Prostate Cancer

Prostate-Only Versus Whole-Pelvic Radiation Therapy in High-Risk and Very High-Risk Prostate Cancer (POP-RT): Outcomes From Phase III Randomized Controlled Trial.

We report the clinical outcomes of a randomized trial comparing prophylactic whole-pelvic nodal radiotherapy to prostate-only radiotherapy (PORT) in high-risk prostate cancer.

This phase III, single center, randomized controlled trial enrolled eligible patients undergoing radical radiotherapy for node-negative prostate adenocarcinoma, with estimated nodal risk ≥ 20%.

Probability of Prostate Cancer Diagnosis following Negative Systematic and Targeted MRI: Transrectal Ultrasound Fusion Biopsy: A Real-Life Observational Study.

The risk of occult prostate carcinoma (PCa) after negative multiparametric MRI (mpMRI)-transrectal fusion biopsy (F-Bx) is unknown. To determine the false-negative predictive value, we examined PCa detection after prior negative F-Bx.

Initial Management of Noncastrate Advanced, Recurrent, or Metastatic Prostate Cancer: ASCO Guideline Update.

Update all preceding ASCO guidelines on initial hormonal management of noncastrate advanced, recurrent, or metastatic prostate cancer.

The Expert Panel based recommendations on a systematic literature review.

Defining oligometastatic hormone sensitive prostate cancer and clinically significant outcomes: Implications on clinical trials?

With the current movement toward treating oligometastatic hormone sensitive prostate cancer (OMPC), we design a study with the objective of gathering opinions regarding what would be considered a clinically significant benefit from such treatments.

Genomic Testing in Patients with Metastatic Castration-resistant Prostate Cancer: A Pragmatic Guide for Clinicians.

Genomic testing is becoming increasingly important in patients with advanced prostate cancer (PC) and is being incorporated in clinical practice to guide treatment.

To review the current understanding of genomic alterations and the status of genomic testing in patients with metastatic castration-resistant PC (mCRPC), and the potential use of genomic tests in clinical practice.

Dosimetry of local failure with single dose 19Gy high-dose-rate brachytherapy for prostate cancer.

Long-term follow up of single dose high-dose rate brachytherapy (HDR BT) for localised prostate cancer has revealed higher than expected rates of biochemical and local failure. This study aimed (i) to investigate the pattern of relapse within the prostate with reference to the initial site of disease in those patients; and (ii) to examine if there were any relationships between the HDR BT dosimetric parameters to these areas of recurrence.

Overdiagnosis in urologic cancer : For World Journal of Urology Symposium on active surveillance in prostate and renal cancer.

Cancer, which historically was diagnosed at late and incurable stages, has expanded to a heterogeneous group of conditions that vary from clinically insignificant to rapidly aggressive and lethal. This evolution is due to the widespread use of screening tests for early detection of cancer, both directed (i.

Transperineal Prostate Biopsy Improves the Detection of Clinically Significant Prostate Cancer among Men on Active Surveillance.

Transperineal prostate biopsy offers improved sampling of the anterior prostate compared to the transrectal approach. The objective of this study was to determine if transperineal prostate biopsy is associated with an increased incidence of cancer upgrading among men on active surveillance for very low or low risk prostate cancer.

Salvage Surgery in Patients with Local Recurrence After Radical Prostatectomy - Beyond the Abstract

In prostate cancer (PCa), recurrences are frequently observed even after curatively intended primary treatment such as radical prostatectomy (RP). Since the introduction of prostate-specific membrane antigen (PSMA)-positron emission tomography (PET) imaging, these recurrences may be accurately delineated, even at very low prostate-specific antigen (PSA) levels.1 This non-invasive means to assess recurrences creates the opportunity to more accurately apply local salvage therapies. As a consequence, PSMA PET imaging is now recommended prior to treatment decisions in men with biochemical recurrence (BCR) if the results will influence subsequent treatment decisions.2

Clinical Utility of 4Kscore, ExosomeDx and Magnetic Resonance Imaging for the Early Detection of High-Grade Prostate Cancer - Beyond the Abstract

As treatment paradigms for prostate cancer have drastically changed over the past decade and most low-grade cancers are now safely monitored with active surveillance, the need for effective screening tools that adequately risk-stratify patients prior to considering prostate biopsy is more important than ever. Liquid biomarkers 4Kscore® and ExosomeDxTM were developed to identify patients at risk for high-grade prostate cancer (here defined as Gleason grade 2 or higher). Multiparametric magnetic resonance imaging (mpMRI) has also been proposed as an imaging-based screening tool prior to prostate biopsy, however, it is unclear when and how to combine mpMRI with liquid biomarkers.

