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Latest & greatest articles for prostate cancer
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Magnetic Resonance Imaging-targeted Biopsy Versus Systematic Biopsy in the Detection of ProstateCancer: A Systematic Review and Meta-analysis Magnetic resonance imaging (MRI)-targeted prostate biopsy (MRI-TB) may be an alternative to systematic biopsy for diagnosing prostate cancer.The primary aims of this systematic review and meta-analysis were to compare the detection rates of clinically significant and clinically insignificant cancer by MRI-TB with those by systematic biopsy in men (...) cancer than systematic biopsy (DR 0.66 [95% CI 0.57-0.76], p<0.0001). The proportion of cores positive for cancer was greater for MRI-TB than for systematic biopsy (relative risk 3.17 [95% CI 2.82-3.56], p<0.0001).MRI-TB is an attractive alternative diagnostic strategy to systematic biopsy.We evaluated the published literature, comparing two methods of diagnosing prostatecancer. We found that biopsies targeted to suspicious areas on magnetic resonance imaging were better at detecting prostatecancer
Ultra-hypofractionated versus conventionally fractionated radiotherapy for prostatecancer: 5-year outcomes of the HYPO-RT-PC randomised, non-inferiority, phase 3 trial. Hypofractionated radiotherapy for prostatecancer has gained increased attention due to its proposed high radiation-fraction sensitivity. Recent reports from studies comparing moderately hypofractionated and conventionally fractionated radiotherapy support the clinical use of moderate hypofractionation. To date (...) , there are no published randomised studies on ultra-hypofractionated radiotherapy. Here, we report the outcomes of the Scandinavian HYPO-RT-PC phase 3 trial with the aim to show non-inferiority of ultra-hypofractionation compared with conventional fractionation.In this open-label, randomised, phase 3 non-inferiority trial done in 12 centres in Sweden and Denmark, we recruited men up to 75 years of age with intermediate-to-high-risk prostatecancer and a WHO performance status between 0 and 2. Patients were randomly
Early versus deferred standard androgen suppression therapy for advanced hormone-sensitive prostatecancer. Standard androgen suppression therapy (AST) using surgical or medical castration is considered a mainstay of advanced hormone-sensitive prostatecancer treatment. AST can be initiated early when disease is asymptomatic or deferred when patients suffer symptoms of disseminated prostate cancer.To assess the effects of early versus deferred standard AST for advanced hormone-sensitive (...) AST. We excluded all other study designs. Participants included had advanced hormone-sensitive prostatecancer receiving surgical or medical castration.Two review authors independently classified studies and abstracted data. The primary outcomes were time to death of any cause and serious adverse events. Secondary outcomes were time to disease progression, time to death from prostatecancer, adverse events and quality of life. We performed statistical analyses using a random-effects model
Enzalutamide with Standard First-Line Therapy in Metastatic ProstateCancer. Enzalutamide, an androgen-receptor inhibitor, has been associated with improved overall survival in men with castration-resistant prostatecancer. It is not known whether adding enzalutamide to testosterone suppression, with or without early docetaxel, will improve survival in men with metastatic, hormone-sensitive prostate cancer.In this open-label, randomized, phase 3 trial, we assigned patients to receive (...) ). Treatment discontinuation due to adverse events was more frequent in the enzalutamide group than in the standard-care group (33 events and 14 events, respectively). Fatigue was more common in the enzalutamide group; seizures occurred in 7 patients in the enzalutamide group (1%) and in no patients in the standard-care group.Enzalutamide was associated with significantly longer progression-free and overall survival than standard care in men with metastatic, hormone-sensitive prostatecancer receiving
