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Castrate resistant radiation

Tatsuaki Daimon, Takeo Kosaka, Mototsugu Oya
Docetaxel chemotherapy for metastatic castration resistant prostate cancer patients has been thought palliative because the radiological response rate is low and durable response is rare. The patient was a 64-year-old man who was diagnosed with cT3aN0M0 prostate cancer and underwent external beam radiation therapy as the initial treatment. He underwent androgen deprivation therapy and 8 cycles of docetaxel chemotherapy. His PSA level decreased and became undetectable and the disease was confirmed to be stable by radiological examination...
2016: American Journal of Clinical and Experimental Urology
Oliver Sartor
Radiopharmaceuticals used in the treatment of castrate-resistant prostate cancer are reviewed herein with an emphasis on sequential and combination therapies. Four bone-seeking radiopharmaceuticals had been approved in the United States. Three of these are β-emitters (phosphorus-32, strontium-89, samarium-153-ethylenediaminetetramethylene-phosphonic acid) that are approved for palliative purposes. One α-emitter (radium-223 [Ra]) is approved for prolongation of survival in bone metastatic castrate-resistant prostate cancer...
September 2016: Cancer Journal
Oladapo Yeku, Susan F Slovin
Immunotherapy for castration-resistant prostate cancer has continued to be an area of active research over the last several years. The enthusiasm of this approach has been based on the assumption of better tolerability and that using the body's own immune system may be more effective than either hormonal or chemotherapy. Sipuleucel-T, a dendritic cell-based vaccine, is the only approved agent in this class for the management of castrate-resistant prostate cancer. Although sipuleucel-T increases overall survival without any significant changes in progression-free survival, other forms of immunotherapy such as PSA-TRICOM, ipilimumab, and chimeric antigen receptor T cell therapy are in advanced stages of clinical development...
September 2016: Cancer Journal
David T Hoang, Kenneth A Iczkowski, Deepak Kilari, William See, Marja T Nevalainen
Despite aggressive treatment for localized cancer, prostate cancer (PC) remains a leading cause of cancer-related death for American men due to a subset of patients progressing to lethal and incurable metastatic castrate-resistant prostate cancer (CRPC). Organ-confined PC is treated by surgery or radiation with or without androgen deprivation therapy (ADT), while options for locally advanced and disseminated PC include radiation combined with ADT, or systemic treatments including chemotherapy. Progression to CRPC results from failure of ADT, which targets the androgen receptor (AR) signaling axis and inhibits AR-driven proliferation and survival pathways...
October 10, 2016: Oncotarget
Wolfgang P Fendler, Svenja Reinhardt, Harun Ilhan, Andreas Delker, Guido Böning, Franz J Gildehaus, Christian Stief, Peter Bartenstein, Christian Gratzke, Sebastian Lehner, Axel Rominger
Prostate cancer can be targeted by ligands to the prostate-specific membrane antigen (PSMA). We aimed to evaluate dosimetry, safety and efficacy of 177Lu-PSMA-617 radioligand therapy (RLT) in patients with metastatic castration-resistant prostate cancer (mCRPC).Fifteen patients each received two cycles of 3.7 GBq (n = 5) or 6.0 GBq (n = 10) 177Lu-PSMA-617 at an eight to ten weeks interval. For safety monitoring, each treatment was followed by dosimetry with serial quantitative SPECT as well as inpatient and outpatient recording of adverse events...
September 24, 2016: Oncotarget
Shozo Okamoto, Anne Thieme, Jakob Allmann, Calogero D'Alessandria, Tobias Maurer, Margitta Retz, Robert Tauber, Matthias M Heck, Hans-Juergen Wester, Nagara Tamaki, Wolfgang P Fendlder, Ken Herrmann, Christian H Pfob, Klemens Scheidhauer, Markus Schwaiger, Sibylle Ziegler, Matthias Eiber
PURPOSE: Prostate-specific membrane antigen (PSMA) targeted radioligand therapy (RLT) is increasingly used in metastatic castration-resistant prostate cancer (mCRPC). We aimed to estimate the absorbed doses for normal organs and tumor lesions using (177)Lu-PSMA-I&T in patients undergoing up to four cycles RLT. Results were compared to pre-therapeutic (68)Ga-PSMA-HBED-CC positron-emission-tomography (PET). METHODS: A total of 34 cycles in 18 patients were analyzed retrospectively...
