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Metastatic hormone sensitive prostate cancer

Charles C Vu, Kevin G Blas, Thomas B Lanni, Gary S Gustafson, Daniel J Krauss
PURPOSE: The recently published ASCENDE-RT randomized clinical trial demonstrated improved biochemical control, albeit with increased toxicity, for a prostate boost with brachytherapy versus external beam radiation therapy alone in patients with intermediate-high risk prostate cancer. In this study, we investigated the cost-effectiveness of these two modalities in the treatment of intermediate-high risk prostate cancer. METHODS AND MATERIALS: A multistate Markov model was created to model a patient with intermediate-high risk prostate cancer...
July 31, 2018: Brachytherapy
Oliver Sartor, Deepali Sharma
223 Radium (223 Ra) is the first alpha-emitting therapy proven effective in human cancer. Prospective randomized trials indicate that 223 Ra, which concentrates after intravenous injection in areas of osteoblastic metastatic disease, can prolong survival in bone-dominant castrate resistant prostate cancer patients. Though radium isotopic therapy is conceptually critical to demonstrate that alpha emitters can be safe and effective, 223 Ra has inherent limitations given its restriction to bone metastatic disease...
June 2018: Translational Andrology and Urology
Aditya Prakash Sharma, Ravimohan S Mavuduru, Girdhar Singh Bora, Sudheer K Devana, Shrawan K Singh, Arup K Mandal
With the emergence of recent landmark trials, the treatment for hormone-sensitive metastatic prostate cancer (hsMPC) is changing from androgen deprivation therapy (ADT) alone to combination therapy. Both, docetaxel chemotherapy and abiraterone in addition to ADT have been extensively studied in well-conducted randomized controlled trials and were shown to improve outcomes. However, this paradigm shift in the treatment has also raised some queries. This mini review reflects upon the four landmark trials and tries to provide some perspective about the decision-making process for the patients with hsMPC...
July 2018: Indian Journal of Urology: IJU: Journal of the Urological Society of India
K Miller
No abstract text is available yet for this article.
August 2018: Der Urologe. Ausg. A
Hongtuan Zhang, Zhenpeng Lian, Guangyu Sun, Ranlu Liu, Yong Xu
To gain a comprehensive understanding of whether ABCC5 can regulate prostate cancer (PCa) progression, we performed microarray data analyses and identified that ABCC5 was drastically increased in primary PCa relative to normal samples, metastatic PCa relative to primary PCa, and castration-resistant PCa relative to hormone naïve PCa, respectively. Multivariate Cox regression analysis suggested that ABCC5 overexpression in PCa was an independent prognostic factor for both poor biochemical recurrence-free and overall survival...
2018: OncoTargets and Therapy
Matteo Giulietti, Matteo Santoni, Alessia Cimadamore, Francesco Carrozza, Francesco Piva, Liang Cheng, Antonio Lopez-Beltran, Marina Scarpelli, Nicola Battelli, Rodolfo Montironi
Tumor microenvironment constitutes a complex network in which tumor cells communicate among them and with stromal and immune cells. It has been shown that cancer cells are able to exchange genetic materials through small extracellular vesicles (EVs), a heterogeneous group of vesicles with different size and shape, cargo content, and function. The importance to investigate populations of circulating EVs would be of great importance as prostate cancer (PCa) biomarkers. In several neoplasms as well as in PCa, nanometer-sized EVs of endosomal origin are implicated in supporting tumor growth and metastatic spread by both altering local stroma cells and creating a protumor environment that favors the formation of pre-metastatic niches...
2018: Frontiers in Oncology
Pasquale Rescigno, David Lorente, David Dolling, Roberta Ferraldeschi, Daniel Nava Rodrigues, Ruth Riisnaes, Susana Miranda, Diletta Bianchini, Zafeiris Zafeiriou, Spyridon Sideris, Ana Ferreira, Ines Figueiredo, Semini Sumanasuriya, Joaquin Mateo, Raquel Perez-Lopez, Adam Sharp, Nina Tunariu, Johann S de Bono
Background: Loss of PTEN is a common genomic aberration in castration-resistant prostate cancer (CRPC) and is frequently concurrent with ERG rearrangements, causing resistance to next-generation hormonal treatment (NGHT) including abiraterone. The relationship between PTEN loss and docetaxel sensitivity remains uncertain. Objective: To study the antitumor activity of docetaxel in metastatic CRPC in relation to PTEN and ERG aberrations. Design setting and participants: Single-centre, retrospective analysis of PTEN loss and ERG expression using a previously described immunohistochemistry (IHC) binary classification system...
