“A novel risk stratification tool that combines pathologic tumor characteristics with data from the Decipher genomic classifier may help predict 5- and 10-year metastasis-free survival in patients with aggressive prostate cancer after radical prostatectomy with an accuracy of 85%, researchers reported.
“It can also be used to identify patients with prostate cancer who could benefit from postoperative adjuvant radiotherapy (aRT), thereby reducing risk of overtreatment, adverse effects, and clinical recurrence (CR), Firas Abdollah, MD, of Vattikuti Urology Institute at the Henry Ford Health System in Detroit, and colleagues reported online in the Journal of Clinical Oncology.”
“In the phase III CA184-095trial reported in the Journal of Clinical Oncology, Tomasz M. Beer, MD, FACP, of the Knight Cancer Institute, Oregon Health and Science University, and colleagues found that ipilimumab (Yervoy) did not increase overall survival vs placebo in men with asymptomatic or minimally symptomatic chemotherapy-naive metastatic castration-resistant prostate cancer without visceral metastases. Ipilimumab was associated with prolonged progression-free survival and a higher prostate-specific antigen (PSA) response rate.”
“The recent report of results of RTOG 9601 by Shipley et al in The New England Journal of Medicine—reviewed in this issue of The ASCO Post—strongly supports the variably used practice of adding ‘androgen blockade’ to salvage radiation therapy in men with a rising prostate-specific antigen (PSA) after radical prostatectomy. The findings show a clear reduction in prostate cancer–specific and overall mortality with the addition of 2 years of bicalutamide to salvage radiation therapy. Another likely (although not demonstrated) benefit is the reduction in the need to treat patients with subsequent life-long continuous or intermittent androgen blockade at the expense of treating all men with 2 years of bicalutamide.”
“Researchers presenting a preclinical study at the 2017 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) demonstrated the efficacy and optimal dose for targeted photodynamic therapy (tPDT) to treat prostate cancer before and during surgery. Prostate-specific membrane antigen (PSMA) was targeted with an anti-PSMA antibody radiolabeled with the tracer indium-111 (111In) and coupled with specialized photosensitizers that cause cell destruction upon exposure to near-infrared (NIR). The combined formula is 111In-DTPA-D2B-IRDye700DX.
” ‘Coupling the photosensitizer to an imaging agent that targets PSMA on the tumor surface makes it possible to selectively and effectively destroy prostate tumor remnants and micrometastases while surrounding healthy tissues remain unaffected,’ said Susanne Lütje, MD, PhD, lead author of the study from the Department of Radiology and Nuclear Medicine at Radboud University Medical Center in Nijmegen, the Netherlands, and the Clinic for Nuclear Medicine at University Hospital Essen, Germany.”
“Combined therapy with abiraterone acetate/prednisone plus androgen deprivation therapy (ADT) significantly improved overall survival and radiographic progression-free survival (PFS) among men with metastatic hormone-naive prostate cancer compared with ADT and placebo alone, according to the results of the phase III LATITUDE trial (abstract LBA3) presented at the 2017 ASCO Annual Meeting.
” ‘In my opinion, these findings support the fact that adding abiraterone and prednisone to castration should now be considered the new standard of care for men with newly diagnosed metastatic prostate cancer,’ said researcher Karim Fizazi, MD, PhD, head of the department of cancer medicine at Gustave Roussy, University Paris-Sud, Villejuif, France.”
“The researchers are using the small molecule Lutetium 177Lu-PSMA-617 to target prostate-specific membrane antigen (PSMA), a protein that is abundantly expressed in 85-90 percent of metastasized prostate cancers. The small molecule binds to PSMA and delivers precise radiation therapy intended to shrink the cancer — even in cases in which cells have yet to form a visible tumor on a bone or CT scan.”
“Testing for combined urinary PCA3 and TMPRSS2:ERG (T2:ERG) RNA can improve detection of prostate cancer, according to a study published online May 18 in JAMA Oncology.
“Martin G. Sanda, M.D., from the Emory University School of Medicine in Atlanta, and colleagues conducted a multicenter diagnostic evaluation and validation in academic and community-based ambulatory urology clinics. A sample of men presenting for first-time prostate biopsy without preexisting prostate cancer were enrolled: 516 in the developmental cohort and 561 in the validation cohort. Urinary PCA3 and T2:ERG RNA were measured before prostate biopsy.”
“A team of researchers from Cleveland Clinic, Louis Stokes Cleveland VA Medical Center, Kaiser Permanente Northwest, and other clinical sites have demonstrated that a new blood test known as IsoPSA detects prostate cancer more precisely than current tests in two crucial measures — distinguishing cancer from benign conditions, and identifying patients with high-risk disease.
“By identifying molecular changes in the prostate specific antigen (PSA) protein, the findings, published online last month by European Urology, suggest that once validated, use of IsoPSA may substantially reduce the need for biopsy, and may thus lower the likelihood of overdetection and overtreatment of nonlethal prostate cancer.”
“Two new studies presented at the Annual Scientific Meeting of the American Urological Association (AUA) offer an improved understanding of some genetic underpinnings of prostate cancer. In one, researchers found that BRCA mutations may raise the risk of the malignancy substantially, while another found a high rate of mutations among other DNA repair genes as well.
” ‘These studies reveal new insights into the role genetic mutations play in the development of prostate cancer, particularly metastatic disease,’ said Scott Eggener, MD, of the University of Chicago Medicine, who moderated the session with these studies, in a press release.”