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cohort in phase II will be reported separately.EPI is a noninvasive, easy-to-use, gene expression urine assay, which has now been successfully validated in over 1000 patients across two prospective validation trials to stratify risk of ≥GG2 from GG1 cancer and benign disease. The test improves identification of patients with higher grade disease and would reduce the total number of unnecessary biopsies.It is challenging to predict which men are likely to have high-grade prostatecancer (PCa (...) A Prospective Adaptive Utility Trial to Validate Performance of a Novel Urine Exosome Gene Expression Assay to Predict High-grade ProstateCancer in Patients with Prostate-specific Antigen 2-10ng/ml at Initial Biopsy Discriminating indolent from clinically significant prostatecancer (PCa) in the initial biopsy setting remains an important issue. Prospectively evaluated diagnostic assays are necessary to ensure efficacy and clinical adoption.Performance and utility assessment of ExoDx Prostate
Radiotherapy to the primary tumour for newly diagnosed, metastatic prostatecancer (STAMPEDE): a randomised controlled phase 3 trial. Based on previous findings, we hypothesised that radiotherapy to the prostate would improve overall survival in men with metastatic prostatecancer, and that the benefit would be greatest in patients with a low metastatic burden. We aimed to compare standard of care for metastatic prostatecancer, with and without radiotherapy.We did a randomised controlled phase (...) 3 trial at 117 hospitals in Switzerland and the UK. Eligible patients had newly diagnosed metastatic prostatecancer. We randomly allocated patients open-label in a 1:1 ratio to standard of care (control group) or standard of care and radiotherapy (radiotherapy group). Randomisation was stratified by hospital, age at randomisation, nodal involvement, WHO performance status, planned androgen deprivation therapy, planned docetaxel use (from December, 2015), and regular aspirin or non-steroidal
2018LancetControlled trial quality: predicted high
ASTRO/AUA Guideline on Hypofractionation for Localized ProstateCancer Supplemental Materials for Hypofractionated Radiation Therapy for Localized ProstateCancer: Executive Summary of an ASTRO, ASCO, and AUA Evidence-Based Guideline - Practical Radiation Oncology Email/Username: Password: Remember me Search Terms Search within Search Share this page: Volume 8, Issue 6, Pages 354–360 Hypofractionated Radiation Therapy for Localized ProstateCancer: Executive Summary of an ASTRO, ASCO, and AUA (...) period for guideline), Bayer (Joint Safety Review Committee; ended during disclosure period for guideline); Per Halvorsen: American College of Radiology Radiation Oncology Practice Accreditation program (honoraria, travel expenses); Karen Hoffman: Vanderbilt University (consultant); Patrick Greany: Department of Defense ProstateCancer Research Program (research funding, honoraria, travel expenses); Bridget Koontz: Janssen (research funding), Blue Earth Diagnostics (advisory board), American Society
and identifying optimal treatment, while considering such factors as disease stage, risk, volume, age, and performance status. The purpose of this American Society of Clinical Oncology (ASCO) guideline is to endorse the American Urological Association (AUA), American Society for Radiation Oncology (ASTRO), and Society of Urologic Oncology (SUO) guideline on Clinically Localized ProstateCancer by Sanda et al, , which was published online in 2017 (available at ) and in print in 2018. This ASCO endorsement (...) POPULATION Section: The Clinically Localized ProstateCancer guideline made recommendations according to shared decision making, cancer severity/risk group (very low– and low-risk disease, intermediate-risk disease, high-risk disease), recommended treatment approaches (active surveillance, prostatectomy, radiotherapy, cryosurgery, high intensity focal ultrasound/focal therapy), and outcome expectations and management (treatment-related adverse events and health-related quality of life, post-treatment
Early Detection of ProstateCancerProstateCancer: Early Detection Guideline - American Urological Association advertisement Toggle navigation About Us About the AUA Membership AUA Governance Industry Relations Education AUAUniversity Education Products & Resources Normal Histology and Important Histo-anatomic Structures Urinary Bladder Prostate Kidney Renovascular Diseases Andrenal Gland Testis Paratesticular Tumors Penis Retroperitoneum Cytology Online Learning For Medical Students Exams/LLL (...) and Quality of Care Accreditations and Reporting Patient Education Early Detection of ProstateCancer (2018) Published 2013; Reviewed and Validity Confirmed 2018 The clinical guideline on Early Detection of ProstateCancer discusses the detection of disease at an early, pre-symptomatic stage through the use of screening tools, such as PSA. Early detection allows for more conservative management, if needed, via means such as active surveillance and watchful waiting. [pdf] Panel Members H. Ballentine Carter
