A Patient's Journey: Can High-Grade PIN Be 'Great News'?

Excerpt:

“This summer, I ended a 3-year vacation from prostate biopsies. I expected the best after years of good news.

“In early August, my urologist, Brian Helfand, MD, PhD, of NorthShore University HealthSystem, called me with what he called ‘great news.’

“I wasn’t so sure about that.

“The overall picture was this: Helfand said the pathologist found “no evidence of malignancy” in slide after slide — 13 all told.

“But one biopsy stood out. So the news wasn’t all great.”

Go to full article.

Do you have questions about this story? Let us know in a comment below. If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our Ask Cancer Commons service.


Immune Analysis of On-Treatment Longitudinal Biopsies Predicts Response to Melanoma Immunotherapy

Excerpt:

“Immune response measured in tumor biopsies during the course of early treatment predicts which melanoma patients will benefit from specific immune checkpoint blockade drugs, researchers at The University of Texas MD Anderson Cancer Center report in the journal Cancer Discovery.

“Analysis of biopsies before treatment did not indicate who would respond in this unique longitudinal study of 53 melanoma patients treated with two immune checkpoint inhibitors between October 2011 and March 2015.

” ‘Before treatment, analyzing samples with a 12-marker immune panel or a 795-gene expression panel, you can’t tell who will respond with any degree of certainty. On treatment, there were night-and-day differences between responders and non-responders,’ said study senior author Jennifer Wargo, M.D., associate professor of Genomic Medicine and Surgical Oncology.”

Go to full article.

Do you have questions about this story? Let us know in a comment below. If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our Ask Cancer Commons service.


Shoddy Biopsies Deny Cancer Patients a Shot at Personalized Treatment

“A huge federal trial of personalized cancer medicine has run into an unexpected roadblock: Many of the tumor samples aren’t robust enough to be put through genetic analysis.

“The samples, taken from patients with advanced cancer, were collected by doctors in hundreds of clinics nationwide. When researchers checked them, they found as many as 1 in 5 didn’t have enough malignant cells to analyze, in most cases because the biopsy had been poorly done.

“The glitch raises troubling questions about the new era of precision medicine.”


New Diagnostic Tools for Prostate Cancer

“Dan Woska was weighing his treatment options after he was found to have prostate cancer two years ago when a friend mentioned a new genomic test that could gauge how lethal his tumor was.

“The test, called Oncotype DX, which looks at the expression of 17 genes in a tumor, cost about $4,000 and was not covered by Mr. Woska’s insurance. But through a patient assistance program, the company that created it, Genomic Health, ran it for him free, using a tiny grain of tissue left over from his biopsy. The results indicated there was an 81 percent probability that Mr. Woska’s tumor would not spread beyond the prostate. On an aggressiveness scale of zero to 100, the tumor was an indolent 15.

“Thrilled and relieved, Mr. Woska decided to forgo radiation and surgery.”


MRI-Ultrasound Fusion Improves Prostate Biopsy Cancer Detection

“Magnetic resonance imaging-ultrasound fusion targeted prostate biopsy (MRF-TB) improves detection and risk stratification of high-grade disease and limits detection of clinically insignificant prostate cancer, according to a study published in the December issue of the The Journal of Urology.

“Neil Mendhiratta, from the New York University Langone Medical Center in New York City, and colleagues reported clinical outcomes for 452 consecutive men presenting for primary . Participants underwent prebiopsy multiparametric magnetic resonance imaging followed by MRF-TB and systematic biopsy.”


Case for Testing Cancer in Blood Builds, One Study at a Time

“Two new studies published on Wednesday of patients with breast and prostate cancers add to growing evidence that detecting bits of cancer DNA circulating in the blood can guide patient treatment.

“Enthusiasm is building for ‘liquid biopsies,’ which offer a non-invasive alternative to standard tissue biopsies and are expected to be a multibillion-dollar market.

“But a key question remains: Do they really work?

“The stakes are high. At least 38 companies are working on liquid biopsies for cancer, according to analysts at investment bank PiperJaffray, who think the U.S. market alone could eventually reach $29 billion a year.”


Urine Biomarkers May Reduce Repeat Biopsies for Prostate Cancer

“Incorporating scores from two urine-based biomarker assays may reduce the number of biopsies men with clinically localized prostate cancer need to undergo without greatly affecting 10-year survival rates, according to the results of a decision analysis.

“ ‘Results from recent studies have demonstrated the potential clinical utility of the urine-based PROGENSA prostate cancer antigen 3 (PCA3) assay (Gen-Probe, Inc.) to predict repeat biopsy outcomes in men with elevated serum PSA levels and previous negative biopsy findings,’ Brian T. Denton, PhD, associate professor of industrial and operations engineering at University of Michigan, and colleagues wrote. ‘A recent literature review reported current evidence suggesting that the PCA3 test is clinically useful for selecting which patients should undergo repeat biopsy. Several studies have determined that urine assessment of [T2:ERG] is also associated with biopsy outcome and may be better at discriminating between low-grade and high-grade cancers.‘ “

“Denton and colleagues performed a decision analysis using a decision tree to evaluate the clinical value of using PCA3 and T2:ERG scores to determine the need for repeat biopsy in men with clinically localized prostate cancer who had at least one prior negative biopsy. Researchers estimated the probability for cancer by using the Prostate Cancer Prevention Trial Risk Calculator.”


PET Imaging Detects Fast-Growing Prostate Cancer

“A molecular imaging biomarker is able to detect fast-growing primary prostate cancer and distinguish it from benign prostate lesions, addressing an unmet clinical need. The new research, published in the July 2015 issue of The Journal of Nuclear Medicine, is significant for patients with suspected prostate cancer that has not been confirmed by standard biopsy.

” ‘We were able to demonstrate in our research that PSMA PET imaging was more specific than MR imaging for detection of clinically significant high-grade prostate cancer lesions, and importantly was able to distinguish benign prostate lesions from primary prostate cancer, currently a difficult diagnostic imaging task,’ stated Steven P. Rowe, MD, PhD, resident at Johns Hopkins Medical Institutions in Baltimore, Md. ‘Additionally, this work demonstrated a direct correlation between PSMA PET radiotracer activity in prostate cancer and prostate adenocarcinoma aggressiveness (Gleason score).’ “


Active Surveillance May Be Safe After Prostate Tumor Upgrade

“Men with low-risk prostate cancer on active surveillance whose tumors are upgraded after a biopsy might not have to rush into surgery, according to new research.

“In these men, the risk for further upgrading, should they choose to remain on surveillance for a while, is relatively low.

“What this study says is that for those who are on the fence or want some additional time to think about it, it’s likely safe to wait for treatment, said Christopher J. Welty, MD, a urology fellow at the University of California, San Francisco.

” ‘You don’t have to jump onto treatment right away just because of an upgrade,’ he told Medscape Medical News.”