Prostate Cancer

More than half of men receiving high-dose-rate brachytherapy for localized prostate cancer report some side effects that in some cases persist for up to 16 years

The first large clinical trial to prospectively evaluate intermittent chemotherapy for androgen-independent prostate cancer showed that a minority of patients can be given chemotherapy "holidays" of clinically meaningful duration.

PSA levels between 4 and 10 ng/mL have a significant positive predictive value (PPV) for finding prostate cancer in men undergoing extended biopsies, according to results of a study

Black men are more likely than white men to have a prostate cancer recurrence after radical prostatectomy, Hadley M. Wood, MD, reported at the 2006 Prostate Cancer Symposium (abstract 138).

In some men with clinically localized prostate cancer, prostatectomy is associated with a survival advantage, according to results of two long-term studies presented at the 2006 Annual Meeting of the American Urological Association.

In patients with T1c prostate cancer undergoing radical prostatectomy, a PSA level of 2.6 to 4.0 ng/mL may be associated with more favorable pathology than a score of 4.1 to 6.0 ng/mL

In this review, we describe how clinical investigators addressed some of the challenges in prostate cancer chemotherapy trials 20 years ago, and we indicate what has evolved in the field since that time. We consider the impact that prostate-specific antigen measurement had in this setting, evolving clinical paradigms, multidisciplinary programs, and the current armamentarium of cancer treatment, including targeted molecular therapy, for patients with hormone-refractory disease.

In this review, we describe how clinical investigators addressed some of the challenges in prostate cancer chemotherapy trials 20 years ago, and we indicate what has evolved in the field since that time. We consider the impact that prostate-specific antigen measurement had in this setting, evolving clinical paradigms, multidisciplinary programs, and the current armamentarium of cancer treatment, including targeted molecular therapy, for patients with hormone-refractory disease.

In this review, we describe how clinical investigators addressed some of the challenges in prostate cancer chemotherapy trials 20 years ago, and we indicate what has evolved in the field since that time. We consider the impact that prostate-specific antigen measurement had in this setting, evolving clinical paradigms, multidisciplinary programs, and the current armamentarium of cancer treatment, including targeted molecular therapy, for patients with hormone-refractory disease.

After 31 years as a freelance writer, Myron Brenton was finally able to quit—"liberation day," he calls it—and devote more time to photography. A diagnosis of prostate cancer did not stop Mr. Brenton from traveling the world (and photographing the world) with his wife Irene. It was another disease, Alzheimer's, which struck his wife, that kept the Brentons at home in Manhattan and led Mr. Brenton to focus his art on photography he could do in his apartment

The FDA has granted Cell Genesys' GVAX immunotherapy fast track designation for prostate cancer. Two independent phase II trials in patients with hormone-refractory metastatic prostate cancer showed that median survival with GVAX compared favorably with that of patients treated with standard docetaxel (Taxotere)/prednisone in previous studies, the company said. Two phase III trials of GVAX have been initiated, VITAL-1 and VITAL-2. Each will enroll approximately 600 patients.

Novel prognostic biomarkers for prostate cancer are moving toward the clinic and may eventually join Gleason score and other predictors of relapse to help with treatment decisions, according to data on two candidate markers presented at the 97th Annual Meeting of the American Association for Cancer Research.

A combination of radiation and suicide-gene therapy is eliminating the spread of prostate cancer; and providing a long-term vaccine against the disease, according to a study presented at the American Society of Clinical Oncology's annual prostate cancer meeting in San Francisco recently.

Cytogen Corporation recently announced the presentation of clinical data demonstrating that a high level of prostate-specific membrane antigen (PSMA) in prostate tissue is a strong predictor of prostate cancer recurrence. The data were presented at the 101st American Urological Association (AUA) Annual Meeting held May 20-25 in Atlanta.

The results of three studies presented at the 2006 Prostate Cancer Symposium suggest that "watchful waiting," monitoring men who have prostate cancer instead of actively treating the disease, may not be the best option for some men with low-risk disease, including older men.

During the past 18 months, researchers have developed substantial evidence supporting the notion that stem cells play a critical role in the development of at least some cancers, their progression, and the prognosis of patients, including breast, brain, lung, and prostate cancer, multiple myeloma, and melanoma.

Cytogen Corporation has submitted an Investigational New Drug (IND) application to the FDA for CYT-500 for the treatment of hormone-refractory prostate cancer.