Hypofractionated Radiation Therapy for Localized ProstateCancerProstateCancer: Hypofractionated Radiotherapy Guideline - American Urological Association advertisement Toggle navigation About Us About the AUA Membership AUA Governance Industry Relations Education AUAUniversity Education Products & Resources Normal Histology and Important Histo-anatomic Structures Urinary Bladder Prostate Kidney Renovascular Diseases Andrenal Gland Testis Paratesticular Tumors Penis Retroperitoneum Cytology (...) is considered low compared to most other neoplasms, with several estimates derived from large populations in the range of 100 to 200 cGy. 5-7 Unlike other solid tumors with higher alpha-beta ratios, the alpha-beta ratio of the adjacent dose-limiting normal structure, namely the rectum, has been estimated to be greater than that of prostatecancer itself. 8,9 An implication of this relationship is that hypofractionation - daily delivery of EBRT with fraction sizes >200 cGy - may further improve
Castration-Resistant ProstateCancerProstateCancer: Castration Resistant Guideline - American Urological Association advertisement Toggle navigation About Us About the AUA Membership AUA Governance Industry Relations Education AUAUniversity Education Products & Resources Normal Histology and Important Histo-anatomic Structures Urinary Bladder Prostate Kidney Renovascular Diseases Andrenal Gland Testis Paratesticular Tumors Penis Retroperitoneum Cytology Online Learning For Medical Students (...) and dangerous drug interactions. This document was amended in April 2014 and March 2015 to reflect literature that was released since the original publication of this guideline in May 2013. An additional amendment was conducted in 2018 to reflect new literature released related to the treatment of patients with non-metastatic castration-resistant prostatecancer. This document will continue to be periodically updated to reflect the growing body of literature related to this disease. Panel Members Michael S
Randomized Trial of Hypofractionated, Dose-Escalated, Intensity-Modulated Radiation Therapy (IMRT) Versus Conventionally Fractionated IMRT for Localized ProstateCancer Hypofractionated radiotherapy delivers larger daily doses of radiation and may increase the biologically effective dose delivered to the prostate. We conducted a randomized trial testing the hypothesis that dose-escalated, moderately hypofractionated intensity-modulated radiation therapy (HIMRT) improves prostatecancer control (...) compared with conventionally fractionated IMRT (CIMRT) for men with localized prostate cancer.Men were randomly assigned to 75.6 Gy in 1.8-Gy fractions delivered over 8.4 weeks (CIMRT) or 72 Gy in 2.4 Gy fractions delivered over 6 weeks (HIMRT, biologically equivalent to 85 Gy in 1.8-Gy fractions assuming prostatecancer α-to-β ratio of 1.5). Failure was defined as prostate-specific antigen (PSA) failure (nadir plus 2 ng/mL) or initiation of salvage therapy. Modified Radiation Therapy Oncology Group
allocation. The primary endpoint was investigator-assessed radiographic progression-free survival (rPFS; based on Response Evaluation Criteria in Solid Tumors version 1.1 and ProstateCancer Clinical Trials Working Group 2 criteria). Efficacy analyses were done in the intention-to-treat population, which included all randomly assigned patients, and safety analyses included all patients who received at least one dose of olaparib or placebo. This trial is registered with ClinicalTrials.gov, number (...) Olaparib combined with abiraterone in patients with metastatic castration-resistant prostatecancer: a randomised, double-blind, placebo-controlled, phase 2 trial Patients with metastatic castration-resistant prostatecancer and homologous recombination repair (HRR) mutations have a better response to treatment with the poly(ADP-ribose) polymerase inhibitor olaparib than patients without HRR mutations. Preclinical data suggest synergy between olaparib and androgen pathway inhibitors. We aimed
5-year survival rate is around 100% for local- and regional-stage prostatecancer, and around 30% for distant-stage prostatecancer (based on data from 2007 to 2013). Definition A malignanttumour of glandular origin, situated in the prostate. It is most commonly seen in older men; between 2011 and 2015 the median age at diagnosis in the US was 66 years. National Cancer Institute; Surveillance, Epidemiology, and End Results program (SEER). SEER stat fact sheets: prostatecancer. 2018 [internet (...) is the principal investigator of an R-21 NIH research grant investigating the tumour-mediated immune responses in African-American men with prostatecancer. Professor Department of Radiation Oncology University of Texas MD Anderson Cancer Center Houston TX Disclosures MSA declares that he has no competing interests. Peer reviewers Clinical Oncology Registrar St Luke's Cancer Centre Royal Surrey Hospital Guildford Surrey UK Disclosures EA has received consultation fees from the following organisations during
Development, Evaluation, and Implementation of a Pan-African Cancer Research Network: Men of African Descent and Carcinoma of the ProstateCancer of the prostate (CaP) is the leading cancer among men in sub-Saharan Africa (SSA). A substantial proportion of these men with CaP are diagnosed at late (usually incurable) stages, yet little is known about the etiology of CaP in SSA.We established the Men of African Descent and Carcinoma of the Prostate Network, which includes seven SSA centers (...) and shipped it to the Center for Inherited Disease Research (Baltimore, MD) and the Centre for Proteomics and Genomics Research (Cape Town, South Africa), where genotypes were generated using the UK Biobank Axiom Array.We used common instruments for data collection and entered data into the shared database. Double-entered data from pilot participants showed a 95% to 98% concordance rate, suggesting that data can be collected, entered, and stored with a high degree of accuracy. Genotypes were obtained from
