Deadly Subtype Makes Up 17% of Metastatic Prostate Cancers

Excerpt:

“Treatment-emergent small cell neuroendocrine prostate cancer, a particularly deadly subtype of the disease, occurs in nearly one-fifth of all cases of metastatic, castration-resistant prostate cancer, study data showed.

“Researchers suggested that the subtype should be treated with novel targeted therapies that are currently in the development or testing phase.”

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High Marks for HIFU in Early Prostate Cancer

Excerpt:

“Men with newly diagnosed, nonmetastatic prostate cancer had a 5-year failure-free survival (FFS) of 88% when treated with focal high-intensity focused ultrasound (HIFU) therapy, results of a multicenter European clinical experience showed.

“The 625-patient cohort had a 5-year overall survival of 99%, and none of the patients died of prostate cancer during a median follow-up of 56 months. In a subgroup of men who submitted questionnaires on patient-reported outcomes, 98% said they did not require absorbent pads for urinary incontinence.”

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FDA Approves Enzalutamide for Nonmetastatic CRPC

Excerpt:

“The FDA has approved enzalutamide (Xtandi) for the treatment of patients with nonmetastatic castration-resistant prostate cancer (CRPC), according to Pfizer and Astellas, the codevelopers of the antiandrogen agent.

“The approval is based on the phase III PROSPER trial, in which the combination of enzalutamide (Xtandi) and androgen deprivation therapy (ADT) reduced the risk of metastases or death by 71% compared with ADT alone for patients with nonmetastatic CRPC. In the double-blind study, the median metastasis-free survival (MFS) was 36.6 months with enzalutamide plus ADT versus 14.7 months with ADT alone (HR, 0.29; 95% CI, 0.24-0.35; P <.0001).”

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New Treatment Lowers Risk for Death from Aggressive Prostate Cancer by Over 70 Percent, Study Finds

Excerpt:

“Some of the 165,000 U.S. men who are estimated to receive a new diagnosis of prostate cancer this year will develop resistance to hormonal therapies for the disease, but a new study by a doctor now at Northwestern Memorial Hospital points to use of an existing drug to help treat them.

“This kind of aggressive cancer has challenged doctors, as effective treatment to improve outcomes for these men hadn’t existed previously. But a clinical trial led by Dr. Maha Hussain, now an oncologist at Northwestern Memorial, showed that taking a drug, enzalutamide, resulted in a 71 percent lower risk of cancer spread or death, compared to those taking a placebo during the three-year trial. The patients involved all had prostate cancer that hadn’t spread but that also had not responded to hormone treatment.”

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Early Treatment of Advanced Prostate Cancer with PSMA-Targeted Radioligand Therapy Prolongs Life

Excerpt:

“Research presented at the 2018 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) demonstrates for the first time the benefit of providing earlier lutetium-177 (177Lu) prostate-specific membrane antigen (PSMA) radioligand therapy to patients with metastatic prostate cancer. Until now, this therapy has only been used in patients with end-stage disease.”

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Lethal Prostate Cancer Treatment May Benefit from Combination Immunotherapy

Excerpt:

“Researchers at the Johns Hopkins Kimmel Cancer Center and the Bloomberg~Kimmel Institute for Cancer Immunotherapy (BKI) released a study investigating the use of combination checkpoint immunotherapy in the treatment of a lethal form of advanced prostate cancer. The study suggested a genetic subset of prostate cancer may benefit from this form of immunotherapy.

“The study targeted AR-V7+ prostate cancer with a combination of two checkpoint blockers, ipilimumab and nivolumab, in 15 patients with this aggressive variant, first discovered at Johns Hopkins in 2014.”

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Upfront MRI Could Rule Out Prostate Ca in Most, Reduce Biopsy Need

Excerpt:

“Upfront use of biparametric magnetic resonance imaging (bpMRI), a more rapid and lower-cost version of multiparametric MRI, rules out almost all significant disease in men with suspected prostate cancer and thus would spare many from invasive biopsy, a new study indicated.

“Among 1,020 men who underwent both bpMRI and standardized transrectal (TRUS) biopsy, low-suspicion bpMRI had a negative predictive value of 97% in ruling out significant prostate cancer (95% CI 95%-99%), reported Lars Boesen, MD, PhD, of Herlev Gentofte University Hospital in Denmark, and colleagues.”

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AZ, MSD’s Lynparza/Abiraterone Combo Hits Prostate Cancer Goals

Excerpt:

“AstraZeneca and MSD have presented data at ASCO showing improvement in radiologic progression-free survival (rPFS) in prostate cancer patients taking a combination of Lynparza and abiraterone.

“Study 08 – a randomised, double-blinded, multi-centre Phase II trial – compared Lynparza (olaparib) in combination with abiraterone to abiraterone alone in patients with previously-treated metastatic castration-resistant prostate cancer, (mCRPC), regardless of homologous recombination repair (HRR) mutation status.”

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AR-V7+ CTCs Predicted Worse PFS, OS in mCRPC

Excerpt:

“Detection of circulating tumor cells (CTCs) positive for the nuclear-specific AR-V7 protein was an independent predictor of shortened progression-free survival (PFS) and overall survival (OS) when treating metastatic castration-resistant prostate cancer (mCRPC) with abiraterone or enzalutamide, according to results of the PROPHECY study (abstract 5004). The findings were presented at the 2018 Annual Meeting of the American Society of Clinical Oncology (ASCO), held June 1–5 in Chicago.

“’Men with AR-V7–positive CTCs have a very low probability of benefit from abiraterone or enzalutamide, ranging from 0% to 11%,’ said Andrew J. Armstrong, MD, of Duke Cancer Institute. ‘However, a lack of AR-V7 detection does not guarantee response or benefit’ where these therapies are concerned, he added.”

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