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Biochemical relapse of prostate cancer

Romuald Zdrojowy, Janusz Dembowski, Bartosz Małkiewicz, Krzysztof Tupikowski, Wojciech Krajewski
INTRODUCTION: Prostate cancer is the most frequent cancer among males in Europe and a leading cause of cancer deaths, with similar proportion in other developed countries. For more than twenty years, external-beam radiation therapy, alongside with radical prostatectomy, has been used as a primary radical therapeutic approach for localized prostate cancer. Yet, EBRT failures relate to 22-69% following curative radiotherapy (± androgen deprivation therapy). Additionally, a proportion of these men will have a biopsy-proven local recurrence...
2016: Central European Journal of Urology
Fred Saad, Mathieu Latour, Jean-Baptiste Lattouf, Hugues Widmer, Kevin C Zorn, Anne-Marie Mes-Masson, Veronique Ouellet, Genevieve Saad, Amol Prakash, Sibgat Choudhury, Gang Han, Pierre Karakiewicz, Jerome P Richie
PURPOSE: Current clinicopathologic parameters are insufficient to predict the likelihood of biochemical recurrence in patients with prostate cancer after radical prostatectomy. Such information may help to identify patients who would likely benefit from adjuvant radiotherapy rather than active surveillance. A multiplex proteomic assay, previously tested on biopsies and found to be predictive of favorable or unfavorable pathology at radical prostatectomy, was assessed for its predictive value to identify patients at higher risk of biochemical relapse...
October 7, 2016: Journal of Urology
Anton M F Kalsbeek, Eva F K Chan, Judith Grogan, Desiree C Petersen, Weerachai Jaratlerdsiri, Ruta Gupta, Ruth J Lyons, Anne-Maree Haynes, Lisa G Horvath, James G Kench, Phillip D Stricker, Vanessa M Hayes
Prostate cancer management is complicated by extreme disease heterogeneity, which is further limited by availability of prognostic biomarkers. Recognition of prostate cancer as a genetic disease has prompted a focus on the nuclear genome for biomarker discovery, with little attention given to the mitochondrial genome. While it is evident that mitochondrial DNA (mtDNA) mutations are acquired during prostate tumorigenesis, no study has evaluated the prognostic value of mtDNA variation. Here we used next-generation sequencing to interrogate the mitochondrial genomes from prostate tissue biopsies and matched blood of 115 men having undergone a radical prostatectomy for which there was a mean of 107 months clinical follow-up...
October 5, 2016: Aging
Paola Mapelli, Elena Incerti, Francesco Ceci, Paolo Castellucci, Stefano Fanti, Maria Picchio
Recurrence of prostate cancer is suspected when an increase in the prostate-specific antigen level is detected after radical treatment; the recurrence could be local relapse, distant relapse, or both. Differentiation between the two patterns of relapse is critical for choosing the proper treatment strategy. Choline PET/CT could be of help in discriminating patients with local, lymph node, and bone recurrences, thus having an impact on patient management.
October 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Mihir Naik, Chandana A Reddy, Kevin L Stephans, Jay P Ciezki, Jorge Garcia, Petros Grivas, Andrew J Stephenson, Eric A Klein, Rahul D Tendulkar
OBJECTIVES/BACKGROUND: To determine whether a 6-month posttreatment prostate-specific antigen (PSA) value in patients with prostate cancer (PCa) treated with concurrent androgen deprivation therapy (ADT) and external beam radiation therapy (EBRT) serves as an early predictor for biochemical relapse free survival (bRFS), distant metastasis-free survival (DMFS), and prostate cancer-specific mortality (PCSM). METHODS: A retrospective review of intermediate-risk and high-risk PCa patients treated with EBRT and concurrent ADT at a single institution between 1996 and 2012...
November 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Giuseppe Palermo, Angelo Totaro, Emilio Sacco, Nazario Foschi, Gaetano Gulino, Marco Racioppi, Pierfrancesco Bassi, Francesco Pinto
BACKGROUND: Prostate cancer (PCa) is the most commonly diagnosed malignancy in men and the second leading cause of cancer death in developed countries. Despite the primary treatments, 20-30% of patients experience a recurrence. The main objective of this study was to evaluate the clinical efficacy of salvage HIFU after radical prostatectomy in terms of biochemical free survival rate (BFSR) and PSA nadir. METHODS: Twenty two patients with local recurrence of Pca after radical prostatectomy underwent HIFU as first-line salvage therapy...
September 28, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
T Bach-Gansmo, C Nanni, P Nieh, L Zanoni, T Bogsrud, H Sletten, K Korsan, J Kieboom, A Chau, P Ward, F Willoch, M Goodman, S Fanti, D M Schuster
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Ahmed Abugharib, William C Jackson, Vasu Tumati, Robert T Dess, Jae Y Lee, Shuang G Zhao, Moaaz Soliman, Zachary S Zumsteg, Rohit Mehra, Felix Y Feng, Todd M Morgan, Neil Desai, Daniel E Spratt
PURPOSE: 'Early' salvage radiotherapy (SRT) following radical prostatectomy (RP) for prostate cancer is commonly advocated in place of adjuvant radiotherapy. Herein, we aimed to determine the optimal definition of 'early' SRT. METHODS: A multi-institutional retrospective study of 657 men who underwent SRT between 1986-2013. Two comparisons were used to determine the optimal definition of early SRT; 1) Time from RP to SRT (<9, 9-21, 22-47, and >48 months), and 2) level of detectable pre-SRT PSA (0...