Abiraterone acetate plus prednisone in patients with newly diagnosed high-risk metastatic castration-sensitive prostatecancer (LATITUDE): final overall survival analysis of a randomised, double-blind, phase 3 trial In the interim analyses of the LATITUDE study, the addition of abiraterone acetate plus prednisone to androgen deprivation therapy (ADT) led to a significant improvement in overall survival and radiographic progression-free survival compared with placebos plus ADT in men with newly (...) diagnosed high-risk metastatic castration-sensitive prostatecancer (mCSPC). Here, we present long-term survival outcomes and safety of abiraterone acetate plus prednisone and ADT from the final analysis of the LATITUDE study.This is a multicentre, randomised, double-blind, phase 3 trial done at 235 sites in 34 countries. Eligible patients (men aged ≥18 years) had newly diagnosed, histologically or cytologically confirmed prostatecancer with metastases, Eastern Cooperative Oncology Group (ECOG
Apalutamide for Metastatic, Castration-Sensitive ProstateCancer. Apalutamide is an inhibitor of the ligand-binding domain of the androgen receptor. Whether the addition of apalutamide to androgen-deprivation therapy (ADT) would prolong radiographic progression-free survival and overall survival as compared with placebo plus ADT among patients with metastatic, castration-sensitive prostatecancer has not been determined.In this double-blind, phase 3 trial, we randomly assigned patients (...) with metastatic, castration-sensitive prostatecancer to receive apalutamide (240 mg per day) or placebo, added to ADT. Previous treatment for localized disease and previous docetaxel therapy were allowed. The primary end points were radiographic progression-free survival and overall survival.A total of 525 patients were assigned to receive apalutamide plus ADT and 527 to receive placebo plus ADT. The median age was 68 years. A total of 16.4% of the patients had undergone prostatectomy or received
Effect of Chemotherapy With Docetaxel With Androgen Suppression and Radiotherapy for Localized High-Risk ProstateCancer: The Randomized Phase III NRG Oncology RTOG 0521 Trial Radiotherapy (RT) plus long-term androgen suppression (AS) are a standard treatment option for patients with high-risk localized prostatecancer. We hypothesized that docetaxel chemotherapy (CT) could improve overall survival (OS) and clinical outcomes among patients with high-risk prostate cancer.The multicenter (...) randomized NRG Oncology RTOG 0521 study enrolled patients with high-risk nonmetastatic disease between 2005 and 2009. Patients were randomly assigned to receive standard long-term AS plus RT with or without adjuvant CT.A total of 612 patients were enrolled; 563 were evaluable. Median prostate-specific antigen was 15.1 ng/mL; 53% had a Gleason score 9 to 10 cancer; 27% had cT3 to cT4 disease. Median follow-up was 5.7 years. Treatment was well tolerated in both arms. Four-year OS rate was 89% (95% CI, 84
Phase III Trial of PROSTVAC in Asymptomatic or Minimally Symptomatic Metastatic Castration-Resistant ProstateCancer PROSTVAC, a viral vector-based immunotherapy, prolonged median overall survival (OS) by 8.5 months versus placebo in metastatic castration-resistant prostatecancer in a phase II study. This phase III study further investigated those findings.Patients were randomly assigned to PROSTVAC (Arm V; n = 432), PROSTVAC plus granulocyte-macrophage colony-stimulating factor (Arm VG; n (...) for the treatment and placebo groups, with the most common being injection site reactions (62% to 72%) and fatigue (21% to 24%). Arrhythmias were the most common cardiac-related events (1.4% to 3.5%). There were no reports of either myocarditis or pericarditis. Serious treatment-related events occurred in less than 1% of all patients.Whereas PROSTVAC was safe and well tolerated, it had no effect on OS or AWE in metastatic castration-resistant prostatecancer. Combination therapy is currently being explored
