Prostate Cancer

Although one in nine men will receive a prostate cancer diagnosis in his lifetime, cutting-edge research has allowed more men to live longer or even be cured. Statistics show that one in nine men will receive a prostate cancer diagnosis during his lifetime, making it the most common cancer among men after skin cancer. But thanks to the work being done at institutions like City of Hope Comprehensive Cancer Center in California, more men are being cured each year, and those who aren’t cured are living longer. One such program that sheds light on this cause is City of Hope’s NoShaver November. The month-long fundraising and awareness campaign urges participants to forego shaving to start a conversation, encourage testing and raise critical funds to continue leading-edge prostate cancer research and promising new therapies conducted at City of Hope.  CURE ® recently spoke with Dr.  Tanya Dorff , a medical oncologist at City of Hope who specializes in prostate cancer, about the...

IMAGE:  Images were acquired 6 days after injection and are displayed at same gray scale with SUVmax of 10. Patients in upper panel (particularly patients 3 and 9) have extensive metastatic... view more  Credit: Jorge A. Carrasquillo, Bernard M. Fine, Neeta Pandit-Taskar, Steven M. Larson et al. Memorial Sloan Kettering Cancer Center and Genentech Inc. A recently discovered prostate cancer-selective antigen has been identified as a useful molecular imaging target for the detection and targeting of metastatic prostate cancer lesions, as reported in the November issue of The Journal of Nuclear Medicine . Using a novel radiotracer, researchers were able to effectively image STEAP1 (six-transmembrane epithelial antigen of prostate-1) in tumors and localize a large number of lesions. Metastatic castration-resistant prostate cancer (mCRPC) is a significant health care problem, with more than 42,000 cases projected in 2020. "While significant strides have been made in detec...

Surgical castration for metastatic prostate cancer is used less frequently than medical castration, yet costs less, requires less follow-up, and may be associated with fewer adverse effects. We sought to evaluate temporal trends and factors associated with the use of surgical castration. This retrospective cohort study sampled 24,805 men with newly diagnosed (de novo) metastatic prostate cancer from a national cancer registry in the United States (2004-2016). Multivariable logistic regression assessed the association between sociodemographics and surgery. Multivariable Cox regression evaluated the association between castration type and overall survival. Overall, 5.4% of men received surgical castration. This decreased from 8.5% in 2004 to 3.5% in 2016 (Per year later: OR 0.89, 95% CI 0.87-0.91,p<0.001). Compared to Medicare, private insurance was associated with less surgery (OR 0.73, 95% CI 0.61-0.87, p<0.001) while Medicaid or no insurance was associated with more surgery (O...

Professor Samer Ezziddin. Credit: Thorsten Mohr Prostate cancer accounts for 26 percent of male cancer cases diagnosed in Germany, making it the most common form of malignant tumor in men. If the cancer becomes metastatic, it is not unlikely that it will prove fatal in the generally elderly patients. Scientists and doctors at Saarland University Hospital recently conducted a clinical trial in which they established the effectiveness of a therapeutic method that is successful in controlling late-stage prostate tumors and their metastases without causing serious side effects. The novel element in their approach involves combining two radioactive substances that are able to destroy the tumor cells by very precisely irradiating them at very short (millimeter or micrometer) range. As a result, a patient's life expectancy can be extended without any substantial impairment in quality of life. The pilot study, which was led by nuclear radiologist Professor Samer Ezziddin, has been p...

Reports of new cancer treatments often raise high hopes and expectations, particularly, of course, among cancer patients and their families. But raising expectations is not something that Samer Ezziddin, Professor of Nuclear Medicine and Director of the Department of Nuclear Medicine at Saarland University Hospital is keen to do. 'In most cases, we cannot heal the patients who take part in our therapeutic programme. Our aim is to extend life expectancy by a number of months or even years, without impairing the patients' quality of life,' explains Ezziddin. And although over the course of his career he has seen patients whose cancer has regressed completely despite extremely poor prognoses, such cases remain the exception and should be regarded as 'statistical outliers' rather than miracle cures. The battle to treat the many different varieties of cancer continues to be very challenging, involving careful but laborious work, where progress is measured in small step...

