THE "NEW" PROSTATE CANCER INFOLINK

In today’s news reports you will find items on:

• Obesity and PSA levels
• Outcomes after external beam radiation therapy
• Mitoxantrone + predisone after taxotere failure

By analyzing data from 3,152 participants with no known prostate cancer in the three most recent National Health and Nutrition Examination Surveys, Culp and Porter have shown that (in the USA)  obese, white, non-Hispanic males have a 46 percent lower likelihood of a PSA level ≥ 4.0 ng/ml than those with a normal body mass index (BMI).

Zelefsky et al. have conducted a survival analysis based on data from a series of 844 patients with localized prostate cancer who were treated with conformal radiation therapy (RT) and followed-up for a median of 9.1 years. According to this analysis, they report that a PSA nadir of ≤ 1.5 ng/ml at 2 years was an independent predictor of progression-free survival after adjusting for T stage, Gleason score, pre-RT PSA value, and RT dose. The 5- and 10-year cumulative incidences of distant metastases were 2.4 and 7.9 percent, respectively, in men with nadir PSA levels ≤ 1.5 ng/ml at 2 years. A nadir PSA level of > 1.5 ng/ml at the 2-year landmark was also a risk factor associated with prostate cancer-specific mortality, after adjusting for T stage and pre-RT PSA value.

Thomas et al. report preliminary data suggesting that mitoxantrone + prednisone (MP) remains an appropriate clinical treatment for patients in relapse after initial chemotherapy with a docetaxel-based regimen who are not appropriate as participants in clinical trials of other, potential second-line regimens. In the authors’ experience, although MP offers only a moderate rate of partial PSA remission, about 50 percent of patients have an improvement in tumor-related pain, their progression-free survival is prolonged, and the side effects of MP are comparatively low.