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Current Cancer Drug Targets 2021More therapy options are available for advanced prostate cancer, including novel inhibitors of androgen synthesis, anti-androgens, chemotherapeutics and targeted... (Review)
Review
More therapy options are available for advanced prostate cancer, including novel inhibitors of androgen synthesis, anti-androgens, chemotherapeutics and targeted therapies. Although patients ´ survival has been improved, management of castration therapy-resistant prostate cancer remains a challenge. Regulation of cellular events in cancer by small non-coding miRNAs is, therefore, an area of special interest. Overexpression of selected miRNA may lead to androgen independence and prostate cancer progression. miRNA may be considered also a biomarker in patients with prostate cancer. In contrast, diminished expression of tumor-suppressive miRNA in prostate cancer leads to enhanced proliferation, reduced apoptosis, increased migration, invasion and epithelial- to-mesenchymal transition. miRNA may be directly involved in the regulation of chemosensitivity in prostate cancer. Experimental overexpression of selected miRNA in chemoresistant prostate cancer leads to the inhibition of cellular stemness and epithelial-to-mesenchymal transition. Reduction of tumor-suppressive miRNA may also lead to hyperactivity of signaling pathways such as that of the epidermal growth factor receptor and mitogen-activated protein kinase. Although considerable progress on miRNA research in prostate cancer has been achieved, therapeutic effects could be improved on the basis of the development of novel delivery methods.
Topics: Androgen Antagonists; Antineoplastic Agents; Biomarkers, Tumor; Carcinogenesis; Disease Progression; Drug Resistance, Neoplasm; Humans; Male; MicroRNAs; Molecular Targeted Therapy; Prostatic Neoplasms; Prostatic Neoplasms, Castration-Resistant
PubMed: 33423646
DOI: 10.2174/1568009620666210108103134 -
World Journal of Urology Feb 2021
Topics: Humans; Male; Neoplasm Staging; Prostatic Neoplasms
PubMed: 33591380
DOI: 10.1007/s00345-021-03618-4 -
Oncogene Dec 2020Prostate cancer is diagnosed mostly in men over the age of 50 years, and has favorable 5-year survival rates due to early cancer detection and availability of curative... (Review)
Review
Prostate cancer is diagnosed mostly in men over the age of 50 years, and has favorable 5-year survival rates due to early cancer detection and availability of curative surgical management. However, progression to metastasis and emergence of therapeutic resistance are responsible for the majority of prostate cancer mortalities. Recent advancement in sequencing technologies and computational capabilities have improved the ability to organize and analyze large data, thus enabling the identification of novel biomarkers for survival, metastatic progression and patient prognosis. Large-scale sequencing studies have also uncovered genetic and epigenetic signatures associated with prostate cancer molecular subtypes, supporting the development of personalized targeted-therapies. However, the current state of mainstream prostate cancer management does not take full advantage of the personalized diagnostic and treatment modalities available. This review focuses on interrogating biomarkers of prostate cancer progression, including gene signatures that correspond to the acquisition of tumor lethality and those of predictive and prognostic value in progression to advanced disease, and suggest how we can use our knowledge of biomarkers and molecular subtypes to improve patient treatment and survival outcomes.
Topics: Drug Resistance, Neoplasm; Humans; Male; Prognosis; Prostatic Neoplasms
PubMed: 33046797
DOI: 10.1038/s41388-020-01496-5 -
European Urology Focus Mar 2020While radiotherapy with androgen deprivation therapy is the current standard of care for the treatment of stage cT4 prostate cancer (PC), surgery may also be an... (Review)
Review
While radiotherapy with androgen deprivation therapy is the current standard of care for the treatment of stage cT4 prostate cancer (PC), surgery may also be an appropriate option in selected patients as part of a multimodal approach. The role and the sequence with which to optimize therapy combinations in this setting are still unknown. This mini review summarizes the current evidence for management of cT4 PC. PATIENT SUMMARY: This mini review examines current evidence for the treatment options for locally advanced prostate cancer. The role of surgery in these patients can be considered as part of a combination treatment strategy along with other modalities such as radiotherapy and hormone therapy.
