Prostate Cancer

Nearly one in six deaths from prostate cancer could be prevented if targeted screening was introduced for men at a higher genetic risk of the disease, according to a new UCL-led computer modelling study. Prostate cancer is the most common form of cancer in men with around 130 new cases diagnosed in the UK every day and more than 10,000 men a year dying as a result of the disease. However, unlike breast and cervical cancer there is currently no national screening programme for this disease in the UK. A blood test that detects raised levels of the prostate-specific antigen (PSA) can be used to screen for prostate cancer. However, this test is not a reliable indicator as it does not accurately distinguish between dangerous cancers from harmless ones -- leading to both unnecessary operations and missed cancers that are harmful. The study, published in PLOS Medicine , modelled the harms and benefits of introducing four-yearly PSA screening for all men aged 55 to 69 versus more targeted ...

Chemotherapy with cabazitaxel ( Jevtana, Sanofi-Aventis) beat treatment with an androgen-signaling inhibitor in the second-line treatment of metastatic castrate-resistant prostate cancer (mCRPC). The first-line treatment for these patients was with docetaxel and then with one of the androgen-signaling inhibitors, either abiraterone (multiple brands) or enzalutamide (Xtandi, Astellas). However, there was evidence of rapid disease progression, and so second-line treatment with either cabazitaxel or the other androgen-signaling inhibitor was initiated. The results showed that men who received carbazitaxel had more than double the rate of imaging-based progression-free survival (PFS; median, 8.0 months vs 3.7 months) and significantly improved overall survival (OS; median, 13.6 months vs 11 months). "Cabazitaxel remained superior regardless of the androgen-signaling-targeted inhibitor received," note the investigators, led by Ronald de Wit, MD, PhD, Erasmus Medical Center,...

Chemotherapy with cabazitaxel ( Jevtana, Sanofi-Aventis) beat treatment with an androgen-signaling inhibitor in the second-line treatment of metastatic castrate-resistant prostate cancer (mCRPC). The first-line treatment for these patients was with docetaxel and then with one of the androgen-signaling inhibitors, either abiraterone (multiple brands) or enzalutamide (Xtandi, Astellas). However, there was evidence of rapid disease progression, and so second-line treatment with either cabazitaxel or the other androgen-signaling inhibitor was initiated. The results showed that men who received carbazitaxel had more than double the rate of imaging-based progression-free survival (PFS; median, 8.0 months vs 3.7 months) and significantly improved overall survival (OS; median, 13.6 months vs 11 months). "Cabazitaxel remained superior regardless of the androgen-signaling-targeted inhibitor received," note the investigators, led by Ronald de Wit, MD, PhD, Erasmus Medical Center,...

To estimate the probability of downgrading to Gleason score ≤7 at radical prostatectomy for men with a prostate needle biopsy demonstrating Gleason score 8 (4 + 4). This is a retrospective review of men with Gleason score 8 (4 + 4) prostate cancer on needle biopsy who then underwent a radical prostatectomy at the Karmanos Cancer Institute or the University of Michigan. Men with any pattern 5 on the diagnostic biopsy were excluded. The objective was to estimate the proportion of patients whose tumors were downgraded to Gleason score ≤7 at radical prostatectomy and to identify clinical and biopsy parameters associated with downgrading. Median age of our cohort was 63 years (IQR: 59, 67.5) and median follow-up was 15 months (IQR: 7, 37). Of the 105 men that met inclusion criteria, 59% (62/105) were downgraded to Gleason score ≤7 at radical prostatectomy. Having ≤2 cores demonstrating Gleason score 8, ≤50% maximal tumor involvement of any individual core positive for Gleason score 8, or ...

Use of inpatient palliative care (IPC) in advanced cancer patients represents a well-established guideline recommendation. A recent analysis demonstrated that genitourinary (GU) cancer patients benefited of IPC at the second lowest rate within the four examined primaries, namely lung, breast, colorectal, and GU. Based on this observation, we examined temporal trends and predictors of IPC use in metastatic prostate cancer patients receiving critical care therapies (CCT). We identified mPCa patients receiving CCT within the Nationwide Inpatient Sample database (2004-2015). IPC use rates were evaluated using univariable estimated annual percentage changes analyses. Multivariable logistic regression (MLR) models were used after adjustment for clustering at hospital level. Of 4168 mPCa patients receiving CCT, 449 (11.3%) received IPC. IPC use increased from 1.2 to 22.3% (EAPC: +19.6%, p < 0.001). After stratification according to regions, race, and teaching status, the highest increase...

Prostate cancer (PCa), the sixth primary cause of cancer death. Still, conflicts are present about the efficacy and safety of Non-steroidal anti-androgens (NSAA). Aim of this study was to assess the efficacy and safety of NSAAs versus any comparator for the treatment of advanced or metastatic PCa. MEDLINE and the Cochrane Library were searched. References of included studies and clinicaltrials.gov were also searched for relevant studies. Only English language studies after 1990 were considered for review. Randomized controlled trials (RCTs) examining the efficacy and safety of NSAAs compared with any comparator including surgery or chemotherapy in mPCa patients were included. The outcomes include efficacy, safety and the tolerability of the treatment. The Cochrane Risk of Bias Assessment Tool was used for quality assessment. Two authors were independently involved in the selection, extraction and quality assessment of included studies and disagreements were resolved by discussion or b...

Progenics Pharmaceuticals, Inc. PGNX, +9.67% said Monday a late-stage trial of a treatment for prostate cancer met its main goal. The New York-based company said the phase 3 trial called Condor evaluating the diagnostic performance of PyL(TM) ((18) F-DCFPyL) in men with biochemical recurrence of prostate cancer met its primary endpoint of improving the visualization of the disease. The trail involved 208 patients at 14 sites in the U.S. and Canada. The company is planning to file a new drug application to the U.S. Food and Drug Administration in the second half of 2020. Shares rose 29% after resuming trade following a halt for the news. The stock has gained 23% in the year through Friday, while the S&P 500 SPX, +0.09% has gained 28.5%.