Study Finds Shorter Radiation Regimen of Stereotactic Body Radiotherapy Safe, Effective for Men with Advanced Prostate Cancer

San Francisco, CA (UroToday.com) -- A study led by researchers at the UCLA Jonsson Comprehensive Cancer Center found shortening a traditional 45-day course of radiation to a five-day course delivered in larger doses is safe and as effective as conventional radiation for men with high-risk forms of prostate cancer.

Stereotactic Body Radiotherapy for High-Risk Localized CARcinoma of the Prostate (SHARP) Consortium: Analysis of 344 Prospectively Treated Patients

Purpose To explore the efficacy and toxicity of stereotactic body radiotherapy (SBRT) in high risk prostate cancer (HRPCa) in a consortium of seven institutional phase II trials and prospective registries.

Methods and materials Individual patient data were pooled for 344 patients with a minimum follow-up of 24 months. Biochemical recurrence-free survival (BCRFS) and distant metastasis-free survival (DMFS) were estimated using a Kaplan-Meier framework. Fine and Gray competing risk and Cox proportional hazards regression models were developed to assess the association between time to BCR and time to distant metastasis and pre-specified variables of interest. Logistic regression models were developed to evaluate associations between acute and late grade ≥2 genitourinary (GU) and gastrointestinal (GI) and the following a priori specified variables: age, dose per fraction, ADT use, and nodal radiotherapy.

Results Median follow-up was 49.5 months. Seventy-two percent of patients received ADT, with a median duration of 9 months, and 19% received elective nodal radiotherapy. Estimated four-year BCRFS and DMFS rates were 81.7% (95% CI, 77.2-86.5%) and 89.1% (95% CI, 85.3%-93.1%). The crude incidences of late grade ≥3 genitourinary and gastrointestinal toxicity were 2.3% and 0.9%.

Conclusions These data support a favorable toxicity and efficacy profile for SBRT for HRPCa. Further prospective studies are needed to evaluate the optimal dose and target volume in the context of SBRT for HRPCa.

Ritchell van Dams, MD, MHS, Naomi Y. Jiang, MD, Donald B. Fuller, MD, Andrew Loblaw, MD, Tommy Jiang, BA, Alan J. Katz, MD, Sean P. Collins, MD, Nima Aghdam, MD, Simeng Suy, PhD, Kevin L. Stephans, MD, Ye Yuan, MD, PhD, Nicholas G. Nickols, MD, PhD, Vedang Murthy, MD, Tejshri P. Telkhade, MD, Patrick A. Kupelian, MD, Michael L. Steinberg, MD, Tahmineh Romero, MS, Amar U. Kishan, MD Source: Ritchell van Dams, Naomi Y. Jiang, Donald B. Fuller, et al. "Stereotactic Body Radiotherapy for High-Risk Localized CARcinoma of the Prostate (SHARP) Consortium: Analysis of 344 Prospectively Treated Patients." International Journal of Radiation Oncology. 2020. https://doi.org/10.1016/j.ijrobp.2021.01.016.


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Study Finds Shorter Radiation Regimen of Stereotactic Body Radiotherapy Safe, Effective for Men with Advanced Prostate Cancer

Brachytherapy boost (BT-boost) or stereotactic body radiation therapy boost (SBRT-boost) for high-risk prostate cancer (HR-PCa).

Systematic review for the treatment of high-risk prostate cancer (HR-PCa, D'Amico classification risk system) with external body radiation therapy (EBRT)+brachytherapy-boost (BT-boost) or with EBRT+stereotactic body RT-boost (SBRT-boost).

Supported progressive resistance exercise training to counter the adverse side effects of robot-assisted radical prostatectomy: a randomised controlled trial.

