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Latest & greatest articles for prostate cancer
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in UK practice and that 18 F-choline PET/CT is currently the only scan commissioned by NHS England in the national PET/CT tender. Axumin is designed to more effectively identify recurrent disease across a wide range of PSA levels compared with standard-of-care imaging (pelvic CT or MRI and bone scans). These lack the sensitivity and specificity to detect prostatecancer when PSA levels are low (Mottet et al. 2017; Cornford et al. 2017). The short uptake period for Axumin allows scans to be done 3 (...) of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 15Current care pathway NICE's guideline on prostatecancer: diagnosis and management recommends routine follow-up to identify recurrent disease in men who have had treatment for localised prostatecancer. According to the guideline, methods of monitoring disease control and detecting recurrence include physical examination, PSA blood tests and imaging investigations. It recommends that PSA levels are checked
Fluorine- or gallium- prostate-specific membrane antigen (PSMA) positron emission tomography (PET) radiotracers in the investigation of recurrent prostatecancer Fluorine- or gallium- prostate-specific membrane antigen positron emission tomography radiotracers - Health Technology Wales > Fluorine- or gallium- prostate-specific membrane antigen positron emission tomography radiotracers Fluorine- or gallium- prostate-specific membrane antigen positron emission tomography radiotracers Topic Status (...) Incomplete Fluorine- or gallium- prostate-specific membrane antigen (PSMA) positron emission tomography (PET) radiotracers in the investigation of recurrent prostatecancer. Outcome of the appraisal The adoption of 68 Ga prostate-specific membrane antigen (PSMA) positron emission tomography (PET) for the diagnosis of recurrent prostatecancer is partially supported by the evidence. The use of 68 Ga PSMA PET provides a high degree of diagnostic accuracy on which to base management decisions as compared
Remote monitoring or self-management for surveillance or follow up of prostatecancer Remote monitoring of prostatecancer - Health Technology Wales > Remote monitoring of prostatecancer Remote monitoring of prostatecancer Topic Status Incomplete Remote monitoring or self-management for surveillance or follow up of prostatecancer. Summary Health Technology Wales researchers searched for evidence on different methods of prostate remote monitoring/self-management. Although a range of evidence
were 18 years or older with locally advanced prostatecancer (either T2b-4, N0 M0 tumours or T2a, N0 M0 tumours provided Gleason score was ≥7 and baseline prostate-specific antigen [PSA] concentration was ≥10 μg/L). We randomly allocated participants in a 2 × 2 factorial design by computer-generated randomisation (using the minimisation technique, and stratified by centre, baseline PSA concentration, clinical tumour stage, Gleason score, and use of a brachytherapy boost) in a 1:1:1:1 ratio to four (...) Short-term androgen suppression and radiotherapy versus intermediate-term androgen suppression and radiotherapy, with or without zoledronic acid, in men with locally advanced prostatecancer (TROG 03.04 RADAR): 10-year results from a randomised, phase 3, The optimal duration of androgen suppression for men with locally advanced prostatecancer receiving radiotherapy with curative intent is yet to be defined. Zoledronic acid is effective in preventing androgen suppression-induced bone loss
Health-related Quality of Life for Abiraterone Plus Prednisone Versus Enzalutamide in Patients with Metastatic Castration-resistant ProstateCancer: Results from a Phase II Randomized Trial Abiraterone and enzalutamide are associated with side effects that may impair health-related quality of life (HRQoL).To assess patient-reported HRQoL, depression symptoms, and cognitive function for abiraterone versus enzalutamide.We randomized 202 patients in a phase II study of abiraterone versus (...) enzalutamide for first-line treatment of metastatic castration-resistant prostatecancer (ClinicalTrials.gov: NCT02125357).Patients completed Functional Assessment of Cancer Therapy-Prostate (FACT-P) and Patient Health Questionnaire-9 (PHQ-9) questionnaires, and Montreal Cognitive Assessment (MoCA) cognitive assessments at baseline and on treatment.To compare the change in FACT-P scores over time between treatment arms, we used a mixed model for repeated measures (MMRM). For FACT-P domains where
