Stacy Loeb, MD, MSc, assistant professor of urology and population health at New York University Langone and the Manhattan VA, New York.
The US Preventive Services Task Force 2017 Draft Recommendation Statement on Screening for Prostate Cancer: An Invitation to Review and Comment. JAMA 2017; 317:1949-50.
In 2012, the U.S. Preventive Services Task Force recommended against prostate cancer screening. This year, the USPSTF published a new draft recommendation based on an updated systematic evidence review. It recommends individualized decision-making about screening for prostate cancer for men ages 55 to 69 years after discussion with a clinician (C recommendation).
10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer. N Engl J Med 2016; 375:1415-24.
Patient-Reported Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer. N Engl J Med 2016; 375:1425-37.
These studies report on the oncologic and functional outcomes from ProtecT, which randomized men with screen-detected prostate cancer to active monitoring, radical prostatectomy, and radiation therapy. At a median of 10 years, there was no difference in prostate cancer-specific mortality among the groups. The active monitoring group had a higher rate of metastasis, but had less impact on urinary, sexual, and bowel function.
Abiraterone for Prostate Cancer Not Previously Treated with Hormone Therapy. N Engl J Med 2017; 377:338-51.
Abiraterone plus Prednisone in Metastatic, Castration-Sensitive Prostate Cancer. N Engl J Med 2017; 377:352-60.
Two major randomized trials led to practice-changing results for men diagnosed with advanced prostate cancer. The STAMPEDE trial found that the addition of abiraterone (ZYTIGA)/prednisone to androgen deprivation therapy (ADT) led to improved survival for men with locally advanced and metastatic prostate cancer compared to ADT alone. Similarly, the LATITUDE trial found that using abiraterone/prednisone plus ADT significantly increased overall survival and radiographic progression-free survival in men with castration-sensitive metastatic prostate cancer.