Latest & greatest articles for prostate cancer

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Top results for prostate cancer

41. Ultra-hypofractionated versus conventionally fractionated radiotherapy for prostate cancer: 5-year outcomes of the HYPO-RT-PC randomised, non-inferiority, phase 3 trial. (Abstract)

Ultra-hypofractionated versus conventionally fractionated radiotherapy for prostate cancer: 5-year outcomes of the HYPO-RT-PC randomised, non-inferiority, phase 3 trial. Hypofractionated radiotherapy for prostate cancer 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 prostate cancer and a WHO performance status between 0 and 2. Patients were randomly

2019 Lancet Controlled trial quality: predicted high

42. Early versus deferred standard androgen suppression therapy for advanced hormone-sensitive prostate cancer. (Abstract)

Early versus deferred standard androgen suppression therapy for advanced hormone-sensitive prostate cancer. Standard androgen suppression therapy (AST) using surgical or medical castration is considered a mainstay of advanced hormone-sensitive prostate cancer 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 prostate cancer 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 prostate cancer, adverse events and quality of life. We performed statistical analyses using a random-effects model

2019 Cochrane

43. Enzalutamide with Standard First-Line Therapy in Metastatic Prostate Cancer. Full Text available with Trip Pro

Enzalutamide with Standard First-Line Therapy in Metastatic Prostate Cancer. Enzalutamide, an androgen-receptor inhibitor, has been associated with improved overall survival in men with castration-resistant prostate cancer. 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 prostate cancer receiving

2019 NEJM Controlled trial quality: predicted high

44. Abiraterone acetate plus prednisone in patients with newly diagnosed high-risk metastatic castration-sensitive prostate cancer (LATITUDE): final overall survival analysis of a randomised, double-blind, phase 3 trial (Abstract)

Abiraterone acetate plus prednisone in patients with newly diagnosed high-risk metastatic castration-sensitive prostate cancer (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 prostate cancer (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 prostate cancer with metastases, Eastern Cooperative Oncology Group (ECOG

2019 EvidenceUpdates

45. Apalutamide for Metastatic, Castration-Sensitive Prostate Cancer. Full Text available with Trip Pro

with metastatic, castration-sensitive prostate cancer 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 (...) Apalutamide for Metastatic, Castration-Sensitive Prostate Cancer. 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 prostate cancer has not been determined.In this double-blind, phase 3 trial, we randomly assigned patients

2019 NEJM Controlled trial quality: predicted high

46. Prostate cancer: diagnosis and management

. Ov Overview erview This guideline covers the diagnosis and management of prostate cancer in secondary care, including information on the best way to diagnose and identify different stages of the disease, and how to manage adverse effects of treatment. It also includes recommendations on follow-up in primary care for people diagnosed with prostate cancer. Who is it for? Healthcare professionals Commissioners and providers of prostate cancer services People with prostate cancer, their families (...) and and that there is limited evidence for some treatment options. [2014] [2014] 1.1.11 Ensure that mechanisms are in place so people with prostate cancer and their primary care providers have access to specialist services throughout the course of their disease. [2008] [2008] 1.1.12 T ell people with prostate cancer and their partners or carers about the effects of prostate cancer and the treatment options on their: sexual function physical appearance continence Prostate cancer: diagnosis and management (NG131) © NICE 2019

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

47. Enzalutamide for hormone-relapsed non-metastatic prostate cancer

that there are fewer people with undetected metastases who would otherwise be labelled as having non- metastatic disease. NICE technology appraisal guidance already recommends enzalutamide for hormone-relapsed metastatic prostate cancer before and after treatment with docetaxel. This appraisal relates to using enzalutamide at an earlier point in the treatment pathway. The committee noted that NHS England's policy stipulates that either enzalutamide or abiraterone (another antiandrogen) is to be offered only once (...) stopping treatment may speed up metastasis. The clinical experts commented that bicalutamide and dexamethasone are sometimes used for hormone-relapsed non-metastatic disease, but that the evidence for their effectiveness is limited. The committee considered ADT to be the standard of care in patients with hormone-relapsed prostate cancer, and the relevant comparator in this appraisal. The compan The company's definition of high risk does not closely match what is considered high y's definition of high

2019 National Institute for Health and Clinical Excellence - Technology Appraisals

48. Phase III Trial of PROSTVAC in Asymptomatic or Minimally Symptomatic Metastatic Castration-Resistant Prostate Cancer Full Text available with Trip Pro

Phase III Trial of PROSTVAC in Asymptomatic or Minimally Symptomatic Metastatic Castration-Resistant Prostate Cancer PROSTVAC, a viral vector-based immunotherapy, prolonged median overall survival (OS) by 8.5 months versus placebo in metastatic castration-resistant prostate cancer 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 prostate cancer. Combination therapy is currently being explored

