At the ESMO 2018 Conference that was recently concluded, there was a report of the clinical experience of 100 men with metastatic castrate resistant prostate cancer (mCRPC) who were consecutively treated with Lu-177 PSMA-I&T Radioligand Therapy.
The understanding that the earlier Provenge is used in castrate resistant men with prostate cancer has led many men to ask why not use Provenge even earlier when they are still castrate sensitive? This question is an excellent one which follows the logical next step; however, the answer is surprising!
According to the results of the STAMPEDE trial.1 adding radiotherapy (radiation) to the current standard-of-care androgen deprivation therapy (ADT of hormone therapy) did not improve the overall survival in all men who are newly diagnosed metastatic prostate cancer.
Why are Zytiga and Xtandi added to ADT and not substituted for ADT? Do I really need to continue ADT when I use Xtandi or Zytiga?
Hormone Therapy (ADT) along with the chemotherapy drug Taxotere (docetaxel) and Estramustine improves survival in men with high risk, localized castration-resistant prostate cancer over ADT alone.
Epic Sciences and Genomic Health, Inc. today announced that a local Medicare Administrative Contractor that assesses molecular diagnostic technologies, has issued a positive final local coverage determination (LCD) for the Oncotype DX® AR-V7 Nucleus Detect™ test.
Recently released and unexpected findings have been announced, contrary to previous understandings, black men who received primary radiation therapy to treat their prostate cancer had lower rates of biochemical cancer recurrence than white men. They also had a lower rate of developing distant metastasis.
There has been much discussion as well as clinical trials about the use of personal genetic information, specifically the presence of mutations in the DNA repair genes such as BRACA2, with the successful use of PARP-Inhibitors and in confirming our understanding that the occurrences of these genetic mutations are an indication of a poor prognosis.
BRACA is not the only DNA repair pathway you nee to be aware of if you have Prostate Cancer. Learn about to other mutations you need to known.
It has been announced that the Phase III ARAMIS Trial (Androgen Receptor inhibiting Agent for Metastatic-free Survival) evaluating an investigational treatment known as darolutamide in men with Non-metastatic Castration-resistant Prostate Cancer (nM0) has successfully met its primary endpoint of extending the metastasis-free survival (MFS) of men compared to placebo.
In certain men newly diagnosed with Advanced Prostate Cancer, or metastatic prostate cancer debunking the tumor with radiation can increase survival advantage.
We know that the incidence of both cardiovascular disease (CVD) and prostate cancer increase with age, resulting in higher mortality. CVD is the second most common cause of death in men with prostate cancer [1,2] Hormone therapy (ADT) with gonadotropin-releasing hormone (GnRH) agonists like Lupron for treatment of prostate cancer has been linked to additional increases in CVD morbidity and mortality. This link is especially evident in the first year of treatment , and men with a history of CVD are at higher risk .
Degarelix, which is different from the (GnRH) agonists, is a GnRH receptor antagonist also approved for the treatment of men with advanced prostate cancer. However, good data is suggesting that degarelix might have a lower incidence of causing CVD than the GnRH agonists
The standard dose of abiraterone acetate (Zytiga) is 1,000 mg. taken on an empty stomach, however, when just 250 mgs are taken with food, it seems that for many men this lower dosage has the same activity as Zytiga at 1,000 mg without food.
Metformin, an inexpensive FDA approved diabetes drug, has been recently re-purposed as a treatment for prostate cancer. It has been associated with a reduced incidence of prostate cancer and improved prostate cancer outcomes.
Recent questions have risen asking whether race modifies the association between metformin use and prostate cancer aggressiveness.
One of the on-going debates surrounds the question, should men with newly diagnosed advanced prostate cancer have a radical prostatectomy (RP). In a retrospective study, it was found that men lived longer if they had an RP followed by adjuvant radiotherapy (XRT). The study was reported in, Cancer, a very reputable Journal.
Circulating tumor cells (CTCs) are cancer cells that detach from a primary cancer tumor and enter a person’s bloodstream. Their goal is to move to another part of the body to form new metastases. These new metastatic lesions are more aggressive than the primary tumor and account for most of the cancer-related deaths.
Data from the phase 2/3 OSPREY 2301 Study has shown that the PSMA-targeted small molecule PET imaging agent (PyL (18F-DCFPyL) designed to better visualize prostate cancer outside of the gland demonstrated high sensitivity and reliably in detecting distant metastatic prostate cancer lesions and also a high specificity in confirming the absence of pelvic lymph nodes.
What is the proper target level for your testosterone to be considered castrate when you are on ADT?
Apalutamide (Erleada) extends time to the development of first metastatic development and it does not degrade the quality of life.
Our genes are continually mutating as our cells go through their normal process of replicating themselves. However, our bodies are blessed with other genes whose job it is to identify these mutations and then repair them before they do any damage, like give us cancer.
There are two phase 1 and 2 clinical trials reporting about a new PSMA targeting alpha emitting investigational radiation treatment. The trials are are very promising. They evaluate a new investigational treatment called Ac-225-PSMA-617.
We now need to wait for a phase 3 trial.