September 22, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
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
Katrina Sweeney, Gunnel Halldén
Prostate cancer is a leading cause of cancer-related death and morbidity in men in the Western world. Tumor progression is dependent on functioning androgen receptor signaling, and initial administration of antiandrogens and hormone therapy (androgen-deprivation therapy) prevent growth and spread. Tumors frequently develop escape mechanisms to androgen-deprivation therapy and progress to castration-resistant late-stage metastatic disease that, in turn, inevitably leads to resistance to all current therapeutics, including chemotherapy...
2016: Oncolytic Virotherapy
Jason W D Hearn, Ghada AbuAli, Chad A Reichard, Chandana A Reddy, Cristina Magi-Galluzzi, Kai-Hsiung Chang, Rachel Carlson, Laureano Rangel, Kevin Reagan, Brian J Davis, R Jeffrey Karnes, Manish Kohli, Donald Tindall, Eric A Klein, Nima Sharifi
BACKGROUND: HSD3B1 (1245A>C) has been mechanistically linked to castration-resistant prostate cancer because it encodes an altered enzyme that augments dihydrotestosterone synthesis from non-gonadal precursors. We postulated that men inheriting the HSD3B1 (1245C) allele would exhibit resistance to androgen-deprivation therapy (ADT). METHODS: In this multicohort study, we determined HSD3B1 genotype retrospectively in men treated with ADT for post-prostatectomy biochemical failure and correlated genotype with long-term clinical outcomes...
October 2016: Lancet Oncology
Marinos Tsiatas, Petros Grivas
Immunotherapy has traditionally been a critical component of the cancer treatment armamentarium in genitourinary (GU) cancers. It has an established role in the management of carefully selected patients with metastatic renal cell carcinoma (RCC) [e.g., high dose interleukin-2 (IL-2)] and non-muscle invasive bladder cancer (NMIBC) [e.g., intravesical Bacillus Calmette-Guérin (BCG)]. In 2010, the sipuleucel-T vaccine was approved by the FDA for the management of metastatic castration-resistant prostate cancer (mCRPC), based on a phase III trial showing overall survival (OS) benefit compared to placebo...
July 2016: Annals of Translational Medicine
Boris Hadaschik
No abstract text is available yet for this article.
August 20, 2016: European Urology
M Francesca Monn, Liang Cheng
INTRODUCTION: Prostatic small cell carcinoma (PSCC) is a rare, aggressive form of prostate cancer associated with poor clinical outcomes. It can arise de novo or in the setting of castrate resistant adenocarcinoma of the prostate. Current therapeutic interventions are based upon observations the PSCC responds similarly to small cell carcinoma of the lung. Standard treatment includes chemotherapy with cisplatin and etoposide, radiation therapy, and occasional extirpative management. Ongoing research into the molecular pathway behind the development of PSCC and potential interventions is resulting in the identification of multiple novel therapeutic targets...
October 2016: Expert Review of Anticancer Therapy
Clemens Kratochwil, Frank Bruchertseifer, Frederik L Giesel, Mirjam Weis, Frederik A Verburg, Felix Mottaghy, Klaus Kopka, Christos Apostolidis, Uwe Haberkorn, Alfred Morgenstern
: Prostate-specific membrane antigen (PSMA) is a promising target in prostate cancer. Recently, we started the first-in-human treatment with an α-radionuclide-labeled PSMA ligand. Although the case series is still ongoing, we here report in advance about two patients in highly challenging clinical situations who showed a complete response to (225)Ac- PSMA-617 therapy. METHODS: (68)Ga-PSMA-11 PET/CT validated the presence of the PSMA-positive tumor phenotype. A 100-kBq activity of (225)Ac-PSMA-617 per kilogram of body weight was administered bimonthly...
July 7, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
L E Howard, A M De Hoedt, W J Aronson, C J Kane, C L Amling, M R Cooperberg, M K Terris, C H Divers, A Valderrama, S J Freedland
BACKGROUND: Skeletal-related events (SREs) including pathologic fracture, spinal cord compression, radiation to bone and surgery to bone, are common in men with bone metastatic castration-resistant prostate cancer (mCRPC). Men with mCRPC are at high risk of death. Whether SREs predict mortality is unclear. We tested the association between SREs and overall survival (OS) in a multiethnic cohort with bone mCRPC, controlling for key covariates unavailable in claims data such as bone pain, number of bone metastases and PSA doubling time (PSADT)...
