Prostate Cancer

The promise of using reverse transcriptase–polymerase chain reaction (RT-PCR) technology for the detection of circulating prostate cancer cells in peripheral blood, although technically feasible at the molecular level, has proven clinically impractical for routine implementation in patient management. Reverse transcriptase–polymerase chain reaction has been successfully applied to detect and quantify (relatively speaking) genes that are differentially expressed in cells and tissues obtained from patients during various stages of malignant growth. In addition, the method has been applied to the detection of circulating cancer cells in peripheral blood using highly specific primer sets for specific molecular targets. These include epithelial cell cytokeratins for breast cancer, as well as enzymes, such as tyrosinase for melanoma and prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA) for prostate cancer, using either nonnested or nested methodologies.

The article by Drs. de la Taille, Olson, and Katz is an accurate and concise review of clinical studies for the detection of circulating prostate cancer cells using reverse transcriptase–polymerase chain reaction (RT-PCR) technology. These investigators from the Department of Urology at Columbia-Presbyterian Medical Center have as much experience as any group in the use of RT-PCR for this purpose. Initially very strong proponents of the efficacy of RT-PCR as a staging tool, they have become slightly more reserved in the current article. In this well-written review, the authors allude to a number of issues affecting RT-PCR results from prostate cancer patients that deserve further comment.

Dr. de la Taille and colleagues from Columbia University provide an overview of the concept of molecular staging” of prostate cancer using reverse transcriptase–polymerase chain reaction (RT-PCR). They do an admirable job of summarizing all of the currently available data on the results of this assay in the clinical staging of prostate cancer. As they note, only their group and one other have been able to demonstrate that a positive assay correlates with final pathologic stage. A limited number of other studies have suggested that the RT-PCR assay can predict prostate-specific antigen (PSA) recurrence.

The reverse transcriptase–polymerase chain reaction (RT-PCR) assay is an extremely sensitive technique for the detection of circulating cells expressing prostate-specific antigen (PSA) in prostate cancer patients. This

PHOENIX-A matched-pair analysis suggests that early postoperative adjuvant radiation therapy significantly re-duces the risk of biochemical failure in prostate cancer patients with capsular penetration after prostatectomy.

PHOENIX-A self-administered questionnaire that measures patients’ sexual problems after radiation therapy for prostate cancer has now been validated and could provide a means of standardizing reports of sexual dysfunction after prostate cancer treatment.

The National Cancer Institute (NCI) will sponsor phase III trials to test the efficacy of AE-941/Neovastat, an angiogenesis inhibitor developed by AEterna Laboratories Inc., a Canadian biotechnology corporation, in the treatment of cancer.

PHOENIX-Updated results from RTOG 86-10 show a continuing trend for improved overall survival among patients with locally advanced prostate cancer who received androgen ablation in addition to radiation therapy, compared with those receiving radiation therapy alone, Miljenko V. Pilepich, MD, reported at the annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

ATHENS-In patients with advanced or inoperable prostate cancer, intermittent androgen suppression shows promise as an equally effective, less toxic, and cheaper alternative to continuous hormone blockade, Dr. Sergio Bracarda, of Perugia University (Italy), said at the 23rd Congress of the European Society for Medical Oncology (ESMO).

Higher doses of radiation, delivered through three-dimensional (3D) conformal therapy, have produced far fewer side effects than expected, according to a national, multicenter clinical trial conducted by the Radiation Therapy Oncology Group

Determination of the percentage of free prostate specific antigen (PSA) via a simple blood test improves the diagnosis of prostate cancer and may limit the need for biopsies, according to two studies published in the September issue of Urology.

PHOENIX-For many men with early-stage prostate cancer, the choice between external beam radiotherapy and brachytherapy (seed implantation) can be made based solely on lifestyle issues and personal preference, according to results of a study reported at the 40th Annual Meeting of the American Society for Therapeutic Radiology and Oncology.

BETHESDA, Md--Citing "an unprecedented opportunity to make substantial strides in the treatment of prostate cancer," an outside panel has urged the National Cancer Institute to increase funding and broaden efforts to understand and defeat the second leading cause of cancer deaths among US men.

AMELIA ISLAND, Fla--Is brachy-therapy for prostate cancer a ‘gimmick’ or a new treatment technique with numerous advantages over either radical prostatectomy or external beam radiotherapy? Very definitely the latter, Jay Friedland, MD, of the H. Lee Moffitt Cancer Center, Tampa, said at the Southern Association for Oncology (SAO) 11th annual meeting.

In a study of the protein p27, researchers at Memorial Sloan-Kettering Cancer Center have confirmed the existence of at

BETHESDA, Md--The reports of the progress review groups on prostate and breast cancers present the National Cancer Institute (NCI) with both opportunities and challenges, director Richard D. Klausner, MD, told the National Cancer Advisory Board.

The optimal management of patients with lymph node-positive prostate cancer remains controversial. The role of pelvic irradiation in patients at high risk for nodal involvement continues to be debated. Studies of prostate

BETHESDA, Md--The Oncologic Drug Advisory Committee (ODAC) has voted not to recommend that the Food and Drug Administration approve Metaret (suramin hexasodium for injection, Parke-Davis) for the treatment of hormone-refractory prostate cancer.

The optimal management of patients with lymph node-positive prostate cancer remains controversial. The role of pelvic irradiation in patients at high risk for nodal involvement continues to be debated. Studies of prostate

Prostate cancer is the most common cancer in the United States, with an estimated 200,000 new cases diagnosed in 1998.[1] Compared with white men, African-American men have a 66% higher incidence of prostate cancer and mortality rates twice as high.[1]

The optimal management of patients with lymph node-positive prostate cancer remains controversial. The role of pelvic irradiation in patients at high risk for nodal involvement continues to be debated. Studies of prostate

STRATFORD, Connecticut--Several studies have shown the ability of the percent-free PSA blood test to help differentiate benign prostatic hyperplasia (BPH) from prostate cancer among men with elevated PSA levels and thus reduce the need for prostate biopsy. Now, two studies in the September issue of Urology have further defined the situations in which percent-free PSA may be used to improve the performance of total PSA level results.

PRINCETON, NJ--Cytogen Corporation is sponsoring a new website on prostate cancer that highlights its diagnostic imaging agent ProstaScint. The agent is used in newly diagnosed patients at high risk for metastases and in postprostatectomy patients with a high suspicion of recurrence or spread.

WILMINGTON, Delaware--Zeneca Pharmaceuticals has received FDA approval to market Zoladex (goserelin acetate implant) for use in combination with the antiandrogen flutamide (Eulexin) prior to and during radiation therapy for the management of early-stage prostate cancer (stages B2-C).

ANN ARBOR, Michigan--Prostate cancer patients are increasingly likely to ask their physicians about alternative (or complementary) therapies, and physicians need to know the evidence, or lack of evidence, supporting their use.