Prostate Radiotherapy for Metastatic Hormone-sensitive ProstateCancer: A STOPCAP Systematic Review and Meta-analysis Many trials are evaluating therapies for men with metastatic hormone-sensitive prostatecancer (mHSPC).To systematically review trials of prostate radiotherapy.Using a prospective framework (framework for adaptive meta-analysis [FAME]), we prespecified methods before any trial results were known. We searched extensively for eligible trials and asked investigators when results (...) % CI 0.69-0.84, p=0.64×10-7), equivalent to ∼10% benefit at 3yr. The effect of prostate radiotherapy varied by metastatic burden-a pattern consistent across trials and outcome measures, including survival (<5, ≥5; interaction HR=1.47, 95% CI 1.11-1.94, p=0.007). There was 7% improvement in 3-yr survival in men with fewer than five bone metastases.Prostate radiotherapy should be considered for men with mHSPC with a low metastatic burden.Prostate cancer that has spread to other parts of the body
Prostate MRI, with or without MRI-targeted biopsy, and systematic biopsy for detecting prostatecancer. Multiparametric magnetic resonance imaging (MRI), with or without MRI-targeted biopsy, is an alternative test to systematic transrectal ultrasonography-guided biopsy in men suspected of having prostatecancer. At present, evidence on which test to use is insufficient to inform detailed evidence-based decision-making.To determine the diagnostic accuracy of the index tests MRI only, MRI (...) -targeted biopsy, the MRI pathway (MRI with or without MRI-targeted biopsy) and systematic biopsy as compared to template-guided biopsy as the reference standard in detecting clinically significant prostatecancer as the target condition, defined as International Society of Urological Pathology (ISUP) grade 2 or higher. Secondary target conditions were the detection of grade 1 and grade 3 or higher-grade prostatecancer, and a potential change in the number of biopsy procedures.We performed
Abiraterone acetate (prostatecancer) - Benefit assessment according to §35a Social Code Book V Extract 1 Translation of Sections 2.1 to 2.6 of the dossier assessment Abirateronacetat (Prostatakarzinom) – Nutzenbewertung gemäß § 35a SGB V (Version 1.0; Status: 13 March 2018). Please note: This translation is provided as a service by IQWiG to English-language readers. However, solely the German original text is absolutely authoritative and legally binding. IQWiG Reports – Commission No. A17-64 (...) Abiraterone acetate (prostatecancer) – Benefit assessment according to §35a Social Code Book V 1 Extract of dossier assessment A17-64 Version 1.0 Abiraterone acetate (prostatecancer) 13 March 2018 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic: Abiraterone acetate (prostatecancer) – Benefit assessment according to §35a Social Code Book V Commissioning agency: Federal Joint Committee Commission
ProstateCancerProstateCancer | Uroweb › ProstateCancerProstateCancer To access the pdfs & translations of individual guidelines, please as EAU member. Non-EAU members can view the web versions. To become an EAU member, click . N. Mottet (Chair), R.C.N. van den Bergh, E. Briers (Patient Representative), P. Cornford (Vice-chair), M. De Santis, S. Fanti, S. Gillessen, J. Grummet, A.M. Henry, T.B. Lam, M.D. Mason, T.H. van der Kwast, H.G. van der Poel, O. Rouvière, D. Tilki, T. Wiegel (...) Guidelines Associates: T. Van den Broeck, M. Cumberbatch, N. Fossati, T. Gross, M. Lardas, M. Liew, L. Moris, I.G. Schoots, P-P.M. Willemse TABLE OF CONTENTS REFERENCES 1. Drost, F.J.H., et al. Prostate MRI, with or without MRI-targeted biopsy, and systematic biopsy for detecting prostatecancer. Cochrane Database of Systematic Reviews, 2019. In press. 2. Van den Broeck, T., et al. Prognostic Value of Biochemical Recurrence Following Treatment with Curative Intent for ProstateCancer: A Systematic Review
Abiraterone acetate (prostatecancer) - Addendum to Commission A17-64 1 Translation of addendum A18-26 Abirateronacetat (Prostatakarzinom) – Addendum zum Auftrag A17-64 (Version 1.0; Status: 11 May 2018). Please note: This translation is provided as a service by IQWiG to English- language readers. However, solely the German original text is absolutely authoritative and legally binding. Addendum 11 May 2018 1.0 Commission: A18-26 Version: Status: IQWiG Reports – Commission No. A18-26 Abiraterone (...) acetate (prostatecancer) – Addendum to Commission A17-64 1 Addendum A18-26 Version 1.0 Abiraterone acetate – Addendum to Commission A17-64 11 May 2018 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic: Abiraterone acetate (prostatecancer) – Addendum to Commission A17-64 Commissioning agency: Federal Joint Committee Commission awarded on: 25 April 2018 Internal Commission No.: A18-26 Address
