Chemotherapy May Not Be Necessary for Intermediate-Risk, Early-Stage Breast Cancer

Excerpt:

“Women with early-stage breast cancer and an intermediate risk recurrence score from a 21-gene expression assay may be able to avoid chemotherapy, according to a retrospective study published in Cancer.

” ‘Through years of research discoveries, it became clear that we were overtreating many women with breast cancer, especially those with early-stage breast cancer,’ Carlos H. Barcenas, MD, assistant professor of breast medical oncology at The University of Texas MD Anderson Cancer Center, said in a press release. ‘In addition to chemotherapy’s obvious side effects, there were also long-term complications for these women as survivors.’ ”

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No Benefit Observed From Combined Irradiation in Intermediate-Risk Prostate Cancer

Excerpt:

“The addition of external-beam radiotherapy (EBRT) to interstitial brachytherapy failed to reduce prostate cancer progression compared to brachytherapy alone in men with intermediate-risk disease, interim data from a randomized trial showed.

“The 5-year freedom from progression was 84.5% with combined-modality radiotherapy and 85.6% with prostate brachytherapy alone. The odds ratio (OR) for brachytherapy versus combined radiotherapy was 1.09 after a median follow-up of 7.7 years, a difference that did not achieve statistical significance for efficacy or meet the prespecified statistical value to stop the trial for futility.”

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Intermediate Risk Prostate Cancer May Be Well Controlled with Brachytherapy Alone

Excerpt:

“For men with intermediate risk prostate cancer, radiation treatment with brachytherapy alone can result in similar cancer control with fewer long-term side effects, when compared to more aggressive treatment that combines brachytherapy with external beam therapy (EBT), according to research presented today at the 58th Annual Meeting the American Society for Radiation Oncology (ASTRO).”

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SBRT Offers Prostate Cancer Patients High Cancer Control and Low Toxicity in Fewer Treatments

Excerpt:

“High dose stereotactic body radiotherapy (SBRT) for men newly-diagnosed with low- or intermediate-risk prostate cancer results in shorter treatment times, low severe toxicity and excellent cancer control rates, according to research presented today at the 58th Annual Meeting of the American Society for Radiation Oncology (ASTRO). The study is the first large, multi-institutional study of SBRT in prostate cancer with long-term follow-up.”

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'Very Big Deal': NCCN Okays Watching More Prostate Cancer

“In a groundbreaking recommendation, the National Comprehensive Cancer Network (NCCN) has broadened the scope of prostate cancers that qualify for active surveillance in the United States to include men with ‘favorable’ intermediate-risk disease.

” ‘I think this is a very big deal,’ said James Mohler, MD, a urologist from Roswell Park Cancer Institute in Buffalo, New York, who is chair of the NCCN prostate cancer guideline panel.

“The recommendations of the NCCN are often followed by clinicians, insurers, and institutions, and the NCCN is the first major organization in the United States to make this recommendation.”


Increased Risk of Aggressive Prostate Cancer in Testicular Cancer Survivors

“Men with a history of testicular cancer had a nearly fivefold higher risk for later  developing prostate cancer than did men without a history of testicular cancer, including an increased risk for developing intermediate- and high-risk disease, according to the results of a case control study.

“ ‘Based on these findings, men with a history of testicular cancer should consider a discussion regarding the risks and benefits of prostate cancer screening with their physicians,’ said Mohummad Minhaj Siddiqui, MD, an assistant professor of surgery at the University of Maryland School of Medicine and director of urologic robotic surgery at the University of Maryland Marlene and Stewart Greenebaum Cancer Center.

“Siddiqui presented the results of the study (Abstract 177) at a press conference held in advance of the 2015 ASCO Genitourinary Cancers Symposium.

“Previous research has demonstrated that there is an increased rate of prostate cancer in men with a history of testicular cancer. Siddiqui and colleagues sought to determine if men with a history of testicular cancer also had an increased risk for intermediate- to high-risk prostate cancers.”


Study Provides Evidence for New Approaches to Prostate Cancer

“Monitoring prostate cancer (PC) by active surveillance (AS), with the expectation to initiate treatment if the cancer progresses, is a preferred initial option for men with low-risk PC and a life expectancy of at least 10 years. According to the results of a new study conducted at Brigham and Women’s Hospital (BWH), there is evidence to also support AS as an initial approach for men with favorable intermediate-risk of PC (men with no evidence of the cancer spreading beyond the prostate, a Gleason score of 3+4 or less and PSA, prostate-specific antigen, under 20). These findings are published online by JAMA Oncology.

” ‘We found that men with favorable intermediate-risk prostate cancer did not have significantly increased risks of death compared to men with low-risk prostate cancer,’ said Ann Caroline Raldow, MD, first author of the study and resident physician at BWH and the Harvard Radiation Oncology Program. ‘The clinical significance of our findings is that men with favorable intermediate-risk prostate cancer may also be able to avoid, or at least defer the side effects of, prostate cancer treatment, and enter an active surveillance program as an initial approach.’ “