THE "NEW" PROSTATE CANCER INFOLINK

Today’s news reports cover items on:

• Gene expression and prostate cancer progression
• Risk of complications from in-office prostate biopsy
• Post-RALP voiding function
• Urinary toxicities after IMRT-SIB
• Drugs in development for CRPC

Carver et al. have published data suggesting that aberrant expression of the ERG gene has a distinct role in prostate cancer progression and cooperates with partial (heterozygous) PTEN gene expression to promote progression of high-grade prostate intraepithelial neoplasia (HG-PIN) to invasive adenocarcinoma. (In English: Changes in the ways two specific genes are expressed seem to affect risk for early prostate cancer progression.)

Matin et al. report that standard urology office procedures on 921 consecutive patients (including 367 cases of prostate biopsy) appear to be extremely safe — at least as conducted in the office practice setting at their academic medical center. Only 7/921 patient events (0.76 percent) were reported, of which the most serious was a single case of acute bacterial prostatitis due to quinolone-resistant Escherichia coli.

Wang et al. have reported on the “natural history” of urinary voiding after a robot-assisted laparoscopic prostatectomy (RALP). They evaluated IPSS and quality of life (QoL) data from 100 consecutive patients treated with RALP between May 2005 and December 2006 and compared these data at 3, 6, and 12 months after surgery with preoperative data. Continence was achieved in 82, 87, and 91 percent of men at 3, 6, and 12 months after RALP, respectively. Significant improvements were also noted in IPSS and QOL scores at all time points for patients with moderate to severe preexisting lower urinary tract symptoms (LUTS).  Patients with mild preexisting LUTS showed no statistically significant improvement in IPSS at 3 and 6 months after surgery but significant improvement was found at 12 months.

McCammon et al. have provided detailed data on urinary toxicity in a consecutive series of 30 patients treated with intensity-modulated radiotherapy (IMRT) + a hypofractionated simultaneous integrated boost (SIB) for intermediate risk prostate cancer. All patients also received androgen deprivation therapy (ADT). Common acute Grade 2 side effects were cystitis (36.7 percent) and urinary frequency/urgency (26.7 percent). At a median follow-up of 24 months, there were two Grade 3 side effects and one Grade 4 event reported. Acute bowel toxicity of Grade 2 or higher was associated with signficantly greater bowel volume receiving a dose of ≥ 25 Gy; late bowel toxicity was associated with a higher bowel maximal dose and a bowel volume receiving ≥ 50 Gy.

Lassi and Dawson have reviewed recent data on drugs in mid to late stage development for treatment of of castration-resistant prostate cancer (CRPC).

Filed under: Diagnosis, Drugs in development, Living with Prostate Cancer, Management, Risk, Treatment, Uncategorized | Tagged: biopsy, CRPC, ERG, expression, gene, IMRT, PTEN, RALP, side effects, toxicity, urinary, voiding |