The epidemiology of prostate cancer (2003-2017)

A recent report in the CDC’s Morbidity and Mortality Weekly Report (MMWR) may offer one of the best analyses of an increasing risk for diagnosis with and death from advanced forms of prostate cancer over the period from 2003 to 2017 (the last year for which we have accurate data from the SEER database). … READ MORE …

Improvements in surgical technique: past and more recent

Nearly 3 years ago now, we first mentioned a surgical technique known as “Retzius-sparing” radical prostatectomy on this web site. … READ MORE …

Long-term use of 5-ARIs in low-risk men on AS

Perhaps unsurprisingly, your sitemaster was a little distracted on March 9 this year (by both the start of the COVID-19 chaos and by his birthday) and so he utterly missed what appears to be a rather important paper on the use of 5α-reductase inhibitors (5-ARIs) in men on active surveillance (AS) for management of low-risk forms of prostate cancer.

… READ MORE …

Onvansertib in treatment of abiraterone-resistant mCRPC

We hear that an investigational drug called onvansertib — a so-called polo-like kinase 1 (PLK1) inhibitor — may have benefit in the treatment of men with metastatic, castration-resistant prostate cancer (mCRPC) who are showing early signs of progression on treatment with abiraterone acetate (Zytiga) + prednisone.

… READ MORE …

SBRT vs. EBRT in treatment of painful spine metastases

New data on this topic — from a Phase II/III clinical trial — have just been presented at the virtual annual meeting of the American Society for Radiation Oncology (ASTRO). Basically, the data from this study by Sahgal et al. indicated that 24 Gy (in two 12 Gy doses) of stereotactic body radiation therapy (SBRT) was more effective in the elimination of spinal pain in patients with metastatic cancer as compared to 20 Gy (in five 4 Gy doses) of conventional, external beam radiation therapy (EBRT).

… READ MORE …

The virtual prostate cancer patient

A new type of “educational” service has been brought to our attention that uses virtual reality (VR) systems allowing a number of opportunities for men to “talk” to a virtual prostate cancer patient about their own risks for prostate cancer and things like the risks and benefits of PSA testing. … READ MORE …

Real-world survival benefit of treatment with sipuleucel-T

So there are new, interesting data regarding the treatment of men with metastatic, castration-resistant prostate cancer (mCRPC) with sipuleucel-T (Provenge) as well as either or both of abiraterone acetate (Zytiga) and enzalutamide (Xtandi) — known generically as androgen-receptor signaling pathway inhibitors or ASPIs. … READ MORE …

Does clinical benefit of ipatasertib outweigh risk for adverse events?

Roche/Genentech’s investigational drug ipatasertib has demonstrated a small but statistically significant benefit in the treatment of men with metastatic, castration-resistant prostate cancer (mCRPC) who had tumors exhibiting loss of the phosphatase and tensin (PTEN) homolog: a 2-month improvement in median radiographic progression-free survival (rPFS). … READ MORE …

Adding ADT to external beam radiation only benefits unfavorable risk patients

In 2013, Zumsteg et al. proposed a refinement in the NCCN “intermediate risk” classification into two subcategories, “favorable intermediate-risk (FIR)” and “unfavorable intermediate-risk (UIR).” … READ MORE …

Risk calculators for men already on active surveillance

The Prostate Active Surveillance Study (PASS), initially funded by the Canary Foundation, is a multi-center research study for men  with low-risk disease who have chosen active surveillance (AS) to manage their prostate cancer. Active surveillance in PASS means closely monitoring men with prostate cancer and offering treatment if test results show the cancer is getting worse. … READ MORE …

Who actually dies from prostate cancer? Additional observations

Earlier today we reported on a recent publication based on data from the CaPSURE registry database, which stated that, among men enrolled in that database, men died sooner from their prostate cancer after they progressed to having metastatic disease over time (median survival, 2.4 years from onset of metastasis) than died from their prostate cancer if they were initially diagnosed with metastatic disease (median survival, 5.3 years). … READ MORE …

Synergy between radiation of metastases and immunotherapy confirmed

Two clinical trials have now confirmed the abscopal or bystander effect in prostate cancer. These effects occur when cancer cells that are not directly treated are nonetheless killed. … READ MORE …

Neoadjuvant CHT + surgery for men with high-risk, localized prostate cancer

Eastham et al. have recently reported — in the Journal of Clinical Oncology — results from a randomized Phase III trial of the surgical treatment of men with high-risk forms of localized prostate cancer. … READ MORE …

Prostate cancer treatment and quality of life in the “real world”

The idea that most men will recover meaningful erectile and sexual function after treatment for prostate cancer has long been disputed by many in the patient community. We now seem to have some better data supporting the patient perspective. … READ MORE …

Does “AR gain” affect responses to drugs like abiraterone in men with CRPC?

Perhaps unsurprisingly, it appears to be true that “AR gain” (see below) does indeed lower overall survival (OS) and progression-free survival (PFS) rates among men with castration-resistant prostate cancer (mCRPC). … READ MORE …