May 2018: European urology oncology
Pedro Barata, Hamid Emamekhoo, Prateek Mendiratta, Vadim Koshkin, Allison Tyler, Moshe Ornstein, Brian I Rini, Timothy Gilligan, Christos Kyriakopoulos, Jorge A Garcia
BACKGROUND: Androgen deprivation therapy plus docetaxel (D-ADT) increases overall survival (OS) in men with high-volume, metastatic hormone-sensitive prostate cancer (mHSPC). Although the vast majority of men initially respond to D-ADT, most will progress and develop castration-resistant prostate cancer (CRPC). Little is known about the optimal treatment sequence for men with progressive disease on D-ADT. PATIENT AND METHODS: Retrospective analysis of consecutive mHSPC patients treated with ≥3 cycles of D-ADT at Cleveland Clinic and University of Wisconsin-Madison was undertaken...
June 7, 2018: Prostate
Pui San Tan, Pedro Aguiar, Benjamin Haaland, Gilberto Lopes
BACKGROUND: Patients with metastatic prostate cancer have poor prognosis. In this study, we compared the addition of abiraterone, docetaxel, bisphosphonate, celecoxib or combinations to standard ADT vs. ADT alone for patients with mHSPC in terms of overall survival (OS), failure-free survival (FFS), and adverse events. METHODS: We searched PubMed and performed a network meta-analysis to generate probabilistic inferences and provide efficacy rankings in terms of posterior hazard ratios with 95% credible intervals (CrI), surface under the cumulative ranking curve (SUCRA), probability better than competing treatments, and probability best...
June 6, 2018: Prostate Cancer and Prostatic Diseases
Kyo Chul Koo, Prokar Dasgupta
With advancements in diagnostic techniques, including molecular and clinical imaging, that directly target cancer cells, oligometastatic prostate cancer (PCa) is being diagnosed in patients who were, in the past, considered to have localized disease. With accumulating evidence, there has been a paradigm shift in considering aggressive treatments targeted at both the primary tumor and metastatic lesions in an aim to avoid and delay the need for palliative treatments and, ultimately, to achieve survival benefits...
July 2018: Yonsei Medical Journal
Emmanuel S Antonarakis, Eric J Small, Daniel Petrylak, David I Quinn, Adam S Kibel, Nancy Chang, Erica Dearstyne, Matthew Harmon, Dwayne Campogan, Heather Haynes, Tuyen Vu, Nadeem A Sheikh, Charles G Drake
BACKGROUND: Sipuleucel-T is FDA-approved for the treatment of metastatic castration-resistant prostate cancer (mCRPC) based on the IMPACT trial showing a 4.1-month benefit in median overall survival (OS) for patients receiving sipuleucel-T vs control. Although efficacy of sipuleucel-T is well-established, its mechanism remains incompletely understood. METHODS: Patient samples from three sipuleucel-T trials were assessed for peripheral cellular immune responses to the immunogen PA2024 and the target antigen prostatic acid phosphatase (PAP)...
June 1, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Vittore Cereda, Vincenzo Formica, Mario Roselli
There is general agreement that increased angiogenesis is an important factor in determining prostate cancer development and prognosis. Vascular Endothelial Growth Factor (VEGF) is thought to play a primary role in the molecular events that lead to prostate cancer progression, from androgen-dependency to castration-resistance until dissemination to the skeleton. Bevacizumab is a recombinant anti-VEGF monoclonal antibody that has exhibited clinical activity in different cancer types. Areas covered: In this review we summarize the data of clinical trials, investigating the effects of bevacizumab in prostate cancer patients...
June 2018: Expert Opinion on Biological Therapy
Ilker Tinay, Mingyue Tan, Bin Gui, Lillian Werner, Adam S Kibel, Li Jia
BACKGROUND: MicroRNAs (miRNAs) are small non-coding RNAs, which negatively regulate gene expression and impact prostate cancer (PCa) growth and progression. Circulating miRNAs are stable and detectable in cell-free body fluids, such as serum. Investigation of circulating miRNAs presents great potential in uncovering new insights into the roles of miRNAs in PCa diagnosis and therapy. METHODS: Using TaqMan miRNA quantitative reverse transcription polymerase chain reaction (RT-qPCR), we compared the expression levels of five miRNAs (miR-193a-3p, miR-9-3p, miR-335-5p, miR-330-3p, and miR-345-5p) in serum samples from 20 normal individuals without cancer, 25 patients with localized disease, 25 patients with hormone-naïve or hormone sensitive metastatic disease, and 25 patients with metastatic castration-resistant prostate cancer (CRPC)...
September 2018: Prostate
Hiromi Sato, Shintaro Narita, Norihiko Tsuchiya, Atsushi Koizumi, Taketoshi Nara, Sohei Kanda, Kazuyuki Numakura, Hiroshi Tsuruta, Atsushi Maeno, Mitsuru Saito, Takamitsu Inoue, Shigeru Satoh, Kyoko Nomura, Tomonori Habuchi
BACKGROUND: Less evidence is known about the role of early changes in serum biomarker after androgen deprivation therapy (ADT) in patients with metastatic hormone-sensitive prostate cancer (mHSPC). Here we evaluated the impact of pre-treatment prognostic factors and early changes in serum biomarkers on prostate specific antigen (PSA) progression-free and overall survival rates in mHSPC. METHODS: We retrospectively reviewed the medical records of 60 mHSPC patients (median age 72 years) treated with ADT whose laboratory data at baseline and following 12 weeks were available...
