Prostate Cancer

Among patients treated through the Veteran’s Health Administration, Black men with prostate cancer were less likely to choose or be offered the most beneficial treatment options.

“One of the toughest parts about having a discussion with a patient about low-risk or early-stage prostate cancer…is actually deciding what might be best for that individual patient,” says Ketan K. Badani, MD.

“I think as technology evolves, we as urologists need to continue to evolve and make changes to our practice,” says Kevin T. Keating, DO.

The PARP inhibitors olaparib and rucaparib are approved by the FDA for the treatment of patients with metastatic castration-resistant prostate cancer.

"Our success depends on your assertive action and membership in organizations serving our specialty—the AACU in particular—as well as your state medical association," writes William C. Reha, MD, MBA.

Wassim Abida, MD, PhD, discusses whether he would recommend PARP inhibitors in patients with metastatic castration-resistant prostate cancer harboring alterations in homologous recombination repair genes other than BRCA1/2.

“While many patients may think of imaging tests, as many other tests, as [having] a binary outcome, it may be important to have a discussion about how the scoring and MRI works, [and] what the patient can expect to see on their report,” says Stella K. Kang, MD.

Decipher Prostate Biopsy, a 22-gene microarray-based genomic classifier, showed potential as a tool to help guide decisions between active surveillance and radical treatment in men with localized prostate cancer.

“What I found exciting was that the extent to which a…PI-RADS 4 score saved biopsies without really affecting the likelihood of detecting clinically significant tumor,” says Stella K. Kang, MD.

Researchers from the FDA’s Center for Drug Evaluation and Research determined that the benefits of androgen receptor inhibitors outweighed the risks in men aged ≥80 years with nonmetastatic castration-resistant prostate cancer.

Adjuvant radiotherapy (RT) after radical prostatectomy was associated with a reduced risk of all-cause mortality compared with early salvage RT.

Vinayak G. Wagaskar, MBBS, shares potential explanations for the obesity paradox in patients with metastatic castration-resistant prostate cancer and provides next steps for exploring this phenomenon.

“There's a lot that urologists can pick up on how to better interact with their patients,” says David King Keller, PhD, of Active Surveillance Patients International.

Evangelia Sereti, MSc, PhD, discusses the design/methodology and results of a preclinical study exploring the combination of the PARP inhibitor olaparib plus the novel agent NOV202 in BRCA1/2-mutated prostate cancer cells.

This article features insights from David Albala, MD, and Judd W. Moul, MD, on using liquid biomarker-based testing for the early detection of prostate cancer.

Vinayak G. Wagaskar, MBBS, explains the “obesity paradox”—improved survival outcomes in patients with a high body mass index—that has been observed in patients with genitourinary malignancies, including prostate cancer.

Prostate cancer screening with MRI-guided biopsy reduced the detection of clinically insignificant prostate cancer versus use of standard biopsy alone, while also demonstrating noninferiority for detecting clinically significant disease.

Screening rates rebounded across most tumor types in late 2020; however, racial and economic disparities persisted.

The so-called “obesity paradox” previously reported in other genitourinary malignancies has now been observed in patients with metastatic castration-resistant prostate cancer.

Between 40% and 50% of patients with mCRPC have loss in PTEN, which is associated with worse prognosis and reduced benefit from AR blockade.

In this subgroup, adjuvant radiotherapy significantly reduced the risk of all-cause mortality versus early salvage radiation therapy.

Expert urologists remark on unmet needs in prostate cancer by emphasizing the importance of reaching under-served communities, addressing patient discomfort, increasing education about liquid biopsy testing, and standardizing prostate size assessment.

“With 18F-DCFPyL-PET/CT, we can find metastatic disease much sooner. Therefore, 1 question that will need to be addressed is: what do we do now?” says Kenneth J. Pienta, MD.

Health care providers focus on genomic testing in heavily treated, metastatic castrate-resistant prostate cancer from the multidisciplinary approach to cancer care.

Health care providers focus on genomic testing in newly diagnosed, high grade, high-risk prostate cancer from the multidisciplinary approach to cancer care.