Prostate Cancer

With additional follow-up of approximately 10 months, monotherapy with the PD-1 inhibitor pembrolizumab (Keytruda) continued to show antitumor activity in men with metastatic castration-resistant prostate cancer. However, monotherapy alone is likely not a sufficient treatment in this patient population, according to Emmanuel Antonarakis, MBBCh, professor of oncology at Johns Hopkins University in Baltimore, Maryland.

Findings from a systematic literature review further our understanding of the prevalence of distinct clinical states of advanced prostate cancer, their association with homologous recombination repair (HRR) gene alterations, and the use of testing methods to identify HRR gene alterations, researchers say.

In a recent study, researchers examined real-world outcomes for patients with metastatic castration-resistant prostate cancer treated with radium-223 (Xofigo). Study author Rana R. McKay, MD, of UC San Diego Health, discusses this study and its significance in the castration-resistant prostate cancer landscape.

After meeting the primary endpoint in a phase 3 study, Myovant Sciences submitted a New Drug Application to the FDA seeking approval of relugolix, an oral nonpeptide gonadotropin-releasing hormone receptor antagonist, as a once-daily treatment for men with advanced prostate cancer.

“The outcomes and experience in the PROfound trial… represent major progress in the treatment of advanced prostate cancer that historically has not been considered amenable to genomic mutation-targeted therapy,” says Maha Hussain, MD.

Advances in genomic testing will help determine lines of therapy in men with mCSPC and mCRPC, according to Raoul S. Concepcion, MD.

Christina Yi, chief operations officer at Dendreon, discussed the efforts being made by the biotech company and its employees to meet the needs of patients with advanced prostate cancer who have chosen treatment with sipuleucel-T (Provenge).

Abreu’s group at USC provides an overview of the transperineal MRI/TRUS fusion prostate biopsy also utilizing the freehand technique.

George and colleagues demonstrate the use of the Michigan Urological Surgery Improvement Collaborative (MUSIC) template to perform a freehand transperineal prostate biopsy using the PrecisionPoint Transperineal Access System.

Pinto and colleagues provide an overview of MRI/TRUS fusion-guided transperineal biopsy utilizing the UroNav platform.

Results from 2 years of follow-up in men undergoing proton beam therapy for localized prostate cancer suggest that treatment with the rectal hydrogel spacer (SpaceOAR) provides better rectal sparing than rectal balloon immobilization.

In this interview, Leonard G. Gomella, MD, discusses the increasingly important role genetic testing plays in prostate cancer, current obstacles to testing, and when and how it will be carried out.

"Death due to prostate cancer was quite rare, with only four men (0.2%) dying of prostate cancer during the study period," writes Badar M. Mian, MD.

Stereotactic body radiation reduced the likelihood for future PSA rises and significantly prolonged survival in men with oligometastatic prostate cancer (≤3 metastases), according to recently published findings from ORIOLE, a phase II, multicenter, randomized, observation-controlled trial.

“It hasn’t become the gold standard yet. There are still a lot of inter-reader reliability issues. The same MRI scans, read by different radiologists, may be read differently," says one urologist.

Nanospectra Biosciences, Inc. recently announced the start of a pivotal study to determine the efficacy of using magnetic resonance imaging/ultrasound fusion imaging technology to direct focal ablation of prostate tissue using nanoparticle-directed laser ablation.

Recent research shows contemporary imaging and biopsy techniques often fail to identify contralateral tumors in men presumed to have unilateral prostate cancer-and the results have significant implications for identifying candidates for hemiablation.

In this video, Scott Eggener, MD, outlines which patients are the best candidates for focal therapy for prostate cancer, and discusses the differences in follow-up for patients treated with focal therapy compared with those undergoing active surveillance.

Martin Gleave, MD, of the University of British Columbia in Vancouver, discusses the Genomic Umbrella Neoadjuvant Study (GUNS) trial, which uses a multi-arm, multistage adaptive design to test targeted therapies in patients with high-risk localized disease by matching neoadjuvant therapies to baseline genomic alterations.

Modest hypofractionation is noninferior to conventional fractionation in the treatment of localized prostate cancer and causes no increase in side effects, according to 8-year outcomes from the CHHiP trial.

Inheriting the adrenal-permissive HSD3B1(1245C) genotype is associated with worse outcomes in low-volume metastatic prostate cancer and might someday help identify patients who could benefit from escalated therapy, according to a recent study.

"The recently reported change in PCa death rates should prompt men to undergo genetic testing and have a discussion with their doctor regarding the benefits and potential harms of PSA-based screening based on their individualized risk of developing the disease," write Franklin Gaylis, MD, and A. Karim Kader, MD, PhD.

Recommendations on opioid prescribing after endourologic and minimally invasive urologic surgery from an expert panel should help urologists align individual prescribing habits with current evidence, reduce opioid overprescribing, and provide a framework for refining patient-centered guidelines for opioid stewardship in urology, said Kevin Koo, MD, MPH, MPhil.

A multicenter study in the United Kingdom found 5-year prostate cancer control rates following treatment with focal therapy are similar to those of patients who have undergone radical prostatectomy, even when accounting for variation in tumor location, size, and risk.

A simple intervention aiming to curb the contribution of postoperative pain medication prescribing to the opioid crisis was shown to reduce post-discharge opioid prescribing and use and increase opioid disposal without seeming to jeopardize pain control for patients who had undergone radical prostatectomy.