with 4-yr intervals starting at age 55yr and screened up to the age of 74yr. Overall, a PSA level of ≥3.0ng/ml triggered biopsy. At time of analysis, 63% of men had died. Overall relative risk of metastatic (M+) disease and prostatecancer (PCa) death was 0.46 (95% confidence interval [CI]: 0.19-1.11) and 0.48 (95% CI: 0.17-1.36), respectively, in favor of screening. This ERSPC Rotterdam pilot 1 study cohort, screened in a period without noteworthy contamination, shows that PSA-based screening could (...) result in considerable reductions of M+ disease and mortality which if confirmed in larger datasets should trigger further discussion on pros/cons of PCa screening. PATIENT SUMMARY: In a cohort with 19yr of follow-up, we found indications for a more substantial reduction in metastatic disease and cancer-specific mortality in favor of prostatecancer screening than previously reported. If confirmed in larger cohorts, these findings should be considered in the ongoing discussion on harms and benefits
months), use of bone-preserving substances (yes vs. no), presence of locoregional disease (N0 vs. N1). b: Deterioration means decrease in score by the respective MID. ADT: androgen deprivation therapy; AE: adverse event; CI: confidence interval; CTCAE: Common Terminology Criteria for Adverse Events; FACT-P: Functional Assessment of Cancer Therapy – Prostate; HR: hazard ratio; MID: minimally important difference; n: number of patients with (at least one) event; N: number of analysed patients; NA (...) Apalutamide (prostatecancer) - Addendum to Commission A19-09 1 Translation of addendum A19-51 Apalutamid (Prostatakarzinom) – Addendum zum Auftrag A19-09 (Version 1.0; Status: 11 July 2019). 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 July 2019 1.0 Commission: A19-51 Version: Status: IQWiG Reports – Commission No. A19-51 Apalutamide (prostate
: No advisor on medical and scientific questions was available for the present dossier assessment. IQWiG employees involved in the dossier assessment: ? Bent Müller ? Christiane Balg ? Gertrud Egger ? Simone Johner ? Inga Overesch ? Anke Schulz ? Anja Schwalm ? Volker Vervölgyi Keywords: enzalutamide, prostaticneoplasms – castration-resistant, benefit assessment, NCT02003924 Extract of dossier assessment A18-80 Version 1.0 Enzalutamide (prostatecancer) 26 February 2019 Institute for Quality (...) Enzalutamide (prostatecancer) - Benefit assessment according to §35a Social Code Book V Extract 1 Translation of the executive summary of the dossier assessment Enzalutamid (Prostatakarzinom) – Nutzenbewertung gemäß § 35a SGB V (Version 1.0; Status: 26 February 2019). Please note: This document was translated by an external translator and is provided as a service by IQWiG to English-language readers. However, solely the German original text is absolutely authoritative and legally binding
Radical Prostatectomy or Watchful Waiting in ProstateCancer - 29-Year Follow-up. Radical prostatectomy reduces mortality among men with clinically detected localized prostatecancer, but evidence from randomized trials with long-term follow-up is sparse.We randomly assigned 695 men with localized prostatecancer to watchful waiting or radical prostatectomy from October 1989 through February 1999 and collected follow-up data through 2017. Cumulative incidence and relative risks with 95 (...) % confidence intervals for death from any cause, death from prostatecancer, and metastasis were estimated in intention-to-treat and per-protocol analyses, and numbers of years of life gained were estimated. We evaluated the prognostic value of histopathological measures with a Cox proportional-hazards model.By December 31, 2017, a total of 261 of the 347 men in the radical-prostatectomy group and 292 of the 348 men in the watchful-waiting group had died; 71 deaths in the radical-prostatectomy group