September 7, 2016: Journal of Urology
Annelies Van Hemelryk, Gert De Meerleer, Piet Ost, Filip Poelaert, Werner De Gersem, Karel Decaestecker, Pieter De Visschere, Valérie Fonteyne
PURPOSE: Improved outcome is reported after surgery or external beam radiation therapy (EBRT) plus androgen deprivation therapy (ADT) for patients with lymph node (LN) positive (N1) prostate cancer (PC). Surgical series have shown that pathologic (p)N1 PC does not behave the same in all patients. The aim of this study was to perform a matched-case analysis to compare the outcome of pN1 and pN0 PC after high-dose EBRT plus ADT. METHODS AND MATERIALS: Radiation therapy up to 80 Gy was delivered to the prostate with a minimal dose of 45 Gy to the pelvis for pN1 patients...
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Philip Cornford, Joaquim Bellmunt, Michel Bolla, Erik Briers, Maria De Santis, Tobias Gross, Ann M Henry, Steven Joniau, Thomas B Lam, Malcolm D Mason, Henk G van der Poel, Theo H van der Kwast, Olivier Rouvière, Thomas Wiegel, Nicolas Mottet
OBJECTIVE: To present a summary of the 2016 version of the European Association of Urology (EAU) - European Society for Radiotherapy & Oncology (ESTRO) - International Society of Geriatric Oncology (SIOG) Guidelines on the treatment of relapsing, metastatic, and castration-resistant prostate cancer (CRPC). EVIDENCE ACQUISITION: The working panel performed a literature review of the new data (2013-2015). The guidelines were updated, and the levels of evidence and/or grades of recommendation were added based on a systematic review of the literature...
August 31, 2016: European Urology
Johannes Schwenck, Hansjoerg Rempp, Gerald Reischl, Stephan Kruck, Arnulf Stenzl, Konstantin Nikolaou, Christina Pfannenberg, Christian la Fougère
PURPOSE: Prostate-specific membrane antigen (PSMA) is expressed ubiquitously on the membrane of most prostate tumors and its metastasis. While PET/CT using (11)C-choline was considered as the gold standard in the staging of prostate cancer, PET with radiolabelled PSMA ligands was introduced into the clinic in recent years. Our aim was to compare the PSMA ligand (68)Ga-PSMA-11 with (11)C-choline in patients with primary and recurrent prostate cancer. METHODS: 123 patients underwent a whole-body PET/CT examination using (68)Ga-PSMA-11 and (11)C-choline...
August 24, 2016: European Journal of Nuclear Medicine and Molecular Imaging
Rakesh Kapoor, Anshuma Bansal, Narendra Kumar, Arun S Oinam
INTRODUCTION: In prostate cancer, higher radiation doses are often related to higher local control rates. However, the clinical effect of these higher doses on normal tissue toxicities is generally overlooked. We dosimetrically analyze sequential intensity modulated radiotherapy (IMRT) plans in high-risk prostate cancer patients and correlate them with acute and late normal tissue toxicities. MATERIALS AND METHODS: Twenty-five high-risk prostate cancer patients were planned with three-dimensional conformal radiotherapy to a dose of 50 Gy delivered in 25 fractions in 5 weeks, followed by seven-field IMRT boost, to a dose of 24 Gy delivered in 12 fractions in 2...
July 2016: Indian Journal of Urology: IJU: Journal of the Urological Society of India
Clemens Kratochwil, Ali Afshar-Oromieh, Klaus Kopka, Uwe Haberkorn, Frederik L Giesel
The prostate-specific membrane antigen (PSMA) is expressed by approximately 90% of prostate carcinomas. The expression correlates with unfavorable prognostic factors, such as a high Gleason score, infiltrative growth, metastasis, and hormone-independence. The high specificity, especially in the undifferentiated stage, makes it an excellent target for diagnosis and therapy. Therefore, antibodies and small molecule inhibitors have been developed for imaging and therapy. In 2011 PSMA-11, a ligand that consists of the Glu-urea-motif and the chelator HBED-CC, which can be exclusively radiolabeled with (68)Ga for PET imaging, presented the clinical breakthrough for prostate cancer diagnostics...
September 2016: Seminars in Nuclear Medicine
Thomas Zilli, Eileen Benz, Giovanna Dipasquale, Michel Rouzaud, Raymond Miralbell
PURPOSE: To evaluate the safety, feasibility, side-effect profile, and proof of concept of external beam radiation therapy (EBRT) with or without a brachytherapy (BT) boost for salvage of exclusive local failure after primary EBRT for prostate cancer. METHODS AND MATERIALS: Fourteen patients with presumed exclusive local recurrence after primary EBRT with or without BT were considered eligible for reirradiation. The median normalized total dose in 2-Gy fractions (NTD2Gy, α/β ratio = 1...
