THE "NEW" PROSTATE CANCER INFOLINK

In today’s news reports we cover items on:

• Prediction of risk for prostate cancer under-grading based on biopsy data
• The obesity/risk equation in prostate cancer
• Capecitabine + docetaxel in metastatic CRPC

Stackhouse et al. have used data from a cohort of 1,701 patients treated at their institution to determine specific clinical factors that seem to affect the under-grading of biopsy Gleason score compared with post-prostatectomy pathology and have developed a model to predict the probability of under-grading in individual patients. They have previously reported that under-grading occurred in 46.6 percent of their cohort. Significant variables predicting under-grading were: age at diagnosis, biopsy Gleason sum, diagnostic PSA level, prostate weight, biopsy positive-to-total core ratio, and maximal percent of cancer in cores (p < 0.05). The predictive accuracy of the nomogram they have developed is 72.4 percent. The authors conclude that “The risk of Gleason sum under grading can be predicted to a satisfactory level using our nomogram” ( but The “New” Prostate Cancer InfoLink suspect that this level of accuracy is probably not as high as one would like to see).

Davies et al. have analyzed data from over 7,000 patients in the Cancer of the Prostate Strategic Urological Research Endeavor (CaPSURE) database with clinically localized prostate cancer, known body mass index, and clinicopathological disease characteristics. Their analysis of these data from a community-based cohort of patients was not able to establish any relationship between body mass index and prostate cancer-specific survival or overall survival. The issue of whether obesity is connected to prostate cancer risk and survival continues to be controversial.

Vaishampayan et al. have published data from a small Phase II study of capecitabine +docetaxel in the treatment of patients with metastatic, castration-resistant prostate cancer (CRPC). A PSA response of ≥ 50 percent was observed in 22/30 patients (73 percent), and 9/30 (30 percent) had a PSA decrease of ≥ 90. The authors state that, “The combination was well tolerated and it demonstrated favorable response rates with durable remission and survival outcomes.” However, this is a small, non-comparative, pilot study and more data would be helpful.

Filed under: Diagnosis, Drugs in development, Management, Risk, Treatment | Tagged: biopsy, capecitabine, CRPC, docetaxel, Gleason score, obesity, risk, under-grading