Today’s prostate cancer news: Wednesday, October 8

Other than the PCA3 report, additional news today includes:

  • A new review on the combination of EBRT and brachytherapy in localized disease
  • Long-term follow-up data on the use of HIFU at a major German center
  • Early trial data on use of Sutent and Rapamume in men who have failed docetaxel
  • The possible role of pituitary gland surgery in very late stage disease

An article by Hurwitz reviews available information about the uses of external beam radiotherapy (EBRT) in combination with low- or high-dose brachytherapy in the treatment of localized prostate cancer. As the author notes, “Controversy persists” regarding the appropriate application of these combined modalities, the choice of low-dose or high-dose boost, isotope selection for low-dose brachytherapy, and the integration of EBRT and brachytherapy.

Blana et al. have published their 8-year experience with 163 patients using high-intensity focused ultrasound (HIFU) in the treatment of localized prostate cancer. All patients had clinical stage T1-T2N0M0, biopsy-proven, localized prostate cancer, with a serum PSA level of ≤ 20 ng/ml, a Gleason score of ≤ 7, and no previous curative treatment. Only patients followed for a minimum of 3 years after the last HIFU session are included in this analysis. Within the 4.8 ± 1.2 years of follow-up, no patient died of prostate cancer. Of the 163 patients, 86.4 percent achieved a PSA nadir of <1 ng/ml and 92.7 percent had negative post-treatment biopsy findings. The actuarial disease-free survival rate at 5 years was 66 percent, with salvage treatment initiated for 12 percent of the patients. The authors conclude that HIFU is an efficient and safe treatment for patients with localized prostate cancer.

Reports by Sonpavde et al. and by  Amato et al. provide data from early-stage clinical trials of sunitinib (Sutent) and rapamycin (Rapamune) in the treatment of castration-refractory prostate cancer (CRPC) after failure of conventional (i.e., docetacel-based) chemotherapy. While the drugs showed some degree of activity, their value in such very late stage patients may be limited.

Hypophysectomy (also sometimes referred to as hypophysis) is the surgical removal of the pituitary gland. Flitsch et al. have reported a recent case of the use of this surgical technique to palliate pain in a man with late stage, castration-resistant prostate cancer. They suggest that the technique, which has a significant history, may be more widely appropriate in such late stage patients.

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