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European Urology Jan 2024
Topics: Male; Humans; Prostatic Neoplasms; Prostate
PubMed: 37833176
DOI: 10.1016/j.eururo.2023.09.021 -
Urologic Oncology Sep 2021Major changes in the field of prostate cancer over the last 25 years include the implementation of prostate specific antigen screening and the recognition that BRCA... (Review)
Review
Major changes in the field of prostate cancer over the last 25 years include the implementation of prostate specific antigen screening and the recognition that BRCA confers hereditary risk of prostate cancer. Quality of life and survivorship have driven risk stratification for localized prostate cancer, facilitated by molecular signatures and leading to increased acceptance of active surveillance as a mainstream treatment option. Advances in technology have improved efficacy and reduced toxicity in both radical prostatectomy and radiation therapy for localized prostate cancer. Improved understanding of the androgen receptor has yielded substantially more effective therapies. Future growth areas include personalized treatment based on genomic and genetic information, theranostics radiopharmaceuticals, and more aggressive treatment of metastatic disease to include focal therapy. Multidisciplinary management between specialized urologists, radiation oncologists, and medical oncologists remains central to maximizing patient outcomes.
Topics: History, 20th Century; History, 21st Century; Humans; Male; Medical Oncology; Prostatic Neoplasms; Time Factors; Urology
PubMed: 34266741
DOI: 10.1016/j.urolonc.2021.04.016 -
Endocrine, Metabolic & Immune Disorders... 2021According to the American Cancer Society, prostate cancer ranks second in terms of mortality and is a front-runner of newly detected cases. Conventional therapies... (Review)
Review
BACKGROUND
According to the American Cancer Society, prostate cancer ranks second in terms of mortality and is a front-runner of newly detected cases. Conventional therapies neither eradicated cancer nor increased the life expectancy of patients obviating the need for less toxic as well as efficient therapies to treat cancer. Gene therapy alone, or in combination with conventional therapies, possesses a strong potential to combat cancer.
METHODS
This review encompasses a brief note on the etiology and conventional therapy of prostate cancer with an emphasis on gene therapy and its suitability for the treatment of prostate cancer.
RESULTS
A comprehensive range of gene therapy approaches have been successfully explored for prostate cancer treatment in animal models and this has been well translated into early clinical trials. We have also discussed in brief about specific therapeutic genes and suitable vector systems for gene therapy in prostate cancer.
CONCLUSION
Based on the results of these clinical trials, the application of gene therapy in prostate cancer therapeutics can be satisfactorily established.
Topics: Biomarkers, Tumor; Gene Expression Regulation, Neoplastic; Genetic Therapy; Genetic Vectors; Humans; Male; Prostatic Neoplasms; Viruses
PubMed: 32473623
DOI: 10.2174/1871530320666200531141455 -
Nature Reviews. Urology Mar 2015The combination of radiation treatment and long-term androgen deprivation therapy (ADT) has been shown in multiple clinical trials to prolong overall survival in men... (Review)
Review
The combination of radiation treatment and long-term androgen deprivation therapy (ADT) has been shown in multiple clinical trials to prolong overall survival in men with high-risk prostate cancer compared with either treatment alone. New radiation technologies enable the safe delivery of high radiation doses that improve cancer control compared with lower radiation doses. Based on the results of multiple randomized trials, clinical practice guidelines for high-risk prostate cancer recommend total radiation doses of at least 75.6 Gy, with long-term (2-3 years) ADT. Ongoing research into hypofractionated radiation treatment, whole-pelvic radiation, and combinations of radiation with novel hormonal agents could further improve cancer control and survival outcomes for patients with high-risk prostate cancer.
Topics: Combined Modality Therapy; Dose Fractionation, Radiation; Humans; Male; Prostatic Neoplasms; Randomized Controlled Trials as Topic; Survival Analysis; Treatment Outcome
PubMed: 25708578
DOI: 10.1038/nrurol.2015.25 -
American Society of Clinical Oncology... May 2018The treatment landscape for metastatic castration-sensitive prostate cancer (mCSPC) has rapidly evolved over the past 5 years. Although androgen-deprivation therapy... (Review)
Review
The treatment landscape for metastatic castration-sensitive prostate cancer (mCSPC) has rapidly evolved over the past 5 years. Although androgen-deprivation therapy (ADT) is still the backbone of treatment, the addition of docetaxel or abiraterone acetate has improved outcomes for patients with mCSPC and become standard of care. With multiple treatment options available for patients with mCSPC, treatment selection to optimize patient outcomes has become increasingly difficult. Here, we review the clinical trials involving ADT plus docetaxel or abiraterone and provide clinicians with guidelines for treatment. Although surgery and/or radiation are standard of care for localized, intermediate- and high-risk prostate cancer, these treatments are not routinely used as part of initial treatment plans for patients with de novo mCSPC. Recent clinical data are challenging that dogma, and we review the literature on the addition of surgery and radiation to systemic therapy for mCSPC. Finally, the standard of care for oligometastatic prostate cancer (a subset of mCSPC with limited metastases) has not been established compared with that for some other cancers. We discuss the recent studies on metastasis-directed therapy for treatment of oligometastatic prostate cancer.