Sometimes after finishing prostate cancer treatment, men get an unwelcome surprise: their prostate-specific antigen (PSA) levels creep higher, suggesting tumors too small to be seen lurk somewhere in the body. This leads to several options. Doctors can continue to monitor a man’s condition with imaging scans. Or, given the anxiety associated with rising PSA, they might try to lower the levels with chemically “castrating” drugs that inhibit testosterone, a hormone that makes prostate tumors grow faster. Following that treatment, called androgen deprivation therapy (ADT), PSA generally declines and may become undetectable. But what if PSA climbs further despite ADT’s inhibiting effects on testosterone? This condition is called nonmetastatic, castration-resistant prostate cancer (nmCRPC). It’s called “nonmetastatic” because cancer hasn’t spread in a way that’s detectable with imaging technology. And it’s called “castration-resistant” because PSA isn’t responding to the chemically castrat...

[embedded content] David F. Penson, MD, MPH, MMHC, chair, Department of Urology, and Paul V. Hamilton, MD and Virginia E. Howd Chair, Urologic Oncology, at Vanderbilt University Medical Center, discusses treatment selection in patients with metastatic hormone-sensitive prostate cancer. Several FDA-approved agents are indicated for patients with mHSPC, including apalutamide (Erleada), abiraterone acetate (Zytiga), and docetaxel. Notably, the FDA granted a priority review designation to a supplemental new drug application for enzalutamide (Xtandi) for the treatment of patients with metastatic hormone-sensitive disease, based on data from the phase III ARCHES and ENZAMET trials. Given the number of agents that are available in this setting, treatment can be individualized to each patient. For example, patients who have epilepsy would not do well on enzalutamide, says Penson. If the patient is a frail diabetic, they may not do well on abiraterone or docetaxel. If a patient has a hi...

[embedded content] David F. Penson, MD, MPH, MMHC, chair, Department of Urology, and Paul V. Hamilton, MD and Virginia E. Howd Chair, Urologic Oncology, at Vanderbilt University Medical Center, discusses treatment selection in patients with metastatic hormone-sensitive prostate cancer. Several FDA-approved agents are indicated for patients with mHSPC, including apalutamide (Erleada), abiraterone acetate (Zytiga), and docetaxel. Notably, the FDA granted a priority review designation to a supplemental new drug application for enzalutamide (Xtandi) for the treatment of patients with metastatic hormone-sensitive disease, based on data from the phase III ARCHES and ENZAMET trials. Given the number of agents that are available in this setting, treatment can be individualized to each patient. For example, patients who have epilepsy would not do well on enzalutamide, says Penson. If the patient is a frail diabetic, they may not do well on abiraterone or docetaxel. If a patient has a hi...

Metastatic prostate cancer remains a life-limiting disease; while we have seen significant advances in systemic approaches which form the backbone of management, no curative paradigm yet exists. Metastasis-directed therapy (MDT) with stereotactic ablative radiotherapy (SABR) has emerged as a promising complementary technique for the management of low-volume metastatic prostate cancer. Herein we will review the rationale, potential benefits, and practical considerations associated with this approach. Oncology (Williston Park, N.Y.). 2019 Oct 28*** epublish *** Ryan M Phillips, Matthew P Deek, Theodore L Deweese, Phuoc T Tran PubMed http://www.ncbi.nlm.nih.gov/pubmed/31661149 https://ift.tt/2XBFl8R

Prostate-specific membrane antigen (PSMA) is a well-established therapeutic and diagnostic target overexpressed in both primary and metastatic prostate cancers. PSMA antibody-drug conjugate (PSMA ADC) is a fully human immunoglobulin G1 anti-PSMA monoclonal antibody conjugated to monomethylauristatin E, which binds to PSMA-positive cells and induces cytotoxicity. In a phase 1 study, PSMA ADC was well tolerated and demonstrated activity as measured by reductions in serum prostate-specific antigen (PSA) and circulating tumor cells (CTCs). To further assess PSMA ADC, we conducted a phase 2 trial in metastatic castration-resistant prostate cancer (mCRPC) subjects who progressed following abiraterone/enzalutamide (abi/enz) therapy. A total of 119 (84 chemotherapy-experienced and 35 chemotherapy-naïve) subjects were administered PSMA ADC 2.5 or 2.3 mg/kg IV q3w for up to eight cycles. Antitumor activity (best percentage declines in PSA and CTCs from baseline and tumor responses through r...

