Top 6 Highlights From the 2015 ASCO GU Cancers Symposium
This slide show includes some of the top highlights from the 2015 ASCO Genitourinary Cancers Symposium, including a study that examined the risk of aggressive prostate cancer in testicular cancer survivors and more.
References:
1. Antonarakis ES, Lu C, Chen Y, et al. AR splice variant 7 (AR-V7) and response to taxanes in men with metastatic castration-resistant prostate cancer (mCRPC). Presented at the 2015 Genitourinary Cancers Symposium. Abstract 138.
2. Hall MD, Schultheiss TE, Farino G, Wong JYC. Increase in higher risk prostate cancer cases following new screening recommendation by the US Preventive Services Task Force (USPSTF). Presented at the 2015 Genitourinary Cancers Symposium. Abstract 143.
3. Musunuru HB, Klotz L, Vespirini D, et al. Cautionary tale of active surveillance in intermediate-risk patients: Overall and cause-specific survival in the Sunnybrook experience. Presented at the 2015 Genitourinary Cancers Symposium. Abstract 163.
4. Haas NB, Manola J, Uzzo RG, et al. Initial results from ASSURE (E2805): Adjuvant sorafenib or sunitinib for unfavorable renal carcinoma, an ECOG-ACRIN-led, NCTN phase III trial. Presented at the 2015 Genitourinary Cancers Symposium. Abstract 403.
5. Riggin AJ, Siddiqui MM. Development of intermediate and high-risk prostate cancer after testicular cancer. Presented at the 2015 Genitourinary Cancers Symposium. Abstract 177.
6. Michalski JM, Moughan J, Purdy J, et al. A randomized trial of 79.2Gy versus 70.2Gy radiation therapy (RT) for localized prostate cancer. Presented at the 2015 Genitourinary Cancers Symposium. Abstract 4.
Slide 1: Androgen Receptor V7 Status Is Not Associated With Resistance to Taxanes: In patients with metastatic castration-resistant prostate cancer (mCRPC), the presence of androgen receptor V7 (AR-V7) in circulating tumor cells did not significantly affect response to treatment with taxane therapy. In a previous study, men with mCRPC expressing AR-V7 had been shown to have primary resistance to two hormone therapies, enzalutamide and abiraterone acetate. The small study enrolled 37 patients with mCRPC, 17 of which expressed AR-V7, a truncated form of the androgen receptor. Data from the study showed that AR-V7 status did not seem to affect patients’ response to treatment with taxane therapy, with similar outcomes seen in AR-V7âpositive and AR-V7ânegative patients.[1] Image source: Emmanuel Antonarakis, MD, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, Maryland.
Slide 2: Higher-Risk Prostate Cancer on the Rise-Early Evidence: A retrospective analysis of 87,562 prostate cancer patients treated since 2005 indicated an increase in the number of higher-risk cases of prostate cancer diagnosed between 2011 and 2013. The proportion of men diagnosed with intermediate- or high-risk prostate cancer gradually decreased between 2005 and 2011 and then increased by 3% each year between 2011 and 2013. The data are preliminary, and there is no data on whether this potential uptick in higher-risk disease will translate into a higher rate of prostate cancer mortality. Intermediate- or high-risk disease was defined as a blood prostate-specific antigen (PSA) level greater than 10. Tumor grade and stage of disease were not taken into account.[2] Image source: Timothy E. Schultheiss, PhD, City of Hope, Duarte, California.
Slide 3: Active Surveillance May Result in Decreased Survival in Men With Intermediate-Risk Prostate Cancer: Compared with patients with low-risk prostate cancer, those with intermediate-risk disease had an almost fourfold higher chance of dying from their prostate cancer within 15 years if managed by active surveillance. The 10-year and 15-year overall survival (OS) rates were 68.4% and 50.3% for intermediate-risk patients. Low-risk patients had 10- and 15-year OS rates of 83.6% and 68.8%, respectively. The prospective study analyzed 945 patients-237 with intermediate-risk disease and 708 with low-risk disease. Intermediate risk was defined as a blood prostate-specific antigen (PSA) level greater than 10, a Gleason score of 7, or a clinical stage of T2b/2c.[3] Image source: D. Andrew Loblaw, MD, Sunnybrook Health Sciences Centre, Toronto, Canada.
Slide 4: Neither Sunitinib Nor Sorafenib Effective As Adjuvant Treatment for Advanced RCC: Neither sunitinib nor sorafenib reduced disease recurrence in patients with locally advanced renal cell carcinoma (RCC) when given to patients as adjuvant therapy, according to the results of the ASSURE (ECOG E2805) trial. A total of 1,943 patients were randomized to receive daily sunitinib, daily sorafenib, or placebo for 12 months. All patients were high risk for recurrence based on tumor size and grade, and lymph node status. Treatment with sunitinib or sorafenib resulted in an average disease recurrence time of 5.6 years compared with 5.7 years in the placebo arm. The 5-year overall survival rates were 76.9%, 80.7%, and 78.7% in the sunitinib, sorafenib, and placebo arms, respectively.[4]Image source: Naomi B. Haas, MD, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania.
Slide 5: Increased Risk of Aggressive Prostate Cancers in Testicular Cancer Survivors: Men with a history of testicular cancer had a nearly fivefold higher risk of later developing prostate cancer compared with men with no history of testicular cancer (P
Slide 6: Higher Radiotherapy Dose No Better Than Standard Dose for Localized Prostate Cancer: A higher radiation therapy dose of 79.2 Gy did not result in improved overall or disease-specific survival compared with the standard 70.2-Gy dose for treating men with intermediate-risk localized prostate cancer. The higher dose did, however, improve local control, distant metastasesâfree survival, and biochemical diseaseâfree survival, but at the expense of significantly greater grade 2 or higher gastrointestinal and genitourinary toxicities. The RTOG 0126 phase III trial randomized 1,532 men 1:1 to receive the different radiation doses. With a median of 7 years of follow-up, the 5- and 10-year overall survival rates were 88% and 67% with the 79.2-Gy dose, and 89% and 66% with the 70.2-Gy dose (P = .87).[6] Image source: Jeff M. Michalski, MD, Washington University School of Medicine in St. Louis, St. Louis, Missouri.