users and nonusers using an age-adjusted Cox regression model.Screening increased the detection of Gleason 6 (hazard ratio [HR] 1.59, 95% confidence interval [CI] 1.47-1.72 and HR 1.39, 95% CI 1.26-1.54) and localized prostatetumors (HR 1.25, 95% CI 1.18-1.32 and HR 1.11, 95% CI 1.03-1.20) more among baseline NSAID nonusers than among users, respectively (p for interaction <0.04 for both). This difference was observed in all three screening rounds. Detection of metastatic prostatecancer (...) was similar in both NSAID users and nonusers. Screening decreased prostatecancer mortality among men using NSAIDs at FinRSPC randomization (HR 0.66, 95% CI 0.49-0.90) but not among nonusers (HR 0.95, 95% CI 0.81-1.12); p for interaction=0.04.Screening detected fewer well-differentiated localized tumors among NSAID users than among nonusers. This suggests that PSA screening may cause less overdiagnosis within this subgroup, whereas mortality benefit may be greater among NSAID users.Prostate cancer
Sequence of hormonal therapy and radiotherapy field size in unfavourable, localised prostatecancer (NRG/RTOG 9413): long-term results of a randomised, phase 3 trial The NRG/RTOG 9413 study showed that whole pelvic radiotherapy (WPRT) plus neoadjuvant hormonal therapy (NHT) improved progression-free survival in patients with intermediate-risk or high-risk localised prostatecancer compared with prostate only radiotherapy (PORT) plus NHT, WPRT plus adjuvant hormonal therapy (AHT), and PORT plus (...) in the NHT plus WPRT group, 17 (5%) of 313 in the NHT plus PORT group, 22 (7%) of 317 in the WPRT plus AHT group, and 14 (4%) of 315 in the PORT plus AHT group. Late grade 3 or worse gastrointestinal adverse events occurred in 22 (7%) of 316 patients in the NHT plus WPRT group, five (2%) of 313 in the NHT plus PORT group, ten (3%) of 317 in the WPRT plus AHT group, and seven (2%) of 315 in the PORT plus AHT group.In this cohort of patients with intermediate-risk and high-risk localised prostatecancer
in a large cohort of men with prostatecancer highly enriched in an AA patient population.Patients were diagnosed with clinically localized adenocarcinoma of the prostate and treated at The Ochsner Clinic (New Orleans, LA, USA) from January 2006 to December 2011. CCP scores were derived from archival formalin-fixed, paraffin-embedded biopsy tissue. CCR scores were calculated as the combination of molecular (CCP score) and clinical (Cancer of the Prostate Risk Assessment [CAPRA] score) components.Active (...) Comparison of the Prognostic Utility of the Cell Cycle Progression Score for Predicting Clinical Outcomes in African American and Non-African American Men with Localized ProstateCancer Better prostatecancer risk stratification is necessary to inform medical management, especially for African American (AA) men, for whom outcomes are particularly uncertain.To evaluate the utility of both a cell cycle progression (CCP) score and a clinical cell-cycle risk (CCR) score to predict clinical outcomes
techniques for prostatecancer are more accur New diagnostic techniques for prostatecancer are more accurate at identifying low- ate at identifying low- risk disease risk disease 3.1 NICE's clinical guideline on prostatecancer considers tumours to be low risk if the following criteria are met: serum prostate-specific antigen (PSA) no more than 10 ng/ml, a Gleason score no more than 6, and a clinical stage of T1 to T2a. (The Gleason Score is a grading system that rates the aggressiveness of the 2 (...) largest areas of prostatecancer cells in a tumour. Each area is scored on how healthy it looks, so healthy tissue scores 1 or 2 and abnormal tissue scores 3). The clinical experts explained that the techniques used to diagnose prostatecancer in the NHS are changing, for example, transrectal ultrasound (TRUS) guided biopsy is being replaced by multiparametric MRI. MRI techniques are more accurate at differentiating low-risk disease that does not need treatment, from disease that is likely to progress