The 5-year incidence of biochemical recurrence (BCR) of prostate cancer decreases with increased experience of the surgeon performing the prostatectomy, Fernando Bianco, MD, reported at the 2006 Prostate Cancer Symposium (abstract 272).

High-dose external beam radiation therapy (EBRT) and brachytherapy are equally effective in treating localized prostate cancer, according to a study presented at the 2006 Prostate Cancer Symposium (abstract 38). "Our findings show that either therapy is an excellent choice for treating early-stage prostate cancer," said John J. Coen, MD, assistant professor of radiation oncology at Harvard Medical School.

Three studies presented at the 2006 Prostate Cancer Symposium and discussed at a press briefing highlight the usefulness, as well as the limitations, of PSA velocity (PSAV) in detecting prostate cancer.

Permanent prostate brachytherapy with or without supplemental therapies is a highly effective treatment for clinically localized prostate cancer, with biochemical outcomes and morbidity profiles comparing favorably with competing local modalities. However, the absence of prospective randomized brachytherapy trials evaluating the role of supplemental external-beam radiation therapy (XRT) has precluded the development of evidence-based treatment algorithms for the appropriate inclusion of such treatment. Some groups advocate supplemental XRT for all patients, but the usefulness of this technology remains largely unproven and has been questioned by recent reports of favorable biochemical outcomes following brachytherapy used alone in patients at higher risk. Given that brachytherapy can be used at high intraprostatic doses and can obtain generous periprostatic treatment margins, the use of supplemental XRT may be relegated to patients with a high risk of seminal vesicle and/or pelvic lymph node involvement. Although morbidity following brachytherapy has been acceptable, supplemental XRT has shown an adverse impact on long-term quality of life. The completion of ongoing prospective randomized trials will help define the role of XRT as a supplement to permanent prostate brachytherapy.

Permanent prostate brachytherapy with or without supplemental therapies is a highly effective treatment for clinically localized prostate cancer, with biochemical outcomes and morbidity profiles comparing favorably with competing local modalities. However, the absence of prospective randomized brachytherapy trials evaluating the role of supplemental external-beam radiation therapy (XRT) has precluded the development of evidence-based treatment algorithms for the appropriate inclusion of such treatment. Some groups advocate supplemental XRT for all patients, but the usefulness of this technology remains largely unproven and has been questioned by recent reports of favorable biochemical outcomes following brachytherapy used alone in patients at higher risk. Given that brachytherapy can be used at high intraprostatic doses and can obtain generous periprostatic treatment margins, the use of supplemental XRT may be relegated to patients with a high risk of seminal vesicle and/or pelvic lymph node involvement. Although morbidity following brachytherapy has been acceptable, supplemental XRT has shown an adverse impact on long-term quality of life. The completion of ongoing prospective randomized trials will help define the role of XRT as a supplement to permanent prostate brachytherapy.

Permanent prostate brachytherapy with or without supplemental therapies is a highly effective treatment for clinically localized prostate cancer, with biochemical outcomes and morbidity profiles comparing favorably with competing local modalities. However, the absence of prospective randomized brachytherapy trials evaluating the role of supplemental external-beam radiation therapy (XRT) has precluded the development of evidence-based treatment algorithms for the appropriate inclusion of such treatment. Some groups advocate supplemental XRT for all patients, but the usefulness of this technology remains largely unproven and has been questioned by recent reports of favorable biochemical outcomes following brachytherapy used alone in patients at higher risk. Given that brachytherapy can be used at high intraprostatic doses and can obtain generous periprostatic treatment margins, the use of supplemental XRT may be relegated to patients with a high risk of seminal vesicle and/or pelvic lymph node involvement. Although morbidity following brachytherapy has been acceptable, supplemental XRT has shown an adverse impact on long-term quality of life. The completion of ongoing prospective randomized trials will help define the role of XRT as a supplement to permanent prostate brachytherapy.

A previously unknown virus, a xenotropic murine-like retrovirus or XMRV, has been shown to be 30 times more common in men with prostate cancer who are homozygous for a defect in the HPC1 gene than in men without the mutation

The National Cancer Institute (NCI) has begun the largest, most comprehensive effort to identify genetic risk factors for two major cancers, a 3-year initiative aimed at deciphering which genetic alterations put people at increased risk of developing breast and prostate cancer.