2019 EvidenceUpdates

49. Effect of Chemotherapy With Docetaxel With Androgen Suppression and Radiotherapy for Localized High-Risk Prostate Cancer: The Randomized Phase III NRG Oncology RTOG 0521 Trial (Abstract)

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 (...) % to 92%) for AS + RT and 93% (95% CI, 90% to 96%) for AS + RT + CT (hazard ratio [HR], 0.69; 90% CI, 0.49 to 0.97; one-sided P = .034). There were 59 deaths in the AS + RT arm and 43 in the AS + RT + CT arm, with fewer deaths resulting from prostate cancer in the AS + RT + CT arm versus AS + RT (23 v 16 deaths, respectively). Six-year rate of distant metastasis was 14% for AS + RT and 9.1% for AS + RT + CT, (HR, 0.60; 95% CI, 0.37 to 0.99; two-sided P = .044). Six-year disease-free survival rate

2019 EvidenceUpdates

50. Prostate MRI, with or without MRI-targeted biopsy, and systematic biopsy for detecting prostate cancer. (Abstract)

Prostate MRI, with or without MRI-targeted biopsy, and systematic biopsy for detecting prostate cancer. 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 prostate cancer. 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 prostate cancer 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 prostate cancer, and a potential change in the number of biopsy procedures.We performed

2019 Cochrane

51. Abiraterone acetate (prostate cancer) - Addendum to Commission A17-64

Abiraterone acetate (prostate cancer) - 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 (prostate cancer) – 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 (prostate cancer) – Addendum to Commission A17-64 Commissioning agency: Federal Joint Committee Commission awarded on: 25 April 2018 Internal Commission No.: A18-26 Address

2019 Institute for Quality and Efficiency in Healthcare (IQWiG)

52. Prostate Cancer

of malignant tumors. UICC International Union Against Cancer. 8th edn. 2017. 73. Cooperberg, M.R., et al. The University of California, San Francisco Cancer of the Prostate Risk Assessment score: a straightforward and reliable preoperative predictor of disease recurrence after radical prostatectomy. J Urol, 2005. 173: 1938. 74. Epstein, J.I., et al. The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. Am J Surg Pathol, 2005. 29: 1228 (...) as predictors for prostate cancer. J Clin Oncol, 2009. 27: 398. 133. Stephan, C., et al. The influence of prostate volume on the ratio of free to total prostate specific antigen in serum of patients with prostate carcinoma and benign prostate hyperplasia. Cancer, 1997. 79: 104. 134. Catalona, W.J., et al. Use of the percentage of free prostate-specific antigen to enhance differentiation of prostate cancer from benign prostatic disease: a prospective multicenter clinical trial. JAMA, 1998. 279: 1542. 135

2019 European Association of Urology

53. Apalutamide (Erleada) - cancer of the prostate

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 prostate cancer. For more information about using Erleada, see the package leaflet

2019 European Medicines Agency - EPARs

54. Abiraterone acetate (prostate cancer) - Benefit assessment according to §35a Social Code Book V

? Volker Vervölgyi ? Siw Waffenschmidt Keywords: abiraterone acetate, prednisone, prednisolone, androgen deprivation therapy, prostatic neoplasms, benefit assessment, NCT01715285, NCT00268476 Extract of dossier assessment A17-64 Version 1.0 Abiraterone acetate (prostate cancer) 13 March 2018 Institute for Quality and Efficiency in Health Care (IQWiG) - iii - Table of contents Page List of tables iv List of abbreviations v 2 Benefit assessment 1 2.1 Executive summary of the benefit assessment 1 2.2 (...) platform trial in advanced or metastatic prostate cancer on the comparison of different systemic drug therapies. The STAMPEDE study includes patients with prostate cancer for whom long-term ADT is intended and whose disease concurs with one of the following 3 groups: 1) newly diagnosed disease with presence of distant metastasis or lymph node metastasis, 2) newly diagnosed disease with high risk locally advanced prostate cancer without distant metastasis or lymph node metastasis, 3) recurrent locally

2019 Institute for Quality and Efficiency in Healthcare (IQWiG)

55. A 16-yr Follow-up of the European Randomized study of Screening for Prostate Cancer Full Text available with Trip Pro

A 16-yr Follow-up of the European Randomized study of Screening for Prostate Cancer The European Randomized study of Screening for Prostate Cancer (ERSPC) has previously demonstrated that prostate-specific antigen (PSA) screening decreases prostate cancer (PCa) mortality.To determine whether PSA screening decreases PCa mortality for up to 16yr and to assess results following adjustment for nonparticipation and the number of screening rounds attended.This multicentre population-based randomised (...) significantly reduces PCa mortality, showing larger absolute benefit with longer follow-up and a reduction in excess incidence. Repeated screening may be important to reduce PCa mortality on a population level.In this report, we looked at the outcomes from prostate cancer in a large European population. We found that repeated screening reduces the risk of dying from prostate cancer.Copyright © 2019. Published by Elsevier B.V.