Effective Project Management of a Pan-African Cancer Research Network: Men of African Descent and Carcinoma of the Prostate (MADCaP) Health research in low- and middle-income countries can generate novel scientific knowledge and improve clinical care, fostering population health improvements to prevent premature death. Project management is a critical part of the success of this research, applying knowledge, skills, tools, and techniques to accomplish required goals. Here, we describe (...) the development and implementation of tools to support a multifaceted study of prostatecancer in Africa, focusing on building strategic and operational capacity.Applying a learning organizational framework, we developed and implemented a project management toolkit (PMT) that includes a management process flowchart, a cyclical center-specific schedule of activities, periodic reporting and communication, and center-specific monitoring and evaluation metrics.The PMT was successfully deployed during year one
Patterns in Patients With Metastatic Castration-Resistant ProstateCancer Previously Treated With Docetaxel-Based Chemotherapy) is a large, global, prospective registry study evaluating real-world treatment patterns of patients with mCRPC who experience disease progression during or after docetaxel therapy. Patients were enrolled worldwide between 2011 and 2014. Treatments were determined by the treating physicians and recorded in categories of chemotherapy, hormonal therapy, targeted therapy (...) Metastatic Castration-Resistant ProstateCancer Previously Treated With Docetaxel-Based Chemotherapy: Treatment Patterns From the PROXIMA Prospective Registry There is a major clinical need to devise an optimal treatment sequence for the multiple therapy options available for patients with metastatic castration-resistant prostatecancer (mCRPC). In the absence of prospective clinical trials, sequencing information can be derived from large, real-world registry studies.PROXIMA (Treatment
Specific Antigen, serum protein associated with prostatecancer QoL Quality of life RD Risk difference RCT Randomized controlled trial RT Radiotherapy RTOG Radiation Therapy Oncology Group criteria, a scoring schema for radiation toxicity rV Volume of rectal tissue receiving a particular dose of radiation. E.g. rv70 is the volume of rectum receiving a dose of 70 Gy SBRT Stereotactic body radiation therapy TAU MUHC Technology Assessment Unit TNM Tumor Node Metastasis- Cancer classification VMAT (...) prostatecancer with low to intermediate risk. Hypofractionated radiotherapy delivers the conventional radiation dose of EBRT in fewer daily treatments. Hence, a larger daily dose of radiation (>2 Gy) is delivered in comparison with conventional EBRT. Hypofractionation or dose-escalation seeks to achieve more accurate targeting of the tumor while simultaneously increasing the dose of radiation. 2-4 However, as the rectum is adjacent to the prostate, it receives a substantial amount of radiation; hence
-naïve metastatic castration-resistant prostatecancer received open-label enzalutamide 160 mg daily. Men with no prostate-specific antigen (PSA) increase at weeks 13 and 21 were treated until PSA progression (≥ 25% increase and ≥ 2 ng/mL above nadir), then randomly assigned at a one-to-one ratio in period two to abiraterone acetate 1,000 mg daily and prednisone 5 mg twice daily with either enzalutamide or placebo (combination or control group, respectively) until disease progression as defined (...) Abiraterone Alone or in Combination With Enzalutamide in Metastatic Castration-Resistant ProstateCancer With Rising Prostate-Specific Antigen During Enzalutamide Treatment Purpose Enzalutamide resistance could result from raised androgens and be overcome by combination with abiraterone acetate. PLATO ( ClinicalTrials.gov identifier: NCT01995513) interrogated this hypothesis using a randomized, double-blind, placebo-controlled design. Patients and Methods In period one, men with chemotherapy
of malignanttumors. UICC International Union Against Cancer. 8th edn. 2017. 73. Cooperberg, M.R., et al. The University of California, San Francisco Cancer of the Prostate Risk Assessment score: a straightforward and reliable preoperative predictor of disease recurrence after radical prostatectomy. J Urol, 2005. 173: 1938. 74. Epstein, J.I., et al. The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of ProstaticCarcinoma. Am J Surg Pathol, 2005. 29: 1228 (...) as predictors for prostatecancer. J Clin Oncol, 2009. 27: 398. 133. Stephan, C., et al. The influence of prostate volume on the ratio of free to total prostate specific antigen in serum of patients with prostatecarcinoma and benign prostate hyperplasia. Cancer, 1997. 79: 104. 134. Catalona, W.J., et al. Use of the percentage of free prostate-specific antigen to enhance differentiation of prostatecancer from benign prostaticdisease: a prospective multicenter clinical trial. JAMA, 1998. 279: 1542. 135