Some patients experience oligo-progression during androgen receptor targeted therapy (ARTT) treatments. This progression might not indicate a real systemic drug resistance, but a selective monoclonal resistance. With the aim to delay the start of new line treatments we treated oligo-progressive sites with radiotherapy. From June 2011 to Febrary 2019, 29 consecutive metastatic castration resistant prostate cancer (mCRPC) patients were submitted to radiotherapy for oligo-progression (1-3 sites) during ARTT for a total of 37 lesions treated. Thirty-one (83.8%) lesions were treated with conformal radiotherapy and 6 (16.2%) with stereotactic radiotherapy. After radiotherapy all patients continued ARTT. Median OS (calculated from ARTT start) was 46,6 months (range 4.4-97.5 months), 2 and 3-year OS were 82.8 and 70.7%, respectively. Median PFS was 18,4 months (range 4.4-45.3 months), 2 and 3-year PFS were 38.3 and 8.5%, respectively. Median overall duration of ARTT treatment was 14.8 months...

While in treatment for aggressive prostate cancer at the VA Puget Sound Health Care System in Seattle, Navy Veteran Allen Petchnick faced a daunting situation. His PSA blood test, the main screening tool for cancer of the prostate, had risen to 13, which for him was dangerously high. Plus, his cancer had spread to other parts of his body. “He was looking at very tough outcomes,” says Dr. Bruce Montgomery, an oncologist at VA Puget Sound. “He was passing out because his tumor had metastasized to lymph nodes in his neck, which was pressing against one of his arteries.” Montgomery led a team that performed DNA sequencing on tissue from Petchnick’s lymph nodes. They spotted mismatch repair (MMR) deficient cells , which usually have genetic mutations that could lead to cancer. Petchnick received immunotherapy, a form of precision oncology in which organisms in the body’s immune system are used to fight cancer. Now age 79, he’s been on immunotherapy drugs for nearly two years. His PSA lev...

Myovant announced that its Phase III HERO trial relugolix met its primary endpoint and six key secondary endpoints in advanced prostate cancer. The company expects to use the data for a New Drug Application (NDA) to the U.S. Food and Drug Administration (FDA) in the second quarter of 2020 and future submissions in Europe and Japan. Myovant is one of the five Vant companies under Vivek Ramaswamy’s Roivant Sciences that was part of the $3 billion deal with Sumitomo Dainippon Pharma. Earlier this month, Roivant agreed to sell ownership of five its Vant companies to Sumitomo Dainippon Pharma. Relugolix is a once-daily, oral gonadotropin-release hormone (GnRH) receptor antagonist that decreases testicular testosterone production. Testosterone is primarily responsible for stimulating prostate cancer. In analysis of the responders, 96.7% of men receiving relugolix achieved sustained testosterone suppression to castrate levels. The company defined “responder” as achieving and maintainin...

Archie Bleyer Incidence of prostate cancer among adolescents and young adults has increased in the United States and many other countries during the past 3 decades, according to study results published in Cancer . Further, young men with prostate cancer appeared less adequately staged at diagnosis and at higher risk for metastatic disease and death compared with older-aged men. “Incidence of invasive cancer among [men aged 20 to 40 years] in the U.S. has been increasing in distinct contrast to older Americans, among whom incidence has been decreasing,” Archie Bleyer, MD, researcher in the department of radiation medicine at Oregon Health & Science University, told HemOnc Today . “Primary care providers should not exclude the possibility of prostate cancer in their male patients who are between [ages] 20 and 40 years, a potential diagnosis that would rarely have been considered previously. Oncologists, too, may want to include the possibility in their differential diagnosis...

