Prostate Cancer

Radioligand Therapy with Lutetium 177-labeled PSMA – I&T for Metastatic Castration-Resistant Prostate Cancer: Clinical Experience with 100 Consecutive Patients

INTRODUCTION & OBJECTIVES: To report our clinical with 177 Lutetium- labeled prostate- specific membrane antigen-ligand (177 Lu-PSMA-I&T) for systemic radioligand therapy in 100 consecutive patients with metastatic castration- resistant prostate cancer (mCRPC).

MATERIALS & METHODS: All patients were treated under a review board-approved compassionate use protocol. 

Pembrolizumab for Patients with Advanced Prostate Adenocarcinoma: Preliminary Results from the KEYNOTE-028 Study

BACKGROUND: Therapies currently available for castrate-refractory prostate cancer (CRPC) provide only modest clinical benefit. Expression of the programmed death 1 (PD-1) receptor and its ligand, PD-L1, has been reported in CRPC. Pembrolizumab, an anti–PD-1 antibody, blocks the interaction between PD-1 and PD-L1. KEYNOTE-028 (NCT02054806) is a nonrandomized, phase 1b trial to evaluate the safety and efficacy of pembrolizumab in 20 advanced solid tumor cohorts.  

PROSPER: A Phase 3, Randomized, Double-blind, Placebo (PBO)-controlled Study of Enzalutamide (ENZA) in Men with Nonmetastatic Castration-Resistant Prostate Cancer (M0 CRPC)

BACKGROUND: Men with M0 CRPC and rapidly rising prostate-specific antigen (PSA) are at high risk of developing metastatic (M1) CRPC. ENZA improves overall survival (OS) and radiographic progression-free survival in men with M1 CRPC. We hypothesized that ENZA will improve metastasis-free survival (MFS) in men with M0 CRPC.

METHODS: Eligible men with M0 CRPC, PSA doubling time ≤ 10 mo and PSA ≥ 2 ng/mL at screening continued androgen deprivation therapy (ADT) and were randomized 2:1 to ENZA 160 mg or PBO.  

Prostate-only Versus Whole-pelvis Radiation with or Without a Brachytherapy Boost for Gleason Grade Group 5 Prostate Cancer: A Retrospective Analysis.

The role of elective whole-pelvis radiotherapy (WPRT) remains controversial. Few studies have investigated it in Gleason grade group (GG) 5 prostate cancer (PCa), known to have a high risk of nodal metastases.

Prostate cancer treatment with Irreversible Electroporation (IRE): Safety, efficacy and clinical experience in 471 treatments.

Irreversible Electroporation (IRE) is a novel image-guided tissue ablation technology that induces cell death via very short but strong pulsed electric fields. IRE has been shown to have preserving properties towards vessels and nerves and the extracellular matrix.

Enzalutamide versus flutamide for castration-resistant prostate cancer after combined androgen blockade therapy with bicalutamide: study protocol for a multicenter randomized phase II trial (the OCUU-CRPC study).

Enzalutamide is an oral androgen receptor targeted agent that has been shown to improve survival in PREVAIL trials and has been approved for patients with chemo-naïve metastatic castration-resistant prostate cancer (CRPC).

Merging new-age biomarkers and nanodiagnostics for precision prostate cancer management.

The accurate identification and stratified treatment of clinically significant early-stage prostate cancer have been ongoing concerns since the outcomes of large international prostate cancer screening trials were reported.

Genomic Evaluation of Multiparametric Magnetic Resonance Imaging-visible and -nonvisible Lesions in Clinically Localised Prostate Cancer.

The prostate cancer (PCa) diagnostic pathway is undergoing a radical change with the introduction of multiparametric magnetic resonance imaging (mpMRI), genomic testing, and different prostate biopsy techniques.

Abiraterone acetate plus prednisone in patients with newly diagnosed high-risk metastatic castration-sensitive prostate cancer (LATITUDE): final overall survival analysis of a randomised, double-blind, phase 3 trial.

In the interim analyses of the LATITUDE study, the addition of abiraterone acetate plus prednisone to androgen deprivation therapy (ADT) led to a significant improvement in overall survival and radiographic progression-free survival compared with placebos plus ADT in men with newly diagnosed high-risk metastatic castration-sensitive prostate cancer (mCSPC).

Microsatellite Instability in Prostate Cancer by PCR or Next-Generation Sequencing.

BACKGROUND: Microsatellite instability (MSI) is now being used as a sole biomarker to guide immunotherapy treatment for men with advanced prostate cancer. Yet current molecular diagnostic tests for MSI have not been evaluated for use in prostate cancer.

