Gene panel predicts low-risk prostate cancer fate
Researchers from the USA have identified a three-gene signature that can predict prostate cancer progression in low Gleason score tumors.
Conditions: Prostate Cancer; Cardiotoxicity; Drug-Related Side Effects and Adverse Reactions; Cardiovascular Diseases Intervention: Other: Social Determinants of Health Sponsors: Abramson Cancer Center of the University of Pennsylvania; American Heart Association Not yet recruiting
This article will describe these 2 situations and their current management but also will come through assessments with the contribution of modern imaging and new treatment options in terms of RT dose and RT±HT combination.PMID:34702645 | DOI:10.1016/j.canrad.2021.08.017
CONCLUSION: We observed increased adoption of hypofractionation at our institution during the study period for both breast and prostate cancer. For bone metastases, hypofractionation had largely been adopted before the study period. There was evidence of an accelerated trend toward hypofractionation for some cancers during the COVID-19 pandemic.PMID:34701250 | DOI:10.1016/j.ijrobp.2021.07.1055
Int J Radiat Oncol Biol Phys. 2021 Nov 1;111(3S):e278. doi: 10.1016/j.ijrobp.2021.07.896.ABSTRACTPURPOSE/OBJECTIVE(S): Guideline and clinical adoption of new radiotherapeutic approaches commonly requires 5-10 years of follow-up in randomized trials to ensure long-term safety. This is resource intensive and slows the pace of advancement. We hypothesized that the relative risk (RR) of radiation-induced gastrointestinal (GI) or genitourinary (GU) toxicity would remain similar or decrease overtime with long-term follow-up.MATERIALS/METHODS: PubMed and Embase were systematically searched for randomized trials evaluating changes...
CONCLUSION: In this large cohort with long-term follow-up and trial-level quality assurance, models based on standard clinicopathologic variables had limitations in accurately estimating prognosis. The proportional benefit of ADT use was consistent, but the absolute magnitude of benefit varied greatly by predicted baseline risk of DM. Incorporation of genomic prognostic information into risk stratification to better estimate absolute ADT benefit are needed and ongoing (NCT04513717).PMID:34700633 | DOI:10.1016/j.ijrobp.2021.07.189
Int J Radiat Oncol Biol Phys. 2021 Nov 1;111(3S):S78-S79. doi: 10.1016/j.ijrobp.2021.07.190.ABSTRACTPURPOSE/OBJECTIVE(S): Radiotherapy (RT) dose escalation for localized prostate cancer has not demonstrated improvement in overall survival (OS) from individual trials. It is unclear if the use of androgen deprivation therapy (ADT) effects the potential benefit of dose escalation. Therefore, to achieve sufficient power to answer this question, we performed a meta-analysis of randomized trials evaluating the benefit of RT dose escalation in localized prostate cancer.MATERIALS/METHODS: The Meta-Analysis of Randomized clinical t...
Int J Radiat Oncol Biol Phys. 2021 Nov 1;111(3S):S76-S77. doi: 10.1016/j.ijrobp.2021.07.186.ABSTRACTPURPOSE/OBJECTIVE(S): The use/prolongation of androgen deprivation therapy (ADT) with external beam radiotherapy (EBRT) improves distant metastasis outcomes in patients with high-risk prostate cancer. The optimal duration of ADT when adding a brachytherapy boost (EBRT+BT) remains unknown.MATERIALS/METHODS: A total of 2935 patients who received treatment across 15 institutions between 2000-2014 were identified (1827 treated with EBRT and 1108 with EBRT+BT). Three broad ADT strata were defined: no ADT, 1-18 months ADT, and 18-...
CONCLUSION: A nomogram tuned to the detection of non-localized disease on PSMA/PET in HR-PCa patients is significantly prognostic of important clinical endpoints, with performance comparable to STAR-CAP and superior to other tools. These data strongly suggest that upstaging based on PSMA PET/CT provides clinically relevant information and warrant prospective validation.PMID:34700573 | DOI:10.1016/j.ijrobp.2021.07.135
CONCLUSION: Neoadjuvant SBRT to 30-35 Gy in 5 fractions followed by RP results in unacceptably high toxicity and severe QoL declines. Locoregional only treatment intensification is oncologically inadequate, as nearly half of men having recurred by 3 years post-treatment. Given the success of definitive radiotherapy plus hormone therapy in locally advanced prostate cancer, the combination of neoadjuvant SBRT and RP should not be further pursued.PMID:34700572 | DOI:10.1016/j.ijrobp.2021.07.134
CONCLUSION: This study represents the strongest evidence to support ADT use and prolongation of adjuvant ADT to at least 18 months in localized prostate cancer in conjunction with definitive RT. The relative benefit of ADT use and adjuvant ADT prolongation was consistent irrespective of RT dose-escalation. In contrast, prolongation of neoadjuvant ADT beyond 2 months did not improve survival outcomes and should not routinely be employed.PMID:34700570 | DOI:10.1016/j.ijrobp.2021.07.046