AUA report and update no. 6: Monday, April 27, 2009

We learned a few other interesting tidbits during a variety of sessions and conversations today.

For starters, here are two items about investigational stage drugs in the management of advanced prostate cancer:

  • The abiraterone + prednisone trial in men with castration-resistant prostate cancer who have received prior doecetaxel therapy is apparently fully accrued and it is projected that the results of this trial may be available at either this meeting or the annual meeting of the American Society for Clinical Oncology meeting in 2010
  • The trial of docetaxel + prednisone with or without bevacizumab is also fully accrued, and the results of this trial may also be presented at ASCO in 2010.

In the educational session on advanced prostate cancer this morning, Adam Kibel, MD suggested that there was compelling evidence for the use of hormonal therapy early in high-risk prostate cancer patients (Gleason score ≥ 7 and PSA > 5 ng/ml) after disease progression, but that there were few data to suggest that early hormone therapy helped patients with a lower Gleason score. And with this comment he still emphasized the importance of considering quality of life factors related to androgen deprivation therapies of any type.

We also note that there has been much media publicity around the idea that statins may lower risk for prostate cancer. However, it should noted that in one of the discussions of this topic on Sunday, a leading researcher in this field proposed that while there may well be an association between statin use and lower risk for prostate cancer, there may be many explanations for this lower risk that are not specific to the use of statins. In other words, taking statins may not actually cause the reduced risk for prostate cancer; the reduction in risk may just be a corollary effect. We are going to hear more about this issue, but it is going to take a large randomized trial like the REDUCE trial to prove an effect one way or another.

There was a very interesting poster presented today on the relationship between deaths from urological cancer and the presence (or absence) of urologists within a particular county across America. The study, by Odisho et al. (abstract no. 454), indicated that the risk of death from prostate cancer was significantly lower in counties where there are at least 1 or 2 urologists per 100,000 population than in those counties where there are no urologists. However, there is no comparable increase in prostate cancer survival as the number of urologists in a specific county gets higher (≥ 3 urologists pre 100,000 people). The same was true for risk of death from bladder and prostate cancers!

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