Patient-reported outcomes following enzalutamide or placebo in men with non-metastatic, castration-resistant prostatecancer (PROSPER): a multicentre, randomised, double-blind, phase 3 trial In the PROSPER trial, enzalutamide significantly improved metastasis-free survival in patients with non-metastatic, castration-resistant prostatecancer. Here, we report the results of patient-reported outcomes of this study.In the randomised, double-blind, placebo-controlled, phase 3 PROSPER trial, done (...) at 254 study sites worldwide, patients aged 18 years or older with non-metastatic, castration-resistant prostatecancer and a prostate-specific antigen doubling time of up to 10 months were randomly assigned (2:1) via an interactive voice web recognition system to receive oral enzalutamide (160 mg per day) or placebo. Randomisation was stratified by prostate-specific antigen doubling time and baseline use of a bone-targeting agent. The primary endpoint was metastasis-free survival, reported elsewhere
Addition of radium-223 to abiraterone acetate and prednisone or prednisolone in patients with castration-resistant prostatecancer and bone metastases (ERA 223): a randomised, double-blind, placebo-controlled, phase 3 trial Abiraterone acetate plus prednisone or prednisolone improves progression-free survival and overall survival in patients with metastatic castration-resistant prostatecancer. Radium-223 improves overall survival and delays the onset of symptomatic skeletal events in patients (...) with castration-resistant prostatecancer and bone metastases. We assessed concurrent treatment with abiraterone acetate plus prednisone or prednisolone and radium-223 in such patients.We did a randomised, double-blind, placebo-controlled, phase 3 trial at 165 oncology and urology centres in 19 countries. Eligible patients were aged 18 years or older, and had histologically confirmed, progressive, chemotherapy-naive, asymptomatic or mildly symptomatic castration-resistant prostatecancer and bone metastases
Gallium-68 Prostate-specific Membrane Antigen Positron Emission Tomography in Advanced ProstateCancer-Updated Diagnostic Utility, Sensitivity, Specificity, and Distribution of Prostate-specific Membrane Antigen-avid Lesions: A Systematic Review and Meta- Accurate staging of high-risk localised, advanced, and metastatic prostatecancer is becoming increasingly more important in guiding local and systemic treatment. Gallium-68 prostate-specific membrane antigen (PSMA) positron emission (...) tomography (PET) has increasingly been utilised globally to assess the local and metastatic burden of prostatecancer, typically in biochemically recurrent or advanced disease. Following our previous meta-analysis, a high-volume series has been reported highlighting the utility of 68Ga-PSMA PET in this setting.To perform a systematic review and meta-analysis to update reported predictors of positive 68Ga-PSMA PET according to prior therapy and proportion of positivity in various anatomical locations
Apalutamide (Erleada) - cancer of the prostate EMA/810516/2018 EMEA/H/C/004452 Erleada (apalutamide) An overview of Erleada and why it is authorised in the EU What is Erleada and what is it used for? Erleada is a cancer medicine used to treat men with cancer of the prostate (a gland of the male reproductive system). It is used when the cancer is not responding to treatments that lower testosterone levels and is at high risk of spreading to other parts of the body. Erleada contains the active (...) substance apalutamide. How is Erleada used? Erleada is available as tablets (60 mg) to be taken by mouth. The recommended dose is 4 tablets (240 mg) a day. Treatment may be stopped temporarily and later restarted at a reduced dose if the patient experiences intolerable side effects. Erleada can only be obtained with a prescription and treatment should be started and supervised by a doctor experienced in the treatment of prostatecancer. For more information about using Erleada, see the package leaflet