Prostate Cancer

        Prostate cancer, second only to skin cancer, is the most common cancer in American men. The American Cancer Society estimates that more than 174,000 new cases of prostate cancer will be diagnosed yearly.         Prostate cancer usually grows slowly. If confined to the prostate, it may not cause any serious damage. Prostate cancer is less likely than other cancers to spread to other parts of the body. However, in some cases, it can be more aggressive, making it one of the leading causes of cancer death among men of all races.         Diagnosis         One in six men will be diagnosed with prostate cancer during his lifetime. Men may have a higher risk for prostate cancer if they are African American, over the age of 65, have a family history of prostate canc...

Prostate cancer detection using transrectal ultrasound-guided biopsy provided the necessary diagnosis to recommend radical treatment. Until recently, patients had a limited number of treatments for localized prostate cancer. These limitations exacerbated the overtreatment of prostate cancer and caused concern that overdiagnosis should be prevented to limit unnecessary treatments and comorbidities. However, in other cancers facing similar concerns, attempts were made to reduce the treatment field and preserve the patient's quality of life while still receiving adequate treatment. Partial nephrectomy, lumpectomy, and other organ-preserving operations quickly gained momentum and were supported by studies showing the potential benefits. Yet, prostate cancer largely remained hindered by concerns that cancer detection was not sufficient to focally treat the prostate. This Achilles heel was finally remedied with the introduction of multiparametric MRI of the prostate. There is now a const...

Investigators will continue treating patients with GEN-1 plus neoadjuvant chemotherapy following the results of a pre-planned interim safety review of the phase 1/2 OVATION 2 study. A data safety monitoring board (DSMB) has unanimously agreed that the phase 1/2 OVATION 2 study (NCT03393884) should continue administering GEN-1 at a dose of 100mg/m2 for patients with advanced ovarian cancer following the results of a pre-planned interim safety review of 55 patients, according to a press release from drug developer Celsion Corporation. 1 Investigators reported that the trial, which had a confidence interval of 80%, identified a progression-free survival hazard ratio of 0.75, which translates to an approximate 33% improvement in risk of cancer progression in patients treated with GEN-1 and neoadjuvant chemotherapy vs neoadjuvant chemotherapy alone. "These findings show a consistent dose-dependent clinical response in both surgical outcome and tumor response, which is further supported...

Scott T. Tagawa, MD, MS, FACP: What is coming next, and what I am hoping for, is worldwide availability [of lutetium-177–PSMA-617] other than just in United States. I hope that [we see more FDA (US Food and Drug Administration) activity this year], now that this drug has breakthrough designation. Initially, I expect on-label use to involve prior use of at least 1 AR [androgen receptor] inhibitor and at least 1 taxane chemotherapy. I think that will be the initial period of time with ramp up. Even though I have been using this type of therapy since 2007, other people have never used it. This is a multidisciplinary type of an approach by nature, which is important to note. The VISION trial was a...

[unable to retrieve full-text content] Optimizing the number of cycles of neoadjuvant chemotherapy in advanced epithelial ovarian carcinoma: A propensity-score matching analysis    MD Linx

NEW YORK – With the help of whole-genome sequencing, a research team from the Netherlands has uncovered subtype-specific features and potentially targetable driver mutations in locally advanced or metastatic neuroendocrine neoplasms (aNEN) — malignancies stemming from neuroendocrine cells in the pancreas, gastrointestinal tract, lung, or other parts of the body. "Historically, [neuroendocrine neoplasm] has long been considered as a difficult malignancy to diagnose, monitor, and treat due to presentation of an inherently wide spectrum of disease progression, cellular differentiation, and low mutational burden, resulting in few targetable mutations and a relatively stable tumor genome," co-senior and co-corresponding author Bianca Mostert, a cancer researcher at Erasmus MC Cancer Institute, and her colleagues wrote. For a paper published in Nature Communications on Thursday, the researchers sequenced the genomes of biopsy samples from 85 individuals with locally advanced o...

Many people with lung cancer show no signs or symptoms at the early stages of cancer development. But by looking back at what symptoms people diagnosed with lung cancer have reported, we can gain insight into some early warning signs people at high risk for lung cancer can look out for. Early-stage lung cancer is more survivable than advanced cancers that have spread (metastasized) to other parts of the body. But because the lungs have very few nerve endings, they don't feel pain or other sensations, so early signs of lung cancer are hard to come by. Depending on the type of lung cancer developing, early signs of lung cancer might include referred pain (pain perceived in an area of the body other than the lungs, such as the shoulder), chronic cough, breathing issues, and weight loss. Some of these symptoms are dependent on the type of cancer, and not every early case of lung cancer has all of these symptoms. Most often, symptoms of lung cancer only show up as...

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Scientists have shown that the biological molecule PD-L1 is a potential target for the treatment of metastasized oral malignant melanoma in dogs. There are a number of cancers that affect dogs, but there are far fewer diagnosis and treatment options for these canine cancers. However, as dogs and humans are both mammals, it is likely that strategies and treatments for cancers in humans can be used for canine cancer, with minor modifications. A team of scientists, including Associate Professor Satoru Konnai from the Faculty of Veterinary Medicine at Hokkaido University, have demonstrated that an anti-cancer therapy that targets the cancer marker PD-L1--a target that has shown great promise for treating cancer in humans--is effective for canine cancer as well. Their findings were published in the journal  npj Precision Oncology . The proteins Programmed Cell Death 1 (PD-1) and its associated molecule, PD-ligand 1 (PD-L1) are involved in the immune response in humans. PD-L1 is ove...

Abstract BACKGROUND AND PURPOSE: Studies systematically evaluating the detection of intramedullary spinal cord metastasis with PET are lacking. Our purpose was to evaluate the visibility of intramedullary spinal cord metastasis on PET in a single institutional series and to correlate PET and MR imaging features. MATERIALS AND METHODS: Patients were included if pretreatment MR imaging identifying an intramedullary spinal cord metastasis and an [ 18 F] FDG-PET examination near the time of MR imaging were available. PET examinations were retrospectively reviewed, with reviewers blinded and then unblinded to the PET report and MR imaging findings. PET intramedullary spinal cord metastasis features were compared with and correlated with previously analyzed MR imaging lesion characteristics. Original clinical PET reports were reviewed. RESULTS: The final study sample was 10 PET examinations in 10 patients with 13 intramedullary spinal cord metastases. In 7 (70%) patients, ...

The MILO/ENGOT-ov11 study (NCT01849874) aims to determine the efficacy of binimetinib (Mektovi) versus physician's choice of chemotherapy (PCC). The study enrolled 341 patients between June 2013 to April 2016. Patients were randomized 2:1 to binimetinib or PCC. Progression-free survival (PFS) data is available for 144 patients and response rate data is available for 135 patients. Forty-seven mutations were found in 5% or more of participants.  According to the analysis, patients harboring a KRAS mutation had 3.4 times the odds of responding to treatment with binimetinib compared to patients who did not (95% CI, 1.57-7.67; P =.002). No difference in effects on PFS were observed between patients with KRAS G12C mutations and those with other KRAS mutations. However, PFS was found to be better in patients harboring a MAP kinase mutation versus those without (HR, 0.5; 95% CI 0.31-0.79; P = 0.003). The same was not observed for this population who received PCC. In ...