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Latest & greatest articles for prostate cancer
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Custirsen in combination with docetaxel and prednisone for patients with metastatic castration-resistant prostatecancer (SYNERGY trial): a phase 3, multicentre, open-label, randomised trial Clusterin is a chaperone protein associated with treatment resistance and upregulated by apoptotic stressors such as chemotherapy. Custirsen is a second-generation antisense oligonucleotide that inhibits clusterin production. The aim of the SYNERGY trial was to investigate the effect of custirsen (...) in combination with docetaxel and prednisone on overall survival in patients with metastatic castration-resistant prostate cancer.SYNERGY was a phase 3, multicentre, open-label, randomised trial set at 134 study centres in 12 countries. Patients were eligible for participation if they had: metastatic castration-resistant prostatecancer and had received no previous chemotherapy; prostate-specific antigen greater than 5 ng/mL; and a Karnofsky performance score of 70% or higher. Patients were randomly assigned
had more favorable-risk prostatecancer (OR, 1.35; 95% CI, 1.16 to 1.56) and a lower risk of aggressive prostatecancer (OR, 0.50; 95% CI, 0.37 to 0.67). The increase in favorable-risk prostatecancer was already observed within the first year of TRT (OR, 1.61; 95% CI, 1.10 to 2.34), whereas the lower risk of aggressive disease was observed after > 1 year of TRT (OR, 0.44; 95% CI, 0.32 to 0.61). After adjusting for previous biopsy findings as an indicator of diagnostic activity, TRT remained (...) Testosterone Replacement Therapy and Risk of Favorable and Aggressive ProstateCancer Purpose The association between exposure to testosterone replacement therapy (TRT) and prostatecancer risk is controversial. The objective was to examine this association through nationwide, population-based registry data. Methods We performed a nested case-control study in the National ProstateCancer Register of Sweden, which includes all 38,570 prostatecancer cases diagnosed from 2009 to 2012, and 192,838
The Performance of PI-RADSv2 and Quantitative Apparent Diffusion Coefficient for Predicting Confirmatory Prostate Biopsy Findings in Patients Considered for Active Surveillance of ProstateCancer To assess the performance of the updated Prostate Imaging Reporting and Data System (PI-RADSv2) and the apparent diffusion coefficient (ADC) for predicting confirmatory biopsy results in patients considered for active surveillance of prostatecancer (PCA).IRB-approved, retrospective study of 371 (...) consecutive men with clinically low-risk PCA (initial biopsy Gleason score ≤6, prostate-specific antigen <10 ng/ml, clinical stage ≤T2a) who underwent 3T-prostate MRI before confirmatory biopsy. Two independent radiologists recorded the PI-RADSv2 scores and measured the corresponding ADC values in each patient. A composite score was generated to assess the performance of combining PI-RADSv2 + ADC.PCA was upgraded on confirmatory biopsy in 107/371 (29%) patients. Inter-reader agreement was substantial (PI
+ 3 tumors. Surgery and radiation continue to be curative treatments for localized disease but have adverse effects such as urinary symptoms and sexual dysfunction that can negatively affect quality of life. For metastatic disease, chemotherapy as initial treatment now appears to extend survival compared with androgen deprivation therapy alone. New vaccines, hormonal therapeutics, and bone-targeting agents have demonstrated efficacy in men with metastatic prostatecancer resistant to traditional (...) The Diagnosis and Treatment of ProstateCancer: A Review. Prostatecancer is the most common cancer diagnosis made in men with more than 160 000 new cases each year in the United States. Although it often has an indolent course, prostatecancer remains the third-leading cause of cancer death in men.When prostatecancer is suspected, tissue biopsy remains the standard of care for diagnosis. However, the identification and characterization of the disease have become increasingly precise through
Abiraterone plus Prednisone in Metastatic, Castration-Sensitive ProstateCancer. Abiraterone acetate, a drug that blocks endogenous androgen synthesis, plus prednisone is indicated for metastatic castration-resistant prostatecancer. We evaluated the clinical benefit of abiraterone acetate plus prednisone with androgen-deprivation therapy in patients with newly diagnosed, metastatic, castration-sensitive prostate cancer.In this double-blind, placebo-controlled, phase 3 trial, we randomly (...) , including the time until pain progression, next subsequent therapy for prostatecancer, initiation of chemotherapy, and prostate-specific antigen progression (P<0.001 for all comparisons), along with next symptomatic skeletal events (P=0.009). These findings led to the unanimous recommendation by the independent data and safety monitoring committee that the trial be unblinded and crossover be allowed for patients in the placebo group to receive abiraterone. Rates of grade 3 hypertension and hypokalemia