To investigate the effects of a supported home-based progressive resistance exercise training (RET) programme on indices of cardiovascular health, muscular strength and health-related quality of life (HR-QoL) in prostate cancer (PCa) patients after treatment with robot-assisted radical prostatectomy (RARP).

Intra-fraction displacement of the prostate bed during post-prostatectomy radiotherapy.

To measure intra-fraction displacement (IFD) in post-prostatectomy patients treated with anisotropic margins and daily soft tissue matching.

Pre-treatment cone beam computed tomography (CBCT) scans were acquired daily and post-treatment CBCTs for the first week then weekly on 46 patients.

PSMA PET/CT vs. CT alone in newly diagnosed biochemical recurrence of prostate cancer after radical prostatectomy: Comparison of detection rates and therapeutic implications.

To compare prostate specific membrane antigen (PSMA) Positron Emission Tomography/Computed Tomography (PET/CT) and computed tomography (CT) alone for the detection of biochemical recurrence of prostate cancer (PCa) and effect on treatment.

Overall survival of black and white men with metastatic castration-resistant prostate cancer (mCRPC): a 20-year retrospective analysis in the largest healthcare trust in England

Background: Prostate cancer in black men is associated with poorer outcomes than their white counterparts. However, most studies reporting this disparity were conducted in localized prostate cancer and primarily in the United States.

Methods: Data regarding prostate cancer incidence and mortality for East London between 2008 and 2010 were obtained from the UK National Disease Registration Service. We further evaluated survival outcomes of 425 cases of mCRPC in St Bartholomew's Hospital, East London, between 1997 and 2016, and analyzed whether ethnicity impacted on responses to different treatment types.

Results: The incidence of prostate cancer in black men was higher than in white men in East London. Prostate cancer-specific mortality was proportional to incidence based on ethnic groups. In the detailed analysis of 425 patients, 103 patients (24%) were black (B), and the remainder white (W). Baseline characteristics were comparable in both groups, although black patients had a lower baseline hemoglobin (p < 0.001). Median overall survival for the total cohort was 25.5 months (B) vs 21.8 months (W) (hazard ratio (HR) = 0.81, p = 0.08). There was prolonged survival in the black population in those who only received hormone-based treatment throughout their treatment course; 39.7 months (B) vs 17.1 months (W) (HR = 0.54, p = 0.019).

Conclusion: Black men may do better than white men with mCRPC, in the context of equal access to healthcare. The study also suggests a greater margin of benefit of hormone-based therapy in the black subpopulation.

Kenrick Ng 1 2, Peter Wilson 1, Katherine Mutsvangwa 1, Luke Hounsome 3, Jonathan Shamash 4
  1. Department of Medical Oncology, Barts Health NHS Trust, London, UK.
  2. UCL Cancer Institute, University College London, London, UK.
  3. National Cancer Registration and Analysis Service, Public Health England, London, UK.
  4. Department of Medical Oncology, Barts Health NHS Trust, London, UK.
Source: Ng, K., Wilson, P., Mutsvangwa, K. et al. Overall survival of black and white men with metastatic castration-resistant prostate cancer (mCRPC): a 20-year retrospective analysis in the largest healthcare trust in England. Prostate Cancer Prostatic Dis (2021). https://doi.org/10.1038/s41391-020-00316-x

Identification of patients with metastatic castration-sensitive or metastatic castration-resistant prostate cancer using administrative health claims and laboratory data.

To develop algorithms to identify metastatic castration-sensitive prostate cancer (mCSPC) patients and castration-resistant prostate cancer (mCRPC) patients, using health claims data and laboratory test results.

Identifying prostate cancer in men with non-suspicious multi-parametric magnetic resonance imaging of the prostate.

To formulate clinical pathways for identifying clinically significant prostate cancer (csPC) and avoiding insignificant prostate cancer (isPC) in those without suspicious regions of interest on multi-parametric magnetic resonance imaging (mpMRI) of the prostate.

Identifying and Addressing Health Disparities among African American Men with Prostate Cancer: a Systematic Literature Review.

To answer the research question inquiring which determinants lead to health disparities among African American Men with Prostate Cancer and what factors influence clinical decision making by oncologists when delivering prostate cancer interventions in order to improve morbidity and mortality.