Readers interested in looking through the 2,600 or so abstracts of papers to be presented at the upcoming annual meeting of the American Urological Association (AUA) can now do so.
This year’s annual meeting of the AUA will be held in New Orleans, LA, starting on May 15. The abstracts can be now accessed (at no cost) on the meeting web site. The easiest way to find prostate cancer-specific abstracts is to look in the “Search by Session Title” area for the sessions dealing explicitly with prostate cancer: there are only 31 of those sessions!
The “New” Prostate Cancer InfoLink will be looking through these abstracts over the next few weeks in the hope of identifying any particularly ground-breaking new information.
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THE "NEW" PROSTATE CANCER INFOLINK 
Disappointing study of pomegranate supplementation by a juice extract. (See abstract no. MP-06-08 in the AUA 2015 annual meeting abstracts for the session on Prostate Cancer: Markers II.)
I’ve been enthusiastic about existing research on supplementation with pomegranate elements, and I take an extract pill daily as insurance against recurrence (and before that to bolster treatment). I’ve followed encouraging research from UCLA (Pantuck and team, using juice, increasing PSADT from about 15 months to 54 months for recurring patients), Johns Hopkins (extract), and the UK (a combo pill that included pomegranate extract).
However, this study by some of the original UCLA research team was disappointing to me. While the few patients in the straight juice arm did pretty well, those in the fairly large juice extract arm increased doubling time only slightly and less than those in the placebo arm. Here’s a key sentence from the results section of the abstract: “… Median PSADT increased 4.5 months in the placebo group (11.1 to 15.6, p=0.0000), 1.6 months in the extract group (12.9 to 14.5, p=0.1258), and 7.6 months in the juice group (12.7 to 20.3, p=0.0041)….”
A couple of thoughts:
— Viva la placebo!
– That 7.6 month increase in the straight juice arm is nice, but it sure is a whole lot lower than the increase of about 39 months in the initial Pantuck UCLA research with juice carried out over 2 years.
It’s not clear what kinds of juice or extract were used.
Interestingly, I have a completely different take on this study, which showed that a very specific subset of patients — those with the manganese superoxide dismutase AA genotype — experienced exhibited a massive a 12-month change in median PSA doubling time (13.6 to 25.6, p = 0.03) while taking the pomegranate extract compared to 1.8-month change among similar patients taking the placebo (10.9 to 12.7 months, p = 0.22). In other words, taking pomegranate extract may be highly beneficial for a subset of patients.
Jim,
It’s not just the placebo effect. PSADT in a single-arm study like the previous ones is a very poor indicator of cancer progression. In a study at Johns Hopkins last year researchers found that 30 percent of men with biochemical recurrence had increases in PSADT of over 200 percent — without any treatment or placebo! They simulated randomized controlled trials using actual tracking data and found that 62 percent would demonstrate significantly increased PSADT in a single arm (non-placebo controlled) study. This is why it is so important to wait for results from placebo-controlled studies.
This study was sponsored by Roll International Corp., the makers of POM Wonderful.
By the way, the only other placebo-controlled study of pomegranate that I’m aware of, a Swiss study in men with prostate cancer (mostly who failed treatment and/or on ADT) also found no benefit to pomegranate.
Insofar as the analysis of those with the mutant MnSOD genotype goes, I would like to see further exploration with other antioxidants, soy isoflavones, smoking cessation, or even just exercise. They don’t mention what proportion of the sample exhibit this polymorphism, so it is hard to judge whether detection of it would be cost-effective.