primary outcome was failure-free survival (treatment failure was defined as radiologic, clinical, or PSA progression or death from prostatecancer).A total of 1917 patients underwent randomization from November 2011 through January 2014. The median age was 67 years, and the median PSA level was 53 ng per milliliter. A total of 52% of the patients had metastatic disease, 20% had node-positive or node-indeterminate nonmetastatic disease, and 28% had node-negative, nonmetastatic disease; 95% had newly (...) was 0.21 in patients with nonmetastatic disease and 0.31 in those with metastatic disease. Grade 3 to 5 adverse events occurred in 47% of the patients in the combination group (with nine grade 5 events) and in 33% of the patients in the ADT-alone group (with three grade 5 events).Among men with locally advanced or metastatic prostatecancer, ADT plus abiraterone and prednisolone was associated with significantly higher rates of overall and failure-free survival than ADT alone. (Funded by Cancer
Vasectomy and ProstateCancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC) Purpose Vasectomy is a commonly used form of male sterilization, and some studies have suggested that it may be associated with an increased risk of prostatecancer, including more aggressive forms of the disease. We investigated the prospective association of vasectomy with prostatecancer in a large European cohort, with a focus on high-grade and advanced-stage tumors, and death due (...) an average follow-up of 15.4 years, 4,377 men were diagnosed with prostatecancer, including 641 who had undergone a vasectomy. Vasectomy was not associated with prostatecancer risk (hazard ratio [HR], 1.05; 95% CI, 0.96 to 1.15), and no evidence for heterogeneity in the association was observed by stage of disease or years since vasectomy. There was some evidence of heterogeneity by tumor grade ( P = .02), with an increased risk for low-intermediate grade (HR, 1.14; 95% CI, 1.01 to 1.29) but not high
Moderate Hypofractionation in High-Risk, Organ-Confined ProstateCancer: Final Results of a Phase III Randomized Trial Purpose To report the final results on treatment outcomes of a randomized trial comparing conventional and hypofractionated radiotherapy in high-risk, organ-confined prostatecancer (PCa). Patients and Methods This single-institution, randomized clinical trial, conducted from January 2003 to December 2007, enrolled 168 patients with high-risk PCa who were randomly assigned (...) in a 1:1 ratio to conventional (80 Gy in 40 fractions in 8 weeks) or hypofractionated radiotherapy (62 Gy in 20 fractions in 5 weeks) to prostate and seminal vesicles. The primary outcome measure was late toxicity. Additional outcomes were freedom from biochemical failure (FFBF), prostatecancer-specific survival (PCaSS), and overall survival (OS), evaluated on an intention-to-treat basis. Results A total of 85 patients were assigned to conventional and 83 to hypofractionated radiotherapy
The 4Kscore blood test accurately identifies men with aggressive prostatecancer prior to prostate biopsy with or without DRE information The 4Kscore Test is a prebiopsy blood test that incorporates four prostate protein biomarkers along with patient clinical information to determine a man's risk for high-grade, aggressive (Gleason ≥7) prostatecancer. However, some men likely to benefit from the test may be seen in primary care settings where the digital rectal examination (DRE) information (...) is not always obtained. In this study, we assessed the clinical validity of the 4Kscore Test when the DRE information was not included in the algorithm.The Prospective 4Kscore Validation Study enrolled 1012 men scheduled for prostate biopsy across 26 urology practices in the United States. The 4Kscore was calculated for each patient with and without DRE information. The primary outcome was Gleason ≥7 prostatecancer on prostate biopsy. The contribution of DRE to the predictive accuracy of the test
Malakoplakia of the Prostate as a Mimicker of ProstateCancer on Prostate Health Index and Magnetic Resonance Imagingâ€“Fusion Prostate Biopsy: A Case Report Background: Isolated malakoplakia of the prostate is a rare inflammatory condition that has been clinically mistaken for prostaticmalignancies. The development of Prostate Imaging Reporting and Data System (PI-RADS) classifications, and Prostate Health Index (PHI) has led to more accurate diagnosis of clinically significant disease (...) and stratification of patients that may be at risk of prostatecancer. Case Presentation: We present a case of a 75-year-old male who was on follow-up with our hospital for elevated prostate specific antigen (PSA). He was admitted for an episode of urosepsis, which was treated with antibiotics and subsequently underwent further workup and was found to have a raised PHI, as well as a high PI-RADS classification and was later found to have malakoplakia based on histology of prostate tissue obtained during targeted