cohort in phase II will be reported separately.EPI is a noninvasive, easy-to-use, gene expression urine assay, which has now been successfully validated in over 1000 patients across two prospective validation trials to stratify risk of ≥GG2 from GG1 cancer and benign disease. The test improves identification of patients with higher grade disease and would reduce the total number of unnecessary biopsies.It is challenging to predict which men are likely to have high-grade prostatecancer (PCa (...) A Prospective Adaptive Utility Trial to Validate Performance of a Novel Urine Exosome Gene Expression Assay to Predict High-grade ProstateCancer in Patients with Prostate-specific Antigen 2-10ng/ml at Initial Biopsy Discriminating indolent from clinically significant prostatecancer (PCa) in the initial biopsy setting remains an important issue. Prospectively evaluated diagnostic assays are necessary to ensure efficacy and clinical adoption.Performance and utility assessment of ExoDx Prostate
Hypofractionated Radiation Therapy for Localized ProstateCancer Hypofractionated Radiation Therapy for Localized ProstateCancer: An ASTRO, ASCO, and AUA Evidence-Based Guideline | Journal of Clinical Oncology Search in: Menu Article Tools ASCO SPECIAL ARTICLE Article Tools OPTIONS & TOOLS COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.18.01097 Journal of Clinical Oncology - published online before print October 11, 2018 Hypofractionated Radiation Therapy (...) for Localized ProstateCancer: An ASTRO, ASCO, and AUA Evidence-Based Guideline x Scott C. Morgan , x Karen Hoffman , x D. Andrew Loblaw , x Mark K. Buyyounouski , x Caroline Patton , x Daniel Barocas , x Soren Bentzen , x Michael Chang , x Jason Efstathiou , x Patrick Greany , x Per Halvorsen , x Bridget F. Koontz , x Colleen Lawton , x C. Marc Leyrer , x Daniel Lin , x Michael Ray , and x Howard Sandler Scott C. Morgan, The Ottawa Hospital and University of Ottawa, Ottawa; D. Andrew Loblaw, Odette Cancer
Radiotherapy to the primary tumour for newly diagnosed, metastatic prostatecancer (STAMPEDE): a randomised controlled phase 3 trial. Based on previous findings, we hypothesised that radiotherapy to the prostate would improve overall survival in men with metastatic prostatecancer, and that the benefit would be greatest in patients with a low metastatic burden. We aimed to compare standard of care for metastatic prostatecancer, with and without radiotherapy.We did a randomised controlled phase (...) 3 trial at 117 hospitals in Switzerland and the UK. Eligible patients had newly diagnosed metastatic prostatecancer. We randomly allocated patients open-label in a 1:1 ratio to standard of care (control group) or standard of care and radiotherapy (radiotherapy group). Randomisation was stratified by hospital, age at randomisation, nodal involvement, WHO performance status, planned androgen deprivation therapy, planned docetaxel use (from December, 2015), and regular aspirin or non-steroidal
2018LancetControlled trial quality: predicted high
allocation. The primary endpoint was investigator-assessed radiographic progression-free survival (rPFS; based on Response Evaluation Criteria in Solid Tumors version 1.1 and ProstateCancer Clinical Trials Working Group 2 criteria). Efficacy analyses were done in the intention-to-treat population, which included all randomly assigned patients, and safety analyses included all patients who received at least one dose of olaparib or placebo. This trial is registered with ClinicalTrials.gov, number (...) Olaparib combined with abiraterone in patients with metastatic castration-resistant prostatecancer: a randomised, double-blind, placebo-controlled, phase 2 trial Patients with metastatic castration-resistant prostatecancer and homologous recombination repair (HRR) mutations have a better response to treatment with the poly(ADP-ribose) polymerase inhibitor olaparib than patients without HRR mutations. Preclinical data suggest synergy between olaparib and androgen pathway inhibitors. We aimed