METHODS: We evaluated two next-generation sequencing (NGS) MSI-detection methods, MSIplus (18 markers) and MSI by Large Panel NGS (> 60 markers), and compared the performance of each NGS method to the most widely used 5-marker MSI-PCR detection system.  

Higher Serum Testosterone Levels Associated with Favorable Prognosis in Enzalutamide- and Abiraterone-Treated Castration-Resistant Prostate Cancer.

Testosterone plays a significant role in maintaining the tumor microenvironment. The role of the target serum testosterone (TST) level in enzalutamide- (Enza) and abiraterone (Abi)-treated castration-resistant prostate cancer (CRPC) patients was studied.

Safety of SBRT in post TURP prostate cancer patients: A propensity score matched pair analysis.

To determine the genitourinary (GU) toxicity outcomes in prostate cancer patients treated with stereotactic body radiotherapy (SBRT) who have undergone a prior transurethral resection of prostate (TURP) and compare it to a similar nonTURP cohort.

Apalutamide: Emerging Therapy for Non-Metastatic Castration-Resistant Prostate Cancer.

Prostate cancer is the second deadliest cancer in the US and the fourth most common cancer among Saudi males. Patients usually present with non-metastatic disease and treated with localized therapy.

Partial versus complete prostatectomy specimen sampling: prospective non-inferiority study for pT3a tumours and surgical margin involvement.

The importance of additional information gained by complete versus partial sampling or prostatectomy specimens is uncertain. There is sparse data on the value of complete versus partial sampling and numbers of inclusions in studies are small and retrospective.

Triple treatment of high-risk prostate cancer. A matched cohort study with up to 19 years follow-up comparing survival outcomes after triple treatment and treatment with hormones and radiotherapy.

To evaluate the efficacy of a triple treatment strategy, including surgery, on high risk prostate cancer comparing long-term survival outcome with a cohort receiving standard radiotherapy with endocrine therapy.

Assessing the Role and Optimal Duration of Hormonal Treatment in Association with Salvage Radiation Therapy After Radical Prostatectomy - Beyond the Abstract

The addition of concomitant hormonal therapy (HT) to postoperative radiation therapy (RT) in patients affected by biochemical relapse (BCR) is still an open question and remains controversial. Evidence from randomized clinical trials (RCTs) suggests that the combination of HT with postoperative RT improves oncologic outcomes. However, use of androgen deprivation therapy (ADT) is associated with several side effects (cardiovascular morbidity, metabolic effects, non-metastatic bone fractures, sexual dysfunction, hot flushes, fatigue, and neurologic side effects) leading to a decreased quality of life. Therefore, the potential benefit of ADT should be weighed against the associated harms. Moreover, HT duration may have a differential effect according to the clinical and pathologic characteristics of patients.

Germline Testing for Men With Prostate Cancer: Navigating an Expanding New World of Genetic Evaluation for Precision Therapy and Precision Management

Germline genetic testing is revolutionizing prostate cancer (PCA) care, with studies revealing inherited mutations (pathogenic variants) in a spectrum of cancer risk genes.1-5 Analyses from clinical cohorts of men with PCA have reported germline mutation rates of 15% to 17% regardless of stage,1,4,5 with rates of DNA repair mutations reported to be approximately 12% in men with metastatic PCA.2 Mutations in multiple genes including BRCA1, BRCA2, HOXB13, ATM, DNA mismatch repair genes, NBN, and CHEK2 confer variable estimates of risk for PCA predisposition, aggressive disease, and lifetime risk.1-5 The highest level of PCA risk has been reported for mutations in BRCA2, and HOXB13, with BRCA2 mutations associated with poor outcomes.1 Genetic testing for men with PCA is being driven increasingly by precision therapy and precision management considerations affecting oncology and urology.

The Impact of 68Ga-PSMA PET/CT and PET/MRI on the Management of Prostate Cancer.

Prostate-specific-membrane-antigen (PSMA) is a transmembrane protein with significantly increased expression in the cells and metastases of prostate carcinoma (PCa). PSMA-expression correlates with higher serum levels of prostate-specific-antigen (PSA) and a higher Gleason Score (GS).

The Tumor Immune Contexture of Prostate Cancer.

One in seven men in North America is expected to be diagnosed with prostate cancer (PCa) during their lifetime (1, 2). While a wide range of treatment options including surgery, radiation, androgen deprivation and chemotherapy have been in practice for the last few decades, there are limited treatment options for metastatic and treatment resistant disease.

How Accurately Can Prostate Gland Imaging Measure the Prostate Gland Volume? Results of a Systematic Review.

The measurement of the volume of the prostate gland can have an influence on many clinical decisions. Various imaging methods have been used to measure it. Our aim was to conduct the first systematic review of their accuracy.

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