Development of a new rutin nanoemulsion and its application on prostatecarcinoma PC3 cell line Biological effects of rutin bioactive are limited due to its poor oral bioavailability and its degradation in aqueous environments. For the purpose of bioenhancement, different nanoemulsion systems of rutin were developed by aqueous titration method using water as dispersion media. The nanoemulsion systems were characterized for surface morphology, droplet size, polydispersity index, zeta potential (...) , in vitro release profile and the formulations were optimized. The anticancer potential of optimized nanoemulsion was evaluated by cells viability (MTT) assay, nuclear condensation, and ROS activity using human prostatecancer (PC3) cell line. On the basis of cell viability data the inhibitory concentration (IC50) value for optimized nanoemulsion formulation on PC3 cancer cells was found to be 11.8 μM. Fluorescent microscopic analysis and intracellular ROS generation demonstrated significant ROS
Limitations Limited availability (restricted to centres with onsite generation facilities) Renal excretion (which makes assessment of primary prostatecancer and local nodes difficult) Uptake is not specific to malignanttumours 1 Efflux of tracer from the tumour after approximately 30min 1 Financial considerations Regulatory issues related to manufacturing Lack of qualified personnel to facilitate preparation at local level 7 Down-regulation of PSMA expression by androgen therapy 21 (...) in detecting recurrent disease compared with radioactive labelled choline. Definitions Prostatecancer recurrence: initially demonstrated by a rise in total serum prostate specific antigen, often despite normal findings with conventional imaging. Known as a biochemical relapse or recurrence 1 . Tracer: a radioactive labeled (radiolabelled) molecule that, when used with imaging, produces images to provide information about tissue metabolism, distribution of the molecule within tissues, or passage
procedures for recurrent prostatecancer; however, questions remain about its long-term efficacy for local and distant tumor control and survival. Relevant Questions: Does salvage HIFU provide effective local tumor control, acceptable rates of remission, and longterm, disease-free survival in patients with recurrent prostatecancer following failure of EBRT or RP? Does salvage HIFU provide acceptable outcomes with regard to urinary function, prostate symptoms, and sexual function? How does salvage HIFU (...) compare with other salvage treatment options for recurrent prostatecancer? Is salvage HIFU safe, and what are the related complications? Have definitive patient selection criteria been established for salvage HIFU treatment for recurrent prostatecancer? Final publication URL The report may be purchased from: Indexing Status Subject indexing assigned by CRD MeSH Chronic Disease; Humans; Male; Neoplasm Recurrence, Local; ProstaticNeoplasms; Salvage Therapy; Ultrasound, High-Intensity Focused
The Fitbit One Physical Activity Tracker in Men With ProstateCancer: Validation Study Physical activity after cancer diagnosis improves quality of life and may lengthen survival. However, objective data in cancer survivors are limited and no physical activity tracker has been validated for use in this population.The aim of this study was to validate the Fitbit One's measures of physical activity over 7 days in free-living men with localized prostate cancer.We validated the Fitbit One against (...) the gold-standard ActiGraph GT3X+ accelerometer in 22 prostatecancer survivors under free-living conditions for 7 days. We also compared these devices with the HJ-322U Tri-axis USB Omron pedometer and a physical activity diary. We used descriptive statistics (eg, mean, standard deviation, median, interquartile range) and boxplots to examine the distribution of average daily light, moderate, and vigorous physical activity and steps measured by each device and the diary. We used Pearson and Spearman
Hypofractionation trials and radiobiology of prostatecancer 28540332 2019 03 06 2331-4737 4 3-4 2017 Mar Oncoscience Oncoscience Hypofractionation trials and radiobiology of prostatecancer. 27-28 10.18632/oncoscience.347 Gulliford Sarah S The Institute of Cancer Research, London, UK. Hall Emma E The Institute of Cancer Research, London, UK. Dearnaley David D The Institute of Cancer Research, London, UK. eng 10588 Cancer Research UK United Kingdom 7253 Cancer Research UK United Kingdom (...) Editorial 2017 04 14 United States Oncoscience 101636666 2331-4737 hypofractionation prostate CONFLICTS OF INTEREST DD and EH are Chief Investigator and Clinical Trial Unit Lead for the CHHiP Trial funded by Cancer Reesearch UK and SG, DD and EH acknowledge NHS funding to the NIHR Biomedical Research Centre at the Royal Marsden NHS Foundation Trust and Institute of Cancer Research. 2016 12 19 2017 03 25 2017 5 26 6 0 2017 5 26 6 0 2017 5 26 6 1 epublish 28540332 10.18632/oncoscience.347 347 PMC5441472