2019 EvidenceUpdates

56. Addition of radium-223 to abiraterone acetate and prednisone or prednisolone in patients with castration-resistant prostate cancer and bone metastases (ERA 223): a randomised, double-blind, placebo-controlled, phase 3 trial (Abstract)

and interstitial lung disease) and one (<1%) in the placebo group (arrhythmia).The addition of radium-223 to abiraterone acetate plus prednisone or prednisolone did not improve symptomatic skeletal event-free survival in patients with castration-resistant prostate cancer and bone metastases, and was associated with an increased frequency of bone fractures compared with placebo. Thus, we do not recommend use of this combination.Bayer.Copyright © 2019 Elsevier Ltd. All rights reserved. (...) Addition of radium-223 to abiraterone acetate and prednisone or prednisolone in patients with castration-resistant prostate cancer 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 prostate cancer. Radium-223 improves overall survival and delays the onset of symptomatic skeletal events in patients

2019 EvidenceUpdates

57. Patient-reported outcomes following enzalutamide or placebo in men with non-metastatic, castration-resistant prostate cancer (PROSPER): a multicentre, randomised, double-blind, phase 3 trial Full Text available with Trip Pro

Patient-reported outcomes following enzalutamide or placebo in men with non-metastatic, castration-resistant prostate cancer (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 prostate cancer. 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 prostate cancer 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

2019 EvidenceUpdates

58. Use of Low-Dose Aspirin and Mortality After Prostate Cancer Diagnosis: A Nationwide Cohort Study. (Abstract)

Use of Low-Dose Aspirin and Mortality After Prostate Cancer Diagnosis: A Nationwide Cohort Study. Recent studies suggest that aspirin use may improve survival in patients with prostate cancer.To assess the association between postdiagnosis use of low-dose aspirin and prostate cancer mortality.Nationwide cohort study.Denmark.Men with incident prostate adenocarcinoma between 2000 and 2011.Nationwide registry data on tumor characteristics, drug use, primary prostate cancer therapy, comorbidity (...) , and socioeconomic parameters. Postdiagnosis use of low-dose aspirin (75 to 150 mg) was defined as 2 or more prescriptions filled within 1 year after prostate cancer diagnosis. Follow-up started 1 year after prostate cancer diagnosis. In secondary analyses, low-dose aspirin use was assessed within exposure periods of 5 or 7.5 years after prostate cancer diagnosis.Of 29 136 patients (median age, 70 years), 7633 died of prostate cancer and 5575 died of other causes during a median follow-up of 4.9 years

2019 Annals of Internal Medicine

59. Darolutamide in Nonmetastatic, Castration-Resistant Prostate Cancer. Full Text available with Trip Pro

Darolutamide in Nonmetastatic, Castration-Resistant Prostate Cancer. Darolutamide is a structurally unique androgen-receptor antagonist that is under development for the treatment of prostate cancer. We evaluated the efficacy of darolutamide for delaying metastasis and death in men with nonmetastatic, castration-resistant prostate cancer.We conducted a randomized, double-blind, placebo-controlled, phase 3 trial involving men with nonmetastatic, castration-resistant prostate cancer (...) with a higher incidence of seizures, falls, fractures, cognitive disorder, or hypertension than placebo.Among men with nonmetastatic, castration-resistant prostate cancer, metastasis-free survival was significantly longer with darolutamide than with placebo. The incidence of adverse events was similar for darolutamide and placebo. (Funded by Bayer HealthCare and Orion Pharma; ARAMIS ClinicalTrials.gov number, NCT02200614.).Copyright © 2019 Massachusetts Medical Society.

2019 NEJM Controlled trial quality: predicted high

60. Biodegradable Rectal Spacers for Prostate Cancer Radiotherapy

. prostatic neoplasms/ 2. (Prostat* adj4 (Neoplasm* or Cancer* or Carcinom* or Adenocarcinom* or Tumour* or Tumor* or Malignan* or Lump* or Masses* or Sarcom* or Metastas*)).tw. 3. 1 or 2 Spacer Inserts 4. Hydrogel/ 5. hydrogel*.tw. 6. hydrodissect*.tw. 7. (spacer* or spacing).tw. 8. ((perirect* or rect* or prostate-rectum or denonvillier* or transperineal*) adj4 space*).tw. 9. or/4-8 Limiting Terms 10. 3 and 9 12. 10 or 11 13. limit 12 to english language 14, limit 13 to human 15. limit 14 to yr=2017 (...) to the NICE document and the current review, the Cochrane review had a much broader remit and examined a large number of differing technologies, concentrating mainly on different RT techniques and doses in patients undergoing RT for pelvic malignancies. The MUHC technology assessment concluded that ?given the limited and inconclusive evidence of the clinical benefit of SpaceOAR®, and the high costs associated with its use at the MUHC routine use of SpaceOAR® in prostate cancer patients receiving RT

2019 Cancer Care Ontario