March 23, the U.S. Food and Drug Administration approved lutetium Lu-177 vipivotide tetraxetan (Pluvicto) for the treatment of adult patients with prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer who have been treated with androgen receptor...

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