Shared Decision-Making in Patients With ProstateCancer in Japan: Patient Preferences Versus Physician Perceptions This article adds the Japanese perspective to our knowledge of shared decision-making (SDM) preferences by surveying patients with prostatecancer (PCA) and physicians in Japan. In 2015, 103 Japanese patients with PCA were asked about their SDM preferences by using an Internet-based 5-point-scale questionnaire. Concurrently, 127 Japanese physicians were surveyed regarding (...) % of Japanese physicians underestimated patients' preference for involvement in making treatment decisions. Patients with lower health-related quality of life (as measured by the Functional Assessment of Cancer Therapy-Prostate [FACT-P]) expressed a stronger preference for SDM. The study shows that the worse the medical situation, the more patients with PCA prefer to be involved in the treatment decision, yet physicians tend to underestimate the preferences of their patients. Perhaps in contrast to common
Brachytherapy for Patients with ProstateCancer: American Society of Clinical Oncology/Cancer Care Ontario Joint Guideline Update Genitourinary Cancer | ASCO Search form Search ASCO Family of Sites ASCOconnection.org features blogs from ASCO members, the online version of the membership magazine, a discussion area, working groups, and links to the ASCO Membership Directory, Career Center, and Volunteer Portal. ASCO’s growing roster of cutting-edge journals serves readers as the most credible (...) , authoritative, peer-reviewed resources for significant clinical oncology research and research that informs the delivery of efficient, high-quality cancer care across the globe. ASCO Practice Central helps oncology professionals navigate a complicated and ever-changing practice environment—while providing high-quality patient care. ASCO University serves as a comprehensive eLearning and mobile learning center that supports lifelong learning for physicians, advanced practice providers, and patient educators
Robot-Assisted Laparoscopic Prostatectomy in a ProstateCancer Patient Undergoing Continuous Ambulatory Peritoneal Dialysis Background: Robot-assisted laparoscopic prostatectomy (RALP) has become the gold standard treatment for organ-confined prostatecancer. However, no proper surgical approach or appropriate postsurgical management of RALP has been established for a patient undergoing peritoneal dialysis. Here, we present a case of a peritoneal dialysis patient who underwent RALP (...) and reinstated peritoneal dialysis with no trouble associated with peritoneal dialysis. Case Presentation: The patient was a 61-year-old man with organ-confined prostatecancer. He had been on peritoneal dialysis for 2 years. The peritoneal dialysis catheter was routed subcutaneously from the left lateral region into the abdominal cavity at the paramedian region. RALP was performed by the transperitoneal anterior approach. The surgical maneuver was not influenced by the peritoneal dialysis catheter at all
Efficacy and Safety of Docetaxel in Elderly Patients With Metastatic Castration-Resistant ProstateCancer Limited data are available about the tolerability and clinical outcomes of elderly patients with metastatic castration-resistant prostatecancer (mCRPC) who are treated with docetaxel. We evaluated the efficacy and safety of docetaxel as first-line chemotherapy for patients with mCRPC who were treated in our institution.We retrospectively identified patients with mCRPC and a Karnosfky (...) performance status of 60% or greater treated with docetaxel on any schedule as first-line chemotherapy between 2008 and 2013. The primary end point was a comparison of median overall survival (OS) according to age in this population. Secondary end points were comparisons of the rates of severe toxicities, prostate-specific antigen (PSA) decline of 50% or greater, and time to progression (TTP). Results were stratified by three age groups: younger than 65 years, 65 to 74 years, and 75 years or older.Among
Association Between Choice of Radical Prostatectomy, External Beam Radiotherapy, Brachytherapy, or Active Surveillance and Patient-Reported Quality of Life Among Men With Localized ProstateCancer. Patients diagnosed with localized prostatecancer have to decide among treatment strategies that may differ in their likelihood of adverse effects.To compare quality of life (QOL) after radical prostatectomy, external beam radiotherapy, and brachytherapy vs active surveillance.Population-based (...) prospective cohort of 1141 men (57% participation among eligible men) with newly diagnosed prostatecancer were enrolled from January 2011 through June 2013 in collaboration with the North Carolina Central Cancer Registry. Median time from diagnosis to enrollment was 5 weeks, and all men were enrolled with written informed consent prior to treatment. Final follow-up date for current analysis was September 9, 2015.Treatment with radical prostatectomy, external beam radiotherapy, brachytherapy, or active