Radiation Plus ADT Boosts Survival in Metastatic Prostate Ca (CME/CE)

Excerpt:

“A large contemporary analysis of men with metastatic prostate cancer has found that adding radiotherapy to androgen deprivation therapy resulted in substantially better survival than androgen deprivation alone.

“With a median follow-up of 5.1 years, giving prostate radiotherapy plus androgen deprivation was associated on univariate analysis with a longer median overall survival of 53 versus 29 months, for a hazard ratio of 0.562 (95% CI 0.498-0.635, P0.001). The effect held in multivariate, propensity score, and landmark analyses — with the last yielding improved overall survival estimates at 3, 5, and 8 years, reported Chad. G. Rusthoven, MD, of University of Colorado School of Medicine, Denver, and colleagues in the Journal of Clinical Oncology.

“The estimates were 62% versus 43% for 3 years, 49% versus 25% for 5 years, and 33% versus 13% for 8 years (HR 0.562, 95% CI 0.498-0.635, P0.001).”

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Shorter Radiation Course Recommended for Early-Stage Breast Cancer Patients

Excerpt:

“Early-stage breast cancer patients receiving a shorter course of whole breast radiation with higher radiation doses per fraction reported equivalent cosmetic, functional and pain outcomes over time as those receiving a longer, lower-dose per fraction course of treatment, according to researchers from The University of Texas MD Anderson Cancer Center.

“Their study, published in Cancer, found patient-reported functional status and breast pain improved significantly following both radiation schedules, and there were no significant differences in physician-reported cosmetic evaluations. With a more convenient treatment schedule and equivalent outcomes, the authors suggest the shorter course as the preferred option for patients.”

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Second-Generation AR-Targeting Agent Explored in High-Risk Prostate Cancer

Excerpt:

“Researchers are hoping the results of a late-stage efficacy and safety study of apalutamide (ARN-509) in patients with high-risk, localized, or locally advanced prostate cancer who are receiving primary radiation therapy will demonstrate an improvement in metastasis-free survival, according to global principal investigator, Howard M. Sandler, MD.

“ ‘The patient population that we’re studying are men who are at risk of dying of prostate cancer,’ Sandler, chair of the Department of Radiation Oncology at Cedars-Sinai Medical Center in Los Angeles, told OncologyLive. ‘If we can provide better upfront disease control, we’re hoping to reduce the number of men who enter into the castrate-resistant prostate cancer stage.’ “

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Total Body Irradiation Did Not Improve Response of Adoptive Cell Transfer

Excerpt:

“Adding total body irradiation to preparative lymphodepletion chemotherapy prior to the adoptive cell transfer of tumor-infiltrating lymphocytes (TILs) had no effect on tumor regression in patients with metastatic melanoma, according to the results of a study published in the Journal of Clinical Oncology.

“However, adoptive cell transfer of TILs did mediate the objective complete response of 24% of patients.

“ ‘The nonmyeloablative chemotherapy regimen thus seemed to provide sufficient lymphodepletion for successful adoptive transfer without the need to add total body irradiation,’ wrote researchers led by Stephanie L. Goff, MD, of the National Cancer Institute.”

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French Trial Shows Benefit of Adding Short-Term Hormone Therapy to Salvage Radiotherapy for Rising PSA After Prostatectomy

Excerpt:

“In the phase III GETUG-AFU 16 trial reported in The Lancet Oncology, Carrie et al found that adding short-term androgen suppression therapy to salvage radiotherapy was associated with improved biochemical or clinical progression-free survival among patients with prostate cancer who exhibited rising prostate-specific antigen (PSA) levels after radical prostatectomy.

“In the open-label trial, 743 patients from 43 sites were randomized between October 2006 and March 2010 to receive radiotherapy alone (n = 374) or with goserelin (Zoladex; n = 369). Patients had received no previous androgen-deprivation therapy or pelvic radiotherapy and had a rising PSA level of 0.2 to < 2.0 μg/L after having a level < 0.1 μg/L for at least 6 months after surgery with no evidence of clinical disease.

“Treatment consisted of three-dimensional (3D) conformal radiotherapy or intensity-modulated radiotherapy at 66 Gy in 33 fractions 5 days per week for 7 weeks or radiotherapy plus 10.8 mg of goserelin by subcutaneous injection on the first day of radiotherapy and 3 months later. The primary endpoint was progression-free survival in the intention-to-treat population.”

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Combining Radiation With Immunotherapy Showing Promise Against Melanoma

Excerpt:

“Combining radiation treatments with a new generation of immunotherapies is showing promise as a one-two-punch against melanoma, Loyola Medicine researchers report in the Journal of Radiation Oncology.

“Radiation kills cancer cells by damaging their DNA. Immunotherapies work by harnessing a patient’s immune system to attack and kill cancer cells. When combined, the two therapies appear to have synergistic effects, according to the article by James S. Welsh, MD and colleagues.

“Dr. Welsh is a professor in the department of radiation oncology of Loyola University Chicago Stritch School of Medicine.”

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Radiotherapy Halves Deaths From Prostate Cancer 15 Years After Diagnosis

Excerpt:

“A longitudinal Nordic study, comparing the results of hormone (antiandrogen) therapy with or without the addition of local radiotherapy, shows that a combination of treatments halves the risk of death from prostate cancer 15 years after diagnosis. This according to a follow-up study recently published in the journal European Urology.

” ‘Before the turn of the century, it was tradition to castrate men with high-risk or aggressive local  with no signs of spreading, as the disease at that point was thought to be incurable,’ says Anders Widmark, senior physician and professor at Umeå University, who led the study.”

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Delays in Radiation Therapy Increase Chance of Breast Tumor Development in Women Treated for Ductal Carcinoma in Situ

Excerpt:

“Women who underwent treatment for ductal carcinoma in situ (DCIS), a noninvasive breast abnormality, were at higher risk of developing malignant breast tumors if they did not receive timely radiation therapy as part of their treatment, according to a study presented here at the AACR Annual Meeting 2016, April 16-20.

“DCIS is the most common premalignant breast lesion, with over 60,000 women diagnosed each year. Not all DCIS will develop into invasive cancer, but because it is difficult to predict which cases will become cancerous, most women diagnosed with DCIS undergo treatment for it.

“ ‘According to the National Comprehensive Cancer Network guidelines, primary treatment options for DCIS include breast-conserving surgery plus radiation, total mastectomy, and breast-conserving surgery alone,’ said the study’s lead author, Ying Liu, MD, PhD, instructor of surgery at Washington University School of Medicine and a research member at Siteman Cancer Center in St. Louis, Missouri. ‘This study shows that it is important for women to understand the benefits of timely receipt of radiation therapy after breast-conserving surgery.’ ”

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Research Shows 98 Percent Cure Rate for Prostate Cancer Using SBRT

Excerpt:

“A five-year study shows that Stereotactic Body Radiation Therapy (SBRT) to treat prostate cancer offers a higher cure rate than more traditional approaches, according to researchers at UT Southwestern Medical Center Harold C. Simmons Comprehensive Cancer Center.

“The study – the first trial to publish five-year results from SBRT  for prostate cancer – found a 98.6 percent cure rate with SBRT, a noninvasive form of radiation treatment that involves high-dose radiation beams entering the body through various angles and intersecting at the desired target. It is a state-of-the-art technology that allows for a concentrated dose to reach the tumor while limiting the radiation dose to surrounding healthy tissue.”

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