May 8, 2018: BMC Urology
Ekaterina Nevedomskaya, Simon J Baumgart, Bernard Haendler
Novel drugs, drug sequences and combinations have improved the outcome of prostate cancer in recent years. The latest approvals include abiraterone acetate, enzalutamide and apalutamide which target androgen receptor (AR) signaling, radium-223 dichloride for reduction of bone metastases, sipuleucel-T immunotherapy and taxane-based chemotherapy. Adding abiraterone acetate to androgen deprivation therapy (ADT) in order to achieve complete androgen blockade has proven highly beneficial for treatment of locally advanced prostate cancer and metastatic hormone-sensitive prostate cancer (mHSPC)...
May 4, 2018: International Journal of Molecular Sciences
Edoardo Francini, Kathryn P Gray, Wanling Xie, Grace K Shaw, Loana Valença, Brandon Bernard, Laurence Albiges, Lauren C Harshman, Philip W Kantoff, Mary-Ellen Taplin, Cristopher J Sweeney
BACKGROUND: Currently, there is no universally accepted prognostic classification for patients (pts) with metastatic hormone sensitive prostate cancer (mHSPC) treated with androgen deprivation therapy (ADT). Subgroup analyses demonstrated that pts with low volume (LV), per CHAARTED trial definition, mHSPC, and those who relapse after prior local therapy (PLT) have longer overall survival (OS) compared to high volume (HV) and de-novo (DN), respectively. Using a hospital-based registry, we aimed to assess whether a classification based on time of metastatic disease (PLT vs DN) and disease volume (LV vs HV) are prognostic for mHSPC pts treated with ADT...
September 2018: Prostate
Alshimaa Mahmoud Alhanafy, Fouad Zanaty, Reda Ibrahem, Suzan Omar
Background and Aim: The optimal management of metastatic hormone-sensitive prostate cancer has been controversial in recent years with introduction of upfront chemohormonal treatment based on results of several Western studies. This changing landscape has renewed interest in the concept “disease volume”, the focus of the present study is the Egyptian patients. Methods: Patients with hormone sensitive metastatic prostate cancer presenting at Menoufia University Hospital, Egypt, during the period from June 2013 to May 2016, were enrolled...
April 27, 2018: Asian Pacific Journal of Cancer Prevention: APJCP
Philipp Nuhn, Johann S De Bono, Karim Fizazi, Stephen J Freedland, Maurizio Grilli, Philip W Kantoff, Guru Sonpavde, Cora N Sternberg, Srinivasan Yegnasubramanian, Emmanuel S Antonarakis
CONTEXT: Introduction of novel agents for the management of advanced prostate cancer provides a range of treatment options with notable benefits for men with metastatic castration-resistant prostate cancer (mCRPC). At the same time, understanding of optimal patient selection, effective sequential use, and development of resistance patterns remains incomplete. OBJECTIVE: To review current systemic therapies and recent advances in drug development for mCRPC and strategies to aid in patient selection and optimal sequencing...
April 16, 2018: European Urology
Daniel W Sonnenburg, Alicia K Morgans
PURPOSE OF REVIEW: In the last decade, there have been multiple landmark therapeutic advances for the treatment of metastatic prostate cancer, both in the castration-resistant and hormone-sensitive setting. In this review, we highlight recent progress and ongoing trials for metastatic prostate cancer, including advances in chemotherapy, androgen receptor-directed therapy, targeted therapies, and immunotherapy. RECENT FINDINGS: Several landmark studies for men with metastatic hormone-sensitive prostate cancer demonstrated improvement in overall survival with the addition of docetaxel chemotherapy or abiraterone acetate to standard androgen deprivation therapy...
April 11, 2018: Current Oncology Reports
Zaina T Al-Salama
Apalutamide (ErleadaTM ) is a next-generation oral androgen receptor (AR) inhibitor that is being developed by Janssen for the treatment of prostate cancer (PC). It binds directly to the ligand-binding domain of the AR and blocks the effects of androgens. In February 2018, apalutamide received its first global approval in the USA for the treatment of non-metastatic castration-resistant PC (nmCRPC). Apalutamide is undergoing phase III investigation in chemotherapy-naive patients with metastatic CRPC (in combination with abiraterone acetate plus prednisone), patients with high-risk localized or locally advanced PC receiving primary radiation therapy, and in patients with metastatic hormone-sensitive PC and biochemically-relapsed PC...
April 2018: Drugs
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