More highlights from the SUO annual meeting

Here are some more summary reports from sessions at the 14th annual meeting of the Society for Urologic Oncology (SUO), made available on the UroToday web site (which is freely accessible to patients, but you do have to register to access it).

The six “Session Highlight” reports are based on a series of presentations and panel discussions and were all focused on factors affecting the use of biomarkers in the diagnosis and work-up of prostate cancer, and and how such vbiomarkers can be utilized to differentiate in a clinically valuable manner between men with more or less aggressive forms of prostate cancer so that their care can be appropriately managed. The reports reflect the opinions of highly respected researchers and clinicians on a variety of significant topics, as follows:

  • Okoro et al. presented data suggesting that a targeted magnetic resonance imaging/ultrasound fusion biopsy significantly outperforms a random 12-core biopsy in the prediction of total prostate cancer tumor volume.
  • Lowrance reviewed data from studies of the comparative effectiveness of robot-assisted as opposed to open radical prostatectomy in the treatment of localized prostate cancer.
  • Taplin reviewed data from a phase II trial evaluating neoadjuvant leuprolide + abiraterone + prednisone compared to leuprolide alone in the management of men with high-risk prostate cancer. Although Taplin has previously reported that declines in patient PSA levels could be observed in the patients randomized to treatment with abiraterone acetate, these decreases in PSA levels do not seem to correlate with response. There was a statistically significant increase in pathologic complete response (pCR), near pCR, tissue DHT and DHEA levels, and serum DHT and DHEA levels in the patients in the abiraterone arm of the trialaberaterone, but this is a small, pilot study involving < 60 men. We need to be cautious about over-interpreting the data from a study like this.
  • Gleave provided a review of what we know about the mechanisms of evolution of castration-resistant prostate cancer. It is becoming evident that castration resistance can come in many different forms and that tumor cells continue to rely on the androgen axis through application of several resistance mechanisms to circumvent attempts to shut down the androgen receptor pathways. Basically, continued activity of the androgen receptor provides alternative pathways for testosterone production and this is an adaptive survival pathway for prostate cancer tumors pathway that is based on up-regulation of ligand synthesis.

These reports on the UroToday web site were all written by Reza Mehrazin, MD, or Philip Abbosh, MD, of the Fox Chase Cancer Center in Philadelphia, Pennsylvania.

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