Prostate Cancer

The expanded FDA approval of abiraterone acetate (Zytiga) now includes its use prior to chemotherapy in men with metastatic castration-resistant prostate cancer.

Researchers have identified a targetable metabolic pathway important for the growth of prostate cancer. The research may also have identified a potentially useful biomarker that can measure the aggressiveness of primary prostate tumors.

Radiotherapy directly after a prostatectomy in prostate cancer patients has long-term benefits, says a 10-year study. The study shows that radiation can prevent biochemical progression, as measured by rising prostate-specific antigen (PSA) levels.

Two groups have each identified distinct gene signatures that may better predict the aggressiveness of prostate cancer at diagnosis.

Data presented from phase II trials at the ESMO 2012 Congress show that two new agents, ODM-201 and tasquinimod, are active in prostate cancer.

Using available data from published studies, researchers found that the advantage for men treated for early low-risk prostate cancer with radical prostatectomy have only a two or three month advantage compared to those who are actively monitored.

The FDA has approved the production and use of 11C choline, an agent used to detect recurrent prostate cancer during PET imaging.

A new study found that aspirin use was associated with a reduced risk of prostate cancer mortality in patients previously treated with prostatectomy or radiotherapy.

Intermittent androgen deprivation was shown to be as effective as continuous therapy in terms of overall survival for men with prostate cancer whose PSA levels were rising after initial or salvage radiotherapy.

The FDA approved enzalutamide, a once-daily oral therapy for men with metastatic castration-resistant prostate cancer that has either spread to other organs or recurred, despite prior surgical or medical treatment.

Results of the phase III AFFIRM trial shows that enzalutamide (MDV3100) significantly prolonged survival of men with metastatic castration-resistant prostate cancer after chemotherapy

We discuss the current controversies in prostate cancer-PSA screening and approaches to initial treatment for men diagnosed with the disease.

According to a study in the journal Cancer, without the use of PSA screening the number of men presenting with cases of metastatic prostate cancer would be three times greater than the actual number observed today.

The results of the 12-year PIVOT trial shows men with early-stage prostate cancer who had a radical prostatectomy did no better than those actively monitored without surgery.

How should oncologists advise patients about the best surgical approach to use to treat their prostate cancer? Quite simply, it is the surgeon, not the approach. The self-fulfilling prophecy about surgery is that the best surgeons tend to do the most surgeries, so an easy metric is volume.

In summary, both RALP and ORP are excellent operations in experienced hands. They are also technically difficult to perform consistently well, so in my view, surgeons should attempt to master the operation they perform rather than hastily switching to robotic surgery, unless they have an opportunity for significant mentorship and surgical volume.

We fervently hope that all surgeons will participate in a comparative outcomes project for the purpose of quality improvement. However, today we will settle for one, we hope, skilled surgeon, open or robotic.

Over the last decade, robotic-assisted laparoscopic prostatectomy (RALP) has rapidly gained in popularity, primarily for three reasons: the enthusiasm of surgeons keen to try something new, medical marketing, and patients’ desire to avoid side effects from surgery.

There is no question that the robot has leveled the playing field. It has allowed more surgeons to offer patients a minimally invasive approach. In terms of perioperative outcomes, there is clear evidence showing shorter hospital stays, less blood loss, lower complication rates, and shorter convalescence with robotic-assisted laparoscopic prostatectomy.

A new noninvasive blood test for prostate cancer detection won the approval of the FDA last month. The manufacturer believes the test will provide better detection and a decrease in costs.

This review by Aneja et al provides an excellent discussion of prostate external beam hypofractionated radiation therapy and its potential benefits and pitfalls.

In this issue of ONCOLOGY, Aneja and colleagues explore the beneficial aspects of the use of hypofractionated radiotherapy in the treatment of adenocarcinoma of the prostate.

Given that prostate cancer is the most common non-cutaneous cancer among men in the Western world, its treatment is of great medical and public significance.

Researchers reported results of an international phase III trial showing that intermittent hormonal therapy is less effective than continuous therapy in prostate cancer with minimal disease.

Results from a randomized phase II study show that 6 months of treatment with abiraterone (Zytiga), in addition to the hormone therapy leuprolide before prostatectomy, resulted in complete response and near-complete response in one-third of men with high-risk prostate cancer.