Topics: Clinical Trials as Topic; Combined Modality Therapy; Disease Management; Humans; Male; Neoplasm Metastasis; Neoplasm Staging; Patient Selection; Prostatic Neoplasms; Treatment Outcome
PubMed: 30231388
DOI: 10.1200/EDBK_200967 -
Nature Reviews. Urology Jun 2016Prostate cancer is a unique and heterogeneous disease. Currently, a major unmet clinical need exists to develop biomarkers that enable indolent disease to be... (Review)
Review
Prostate cancer is a unique and heterogeneous disease. Currently, a major unmet clinical need exists to develop biomarkers that enable indolent disease to be distinguished from aggressive disease. The prostate is an abundant secretor of glycoproteins of all types, and alterations in glycans are, therefore, attractive as potential biomarkers and therapeutic targets. Despite progress over the past decade in profiling the genome and proteome, the prostate cancer glycoproteome remains relatively understudied. A wide range of alterations in the glycoproteins on prostate cancer cells can occur, including increased sialylation and fucosylation, increased O-β-N-acetylglucosamine (GlcNAc) conjugation, the emergence of cryptic and high-mannose N-glycans and alterations to proteoglycans. Glycosylation can alter protein function and has a key role in many important biological processes in cancer including cell adhesion, migration, interactions with the cell matrix, immune surveillance, cell signalling and cellular metabolism; altered glycosylation in prostate cancer might modify some, or all of these processes. In the past three years, powerful tools such as glycosylation-specific antibodies and glycosylation gene signatures have been developed, which enable detailed analyses of changes in glycosylation. Thus, emerging data on these often overlooked modifications have the potential to improve risk stratification and therapeutic strategies in patients with prostate cancer.
Topics: Animals; Disease Progression; Glycosylation; Humans; Male; Polysaccharides; Prostatic Neoplasms
PubMed: 27091662
DOI: 10.1038/nrurol.2016.65 -
BioMed Research International 2018
Topics: Humans; Male; Prostatic Neoplasms
PubMed: 29511674
DOI: 10.1155/2018/2807813 -
Seminars in Nuclear Medicine Jul 2019Prostate cancer is a major global health care challenge. Due to the recent relevant improvements in the diagnosis, imaging and treatment, management of these patients is... (Review)
Review
Prostate cancer is a major global health care challenge. Due to the recent relevant improvements in the diagnosis, imaging and treatment, management of these patients is becoming extremely complex. However, new multiple diagnostic procedures and treatment options, tailored on the single patient, require a multidisciplinary effort. Molecular imaging is gaining importance in the decision making process of prostate cancer patients, playing a key role in the majority of clinical setting, including staging, restaging during biochemical recurrence and castration-resistant stage. Moreover recent significant advances are changing the management of these patients impacting on the choice of therapeutic strategy. In particular, prostate-specific membrane antigen PET imaging is assuming the role of the gatekeeper addressing patients to the correct treatment option and also, in the advanced stages, selecting patients potentially suitable for targeted α- or β-therapy bridging to the fascinating concept of theranostic. Even if radioligand therapy found its first clinical application in 1946, in the last few years several α- or β-radionuclide prostate-specific membrane antigen-labeled for targeted therapy have been proposed where other treatment options do not show a significant impact on survival. The theranostic field is experiencing a rapid growth in prostate cancer giving to nuclear medicine a central role that has to be confirmed by further prospective studies.
Topics: Humans; Male; Molecular Imaging; Neoplasm Staging; Prostatic Neoplasms; Safety
PubMed: 31227048
DOI: 10.1053/j.semnuclmed.2019.02.002 -
Seminars in Oncology Oct 2017Prostate cancer is a heterogeneous disease with a variable natural history. Therefore, optimal management remains challenging. While many men with newly diagnosed... (Review)
Review
Prostate cancer is a heterogeneous disease with a variable natural history. Therefore, optimal management remains challenging. While many men with newly diagnosed prostate cancer may be candidates for active surveillance, there are others who will benefit from aggressive local therapy. Radical prostatectomy is associated with improvements in cancer-specific mortality, metastasis-free survival, and need for palliative treatments when compared with observation in several randomized controlled trials. Additionally, radical prostatectomy may have some oncologic benefit over radiation therapy. All aggressive therapy for prostate cancer negatively impacts erectile function and urinary continence. The decision for which treatment modality to pursue should incorporate shared decision making and consider cancer risk and severity in addition to patient preferences.
Topics: Combined Modality Therapy; Humans; Male; Outcome Assessment, Health Care; Prostate-Specific Antigen; Prostatectomy; Prostatic Neoplasms
PubMed: 29580436
DOI: 10.1053/j.seminoncol.2018.01.003 -
The Journal of Urology Nov 2022
Topics: Humans; Male; Medical Oncology; Prostatic Neoplasms; Urology
PubMed: 35984095
DOI: 10.1097/JU.0000000000002909