Researchers from MD Anderson in Texas have uncovered new clues as to why immunotherapy may fail in ... [+] many men with prostate cancer. Getty Immunotherapy drugs called immune checkpoint inhibitors have revolutionized therapy for several types of cancer. However, so far these drugs have been mostly ineffective for one of the most common types, prostate cancer. New work from researchers at MD Anderson Cancer Center in Texas has revealed a major new clue as to why immunotherapy has been largely unsuccessful o far in these patients. The research published this week in the journal Cell , describes how the metastatic prostate tumors destroy bone, unleashing a protein called TGF-Beta (β), which disrupts tumor-busting immune cells. They show that T-cells which would normally be stimulated to attack the tumor after treatment with immune checkpoint inhibitors are blocked by TGF-β. Prostate cancer is a common cancer in men and often becomes significantly more serious for the patient ...

The last five years has witnessed a remarkable evolution in the management of metastatic hormone-sensitive prostate cancer (mHSPC), with multiple agents demonstrating profound benefit in combination with initial androgen deprivation therapy (ADT). Historically, in a time when systemic therapy options were scarce, the responsibility of monitoring ADT efficacy fell squarely on urologists. As the disease progressed inevitably to the castration-resistant state, primary care would transition to medical oncologists, with urologists limited to providing interventional support for local complications on an as needed basis. BJU international. 2019 Oct 29 [Epub ahead of print] I A Thangasamy, E M Kwan, J Teh, N Sathianathen, O Alghazo, S Siva, A Azad, D G Murphy Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia., Department of Medicine, School of Clinical Sciences, Monash University, Australia., Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbo...

Prostate cancer that spreads to the bone triggers the destruction of bone tissue that, in turn, thwarts the effectiveness of immune checkpoint inhibitors by blocking the development of T cells that are crucial to successful treatment, researchers from The University of Texas MD Anderson Cancer Center report in Cell. The discoveries by a team led by Padmanee Sharma, M.D., Ph.D., professor of Genitourinary Medical Oncology and Immunology at MD Anderson, explain why immunotherapy has been largely unsuccessful against prostate cancer bone metastases and point to a possible combination that could reverse the resistance. Their findings also highlight the need to look at metastatic cancer in a different light. We tend to think of stage 4 disease as being uniform, but it's not all the same. We need to be more thoughtful about the immune microenvironment in different areas of metastasis to take into account different immune responses in those microenvironments when we develop treatment...

[unable to retrieve full-text content] Trovagene (TROV) Presents Positive Data in Metastatic Prostate Cancer Phase 2 Trial Showing Clinical Response in Patients Resistant to Zytiga    StreetInsider.com https://ift.tt/2CIW3th

Immuno-oncology therapies like checkpoint-inhibiting drugs have been largely ineffective in prostate cancer. Researchers at the University of Texas MD Anderson Cancer Center want to change that—and they believe they’ve found a drug combination strategy that could work. The challenge in treating prostate cancer is that when the tumors spread to bone, they destroy tissue, and in so doing they block the development of immune-boosting T cells that are critical to the success of checkpoint inhibitors. The MD Anderson team scrutinized that process in the hopes of finding a therapy that would prevent it. They discovered that when tumors destroy bone, massive amounts of a protein called transformational growth factor-beta (TFG-beta) are produced. That prevents helper T cells from transforming into the Th1 CD4 effector cells that would normally prompt the immune system to recognize and attack cancer in response to treatment with checkpoint inhibitors. Combining an anti-TGF-beta drug with a c...

  SAN DIEGO , Nov.14, 2019 /PRNewswire/ --  TrovaGene, Inc. ,   (Nasdaq: TROV), a clinical-stage, Precision Cancer Medicine™ oncology therapeutics company developing drugs that target cell division (mitosis), for the treatment of various cancers including prostate, colorectal and leukemia, today announced new positive data from its Phase 2 trial evaluating onvansertib in combination with Zytiga® (abiraterone acetate - Johnson & Johnson)/prednisone in patients with metastatic Castration-Resistant Prostate Cancer (mCRPC). The data are being presented today at the European Multidisciplinary Congress on Urological Cancers (EMUC) in Vienna, Austria . "The new data shared today builds upon the encouraging clinical response seen to date when onvansertib is added to treatment in patients who have developed resistance to androgen receptor signaling inhibitor (ARSi), Zytiga®," said Dr. Mark Erlander , Chief Scientific Officer of Trovagene. "Of particul...