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Hannah M Bruce, Phillip D Stricker, Ruta Gupta, Richard R Savdie, Anne-Maree Haynes, Kate L Mahon, Hui-Ming Lin, James G Kench, Lisa G Horvath
BACKGROUND: Positive surgical margins (PSMs) in localized prostate cancer (PC) confer a two- to three-fold increased risk of biochemical relapse (BR). Absent/weak AZGP1 expression and Gleason grade ≥4 at the margin are each independent predictors of BR in patients with PSMs. Our study aimed to determine whether the biomarkers AZGP1 expression and Gleason grade at the site of a PSM are significant independent markers of biochemical and clinical relapse (CR) when modeled together and whether one of these biomarkers may be superior in its capacity to predict outcome...
December 2016: Prostate
Joshua J Morigi, S Fanti, D Murphy, Michael S Hofman
PURPOSE OF REVIEW: PET/CT imaging in men with prostate cancer (PCa) is rapidly growing as clinicians are becoming aware of its possible fundamental role in the diagnostic flow chart of these patients. As this technology becomes more available worldwide, a considerable number of scientific studies are focusing on specific clinical scenarios and novel PET radiopharmaceuticals that might assist improving early diagnosis and shifting to a truly tailored treatment for PCa. This review focuses on the most recent and important publications in PET/CT imaging of PCa...
September 2016: Current Opinion in Urology
Ilya Sobol, Harras B Zaid, Rimki Haloi, Lance A Mynderse, Adam T Froemming, Val J Lowe, Brian J Davis, Eugene D Kwon, R Jeffrey Karnes
PURPOSE: We identify sites and patterns of cancer recurrence in patients with post-prostatectomy biochemical relapse using (11)C-choline positron emission tomography/computerized tomography and endorectal coil multiparametric magnetic resonance imaging. MATERIALS AND METHODS: Between January 2008 and June 2015, 2,466 men underwent choline positron emission tomography for suspected prostate cancer relapse at our institution. Of these men 202 did not receive hormone or radiation therapy, underwent imaging with choline positron emission tomography and multiparametric magnetic resonance imaging, and were found to have disease recurrence...
July 20, 2016: Journal of Urology
Pedro Castelo-Branco, Ricardo Leão, Tatiana Lipman, Brittany Campbell, Donghyun Lee, Aryeh Price, Cindy Zhang, Abolfazl Heidari, Derek Stephens, Stefan Boerno, Hugo Coelho, Ana Gomes, Celia Domingos, Joana D Apolonio, Georg Schäfer, Robert G Bristow, Michal R Schweiger, Robert Hamilton, Alexandre Zlotta, Arnaldo Figueiredo, Helmut Klocker, Holger Sültmann, Uri Tabori
The identification of new biomarkers to differentiate between indolent and aggressive prostate tumors is an important unmet need. We examined the role of THOR (TERT Hypermethylated Oncological Region) as a diagnostic and prognostic biomarker in prostate cancer (PCa).We analyzed THOR in common cancers using genome-wide methylation arrays. Methylation status of the whole TERT gene in benign and malignant prostate samples was determined by MeDIP-Seq. The prognostic role of THOR in PCa was assessed by pyrosequencing on discovery and validation cohorts from patients who underwent radical prostatectomy with long-term follow-up data...
July 16, 2016: Oncotarget
Fabien Calcagno, Guillaume Mouillet, Olivier Adotevi, Tristan Maurina, Thierry Nguyen, Philippe Montcuquet, E Curtit, F Kleinclauss, Xavier Pivot, Christophe Borg, Antoine Thiery-Vuillemin
After curative local therapy, biochemical recurrence is a mode of relapse among patient with prostate cancer (PC). Deferring androgen deprivation therapy (ADT) or offering non-hormonal therapies may be an appropriate option for these non-symptomatic patients with no proven metastases. Metronomic cyclophosphamide (MC) has shown activity in metastatic PC setting and was chosen to be assessed in biochemical relapse. This prospective single-arm open-label phase II study was conducted to evaluate MC regimen in patients with biochemical recurrent PC...
August 2016: Medical Oncology
Naresh Regula, Michael Häggman, Silvia Johansson, Jens Sörensen
PURPOSE: Malignant de novo lipogenesis is strongly linked to the aggressiveness of prostate cancer (PCa) under experimental conditions. (11)C-Acetate PET/CT is a potential noninvasive biomarker of malignant lipogenesis in PCa, but its prognostic value is not known. The objective of this study was to analyse (11)C-acetate PET/CT image metrics in relation to survival. METHODS: All patients undergoing (11)C-acetate PET/CT in one university hospital from 2005 to 2011 due to PSA relapse after previous prostatectomy were retrospectively evaluated...
July 8, 2016: European Journal of Nuclear Medicine and Molecular Imaging
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