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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Immunotherapy Could Stop Prostate Cancer Spreading, Trial Shows

Excerpt:

“Men with otherwise untreatable prostate cancer could halt its spread and survive longer by undergoing immunotherapy treatment, a trial has shown.

“More than a third of men with an advanced form of the cancer were still alive and one-in-10 had not had further growth after a year on the drug pembrolizumab, the study found.

“It is the first time immunotherapy has been shown to benefit some men with prostate cancer, the researchers said.”

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Abiraterone May Be More Effective in Black Men With Prostate Cancer

Excerpt:

“Black men with metastatic castration-resistant prostate cancer (CRPC) who received hormonal therapy with the adrenal inhibitor abiraterone had greater and longer-lasting responses compared with white men, according to the results of a late-breaking study (abstract LBA5009) presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting, held in Chicago June 1–5.

“The prospective study found that black men were more likely to have a decline in prostate-specific antigen (PSA) and had a longer median time to PSA worsening than white men. The findings were presented by Daniel George, MD, professor of medicine and surgery at Duke University.”

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No Survival Bump With More Frequent PSA Screens for Localized Prostate Cancer

Excerpt:

“Undergoing more frequent prostate-specific antigen (PSA) screening after radical prostatectomy or primary radiation for localized prostate cancer was not associated with improved overall survival (OS), regardless of disease risk, according to results of the AFT-30 study (abstract 6503) presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting, held June 1–5 in Chicago.

“‘Based on our study results, PSA testing every 3 to 6 months may represent overutilization of care,’ said Ronald Chen, MD, of the University of North Carolina at Chapel Hill. ‘This study provides empiric data to inform future guidelines and clinical practice.'”

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Six Tips to Spot Cancer ‘Fake News’

Excerpt:

Cancer is a popular topic for the media, as people care and worry about it in equal measure.

“News reports help people find out what researchers are working on, and how charitable donations are being spent. They also helps generate interest in the amazing science going on. But perhaps most of all, health stories and clinical trial results have a direct impact on people, raising interest in the latest discoveries further.

“And when it comes to , the emotion that’s tied to the subject means that scientific results must be discussed in a measured and accurate way. And most of the time that’s exactly what happens.”

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Apalutamide Reduces Risk of PSA Progression by 94% in Nonmetastatic CRPC

Excerpt:

“Apalutamide (Erleada) lowered the risk of PSA progression by 94% in patients with nonmetastatic castration-resistant prostate cancer (CRPC), according to a posthoc analysis from the phase III SPARTAN trial presented at the 2018 American Urological Association (AUA) Annual Meeting.

“The median time to PSA progression was not reached in the apalutamide arm compared with 3.71 months in the placebo group (HR, 0.064; 95% CI, 0.052-0.080; <.0001). A separate retrospective cohort study presented at AUA underscored the significance of these apalutamide data by confirming prior observations of the link between faster PSA doubling time (PSADT) and poorer metastasis-free survival (MFS) and overall survival (OS).”

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Study Finds More Than 40 Percent of Prostate Biopsies Could Be Avoided with New Blood Test

Excerpt:

A multi-center study that validates the clinical performance of IsoPSA—a new blood test that has proven to be more accurate in predicting overall risk of prostate cancer than standard prostate-specific antigen (PSA) – will be presented during a special press conference at the 13th Annual Meeting of the American Urological Association (AUA) on May 18 in San Francisco.

“Results showed that more than 40 percent of biopsies could have been avoided in both the preliminary study (45.1 percent) and validation study (47 percent), suggesting that use of IsoPSA may substantially reduce the need for , and may thus lower the likelihood of overdetection and overtreatment of nonlethal  cancer.”

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