July 5, 2016: Prostate Cancer and Prostatic Diseases
W S Jang, K S Cho, K H Kim, C Y Yoon, Y J Kang, J Y Lee, W S Ham, K H Rha, S J Hong, Y D Choi
BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) has a prognostic value in patients with metastatic castration-resistant prostate cancer receiving systemic therapy. However, the prognostic significance of NLR was never previously evaluated in patients who underwent radical prostatectomy (RP) for prostate cancer. In the present study, we investigated the influence of NLR on survival after a RP for prostate cancer. METHODS: We retrospectively reviewed clinical data of 2301 patients with prostate cancer who underwent RP at our institution between 2000 and 2010...
September 2016: Prostate Cancer and Prostatic Diseases
Christopher Parker, Steven E Finkelstein, Jeff M Michalski, Joe M O'Sullivan, Øyvind Bruland, Nicholas J Vogelzang, Robert E Coleman, Sten Nilsson, Oliver Sartor, Rui Li, Monica A Seger, David Bottomley
BACKGROUND: The phase 3 ALSYMPCA trial enrolled metastatic castration-resistant prostate cancer patients with or without baseline opioid use. OBJECTIVE: To assess the efficacy and safety of radium-223 dichloride (radium-223) versus placebo in ALSYMPCA patients by baseline opioid use. DESIGN, SETTING, AND PARTICIPANTS: Nine hundred and twenty one patients enrolled at 136 centers globally. INTERVENTION: Radium-223 (50 kBq/kg, intravenous injection) every 4 wk for six cycles or matching placebo, each plus best standard of care...
June 22, 2016: European Urology
Jayant K Rane, Holger Hh Erb, Giovanna Nappo, Vincent M Mann, Matthew S Simms, Anne T Collins, Tapio Visakorpi, Norman J Maitland
Radiation therapy is a major primary treatment option for both localized early stage prostate cancer, and for advanced, regionally un-resectable, cancer. However, around 30% of patients still experience biochemical recurrence after radiation therapy within 10 years. Thus, identification of better biomarkers and new targets are urgently required to improve current therapeutic strategies. The miR-99 family has been shown to play an important role in the regulation of the DNA damage response, via targeting of the SWI/SNF chromatin remodeling factors, SMARCA5 and SMARCD1 in cell line models...
June 21, 2016: Oncotarget
Tara Horrill
A 65-year-old man presents to the emergency department with increasing back pain. His history includes hypertension, peripheral neuropathy, duodenal ulcer, superior mesenteric vein thrombus, stage IIB colon cancer treated with surgery and adjuvant chemotherapy, renal cell carcinoma treated with surgery, and prostate cancer treated with surgery and radiation. He is otherwise healthy. His family history is positive for colon cancer. Physical examination found significantly elevated blood pressure and a computed tomography scan of the thoracic and lumbar spine was performed, with findings of a type B aortic dissection extending from the aberrant right subclavian artery down to the abdominal aorta...
July 1, 2016: Oncology Nursing Forum
Keisuke Yoshida, Tomohiro Kaneta, Shoko Takano, Madoka Sugiura, Tsuyoshi Kawano, Ayako Hino, Tou Yamamoto, Kazuya Shizukuishi, Masato Kaneko, Christian Zurth, Tomio Inoue
OBJECTIVE: This open-label, non-randomized, phase I study examined the pharmacokinetics (PK) and radiation dosimetry of a single dose of radium-223 in Japanese patients with castration-resistant prostate cancer (CRPC) and bone metastases. METHODS: Six male Japanese patients (mean age 72.5 years, range 65-79 years) with histologically or cytologically confirmed stage IV adenocarcinoma of the prostate were recruited. A single IV dose of radium-223 was delivered intravenously (IV) via slow bolus over a 2-5 min period: Cohort 1 received 50 kBq/kg and Cohort 2 received 100 kBq/kg...
August 2016: Annals of Nuclear Medicine
Ahmed Larbi, Benjamin Dallaudière, Vasiliki Pasoglou, Anwar Padhani, Nicolas Michoux, Bruno C Vande Berg, Bertrand Tombal, Frédéric E Lecouvet
OBJECTIVES: To determine the proportion of prostate cancer (PCa) patients with oligometastatic disease (≤3 synchronous lesions) using whole body magnetic resonance imaging with diffusion-weighted imaging (WB-MRI/DWI). To determine the proportion of patients with nodal disease confined within currently accepted target areas for extended lymph node dissection (eLND) and pelvic external beam radiation therapy (EBRT). SUBJECTS AND METHODS: Two radiologists reviewed WB-MRI/DWI studies in 96 consecutive newly diagnosed metastatic PCa patients; 46 patients with newly diagnosed castration naive PCa (mHNPC) and 50 patients with first appearance of metastasis during monitoring for non-metastatic castration resistant PCa (M0 to mCRPC)...
August 2016: Prostate
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