Prostate Cancer

A single baseline PSA measurement taken during midlife strongly predicted the subsequent diagnosis of aggressive prostate cancer up to 12 years later among African-American men in the U.S.

"While there was no further reduction of prostate cancer risk after finasteride was discontinued, there was also no evidence that stopping finasteride resulted in more cases of prostate cancer," writes Badar M. Mian, MD.

Retrospective cohort study identifies wide variation in treatment rates, spending.

Both the efficacy and safety of abiraterone acetate (ZYTIGA) treatment for metastatic castrate-resistant prostate cancer (mCRPC) appear to differ depending on race, according to results of Abi Race, a prospective, multicenter trial presented at the American Society of Clinical Oncology annual meeting in Chicago.

Median overall survival for African-American men with advanced prostate cancer who are treated with docetaxel (Taxotere) is similar to that of Caucasian men, according to an analysis of pooled data from nine randomized phase III clinical trials.

"Two provocative studies reported at the 2018 ASCO annual meeting provide additional insight into prostate cancer racial disparities in a different group of patients, namely men with advanced prostate cancer who participated in a variety of clinical trials," writes Leonard G. Gomella, MD.

In this interview, John W. Davis, MD, discusses the advantages and limitations of focal therapy, the ideal candidate, and what current guidelines say about its use.

Imaging with 18F fluciclovine PET/CT (Axumin) tomography identified sites of disease recurrence in a majority of prostate cancer patients with biochemical recurrence and led to changes in treatment course in 59% of men scanned.

Costs could be slashed by $320 million if all men with Gleason scores of 6 or lower pursued initial conservative management, says researcher Justin Trogdon, PhD.

Treatment with apalutamide (Erleada) resulted in a rapid and substantial decline in PSA, and greater magnitude of PSA decline correlated with improvement in several oncologic endpoints, results from the phase III SPARTAN study showed.

A study investigating associations between statin use and prostate cancer outcomes provides further evidence that the medication may have race-related benefit, providing protective effects among Caucasian men but not in African-Americans.

Studies show moderate alcohol intake has surprising links to prostate disease.

"While these results cannot be extrapolated to men with very high PSA level or advanced clinical stage, the study provides appropriate benchmark data for our contemporary patients with high-risk clinically localized prostate cancer," writes Badar M. Mian, MD.

Men with AR-V7-positive prostate cancer seem to respond positively to a combination therapy with ipilimumab (Yervoy) and nivolumab (Opdivo).

Researchers studied data from a racially diverse cohort of 650 men undergoing a prostate biopsy between January 2007 and January 2018.

Other pipeline products discussed in this round-up include agents for metastatic urothelial cancer, clear cell renal cell carcinoma, and stress urinary incontinence.

Radical prostatectomy can provide superior survival compared with radiation therapy, especially in young and healthy men.

Personally tailored intervention generates patient interest, QoL improvements.

Benefit evident regardless of metastasis site, phase III analysis shows.

~40% of sipuleucel-T recipients in lowest PSA quartile alive after 5 years.

It appears to be safe for clinicians to consider testosterone therapy for symptomatic men with testosterone deficiency and a history of prostate cancer, according to new data presented at the AUA annual meeting in San Francisco.

Although active surveillance for prostate cancer is on the rise in younger, privately insured men, many patients do not undergo a repeat biopsy.

The combination appears to be a more powerful predictor than mpMRI/PSA density.

Other take-home messages on transplantation from AUA 2018 included the finding that kidney paired donations have more than doubled since their inception in 2009 as well as early robotic kidney transplantation studies.

"Despite the potential benefits (fewer biopsies, less cost), the proposed approach to cancer detection and biopsy-that can miss 16%-40% of existing csPCa-may be difficult to justify for all patients," writes Badar M. Mian, MD.