Topics: Combined Modality Therapy; Humans; Male; Neoplasm Staging; Prostatic Neoplasms
PubMed: 31266732
DOI: 10.1016/j.euf.2019.06.012 -
Current Urology Reports Aug 2017The purpose of this review is to examine prostate cancer racial disparities specific to the African-American population. (Review)
Review
PURPOSE OF REVIEW
The purpose of this review is to examine prostate cancer racial disparities specific to the African-American population.
RECENT FINDINGS
African-American men are more likely to be diagnosed with prostate cancer, present at an earlier age; are more likely to have locally advanced or metastatic disease at diagnosis; and have suboptimal outcomes to standard treatments. Prostate cancer treatment requires a nuanced approach, particularly when applying screening, counseling, and management of African-American men. Oncological as well as functional outcomes may differ and are potentially due to a combination of genetic, molecular, behavioral, and socioeconomic factors.
Topics: Black or African American; Age of Onset; Early Detection of Cancer; Healthcare Disparities; Humans; Male; Neoplasm Staging; Prostatic Neoplasms; Treatment Outcome; United States
PubMed: 28808871
DOI: 10.1007/s11934-017-0724-5 -
Cancer Radiotherapie : Journal de La... 2022We present the update of the recommendations of the French society of oncological radiotherapy on external radiotherapy of prostate cancer. External radiotherapy is...
We present the update of the recommendations of the French society of oncological radiotherapy on external radiotherapy of prostate cancer. External radiotherapy is intended for all localized prostate cancers, and more recently for oligometastatic prostate cancers. The irradiation techniques are detailed. Intensity-modulated radiotherapy combined with prostate image-guided radiotherapy is the recommended technique. A total dose of 74 to 80Gy is recommended in case of standard fractionation (2Gy per fraction). Moderate hypofractionation (total dose of 60Gy at a rate of 3Gy per fraction over 4 weeks) in the prostate has become a standard of therapy. Simultaneous integrated boost techniques can be used to treat lymph node areas. Extreme hypofractionation (35 to 40Gy in five fractions) using stereotactic body radiotherapy can be considered a therapeutic option to treat exclusively the prostate. The postoperative irradiation technique, indicated mainly in case of biological recurrence and lymph node involvement, is detailed.
Topics: Dose Fractionation, Radiation; France; Humans; Lymphatic Irradiation; Male; Neoplasm Recurrence, Local; Organs at Risk; Patient Positioning; Prostatectomy; Prostatic Neoplasms; Radiation Oncology; Radiosurgery; Radiotherapy, Image-Guided; Radiotherapy, Intensity-Modulated; Time Factors; Tumor Burden
PubMed: 34955419
DOI: 10.1016/j.canrad.2021.11.017 -
Current Opinion in Urology Nov 2019To provide a comprehensive review of the available biomarkers for the detection and active surveillance of prostate cancer and simplify decision-making while choosing... (Review)
Review
PURPOSE OF REVIEW
To provide a comprehensive review of the available biomarkers for the detection and active surveillance of prostate cancer and simplify decision-making while choosing between them.
RECENT FINDINGS
The limitations of PSA and mpMRI and the invasive nature of prostate biopsy has led to a constant search for serum and urinary biomarkers for both the detection and monitoring during active surveillance of prostate cancer. 4K, PHI and PCA3 have been validated in prospective clinical trials for initial detection of prostate cancer and recent evidence points to potential differentiation between indolent and aggressive cancer. However, the usage in monitoring tumor dynamics is debatable because of lack of conclusive evidence. The answer to the existing problems lies in high-quality studies to establish definitive evidence and also to help choose between the plethora of biomarkers available today.
SUMMARY
Despite the advancements in innovation and usage of biomarkers in prostate cancer, there exists tremendous potential in improving them to fulfil the unmet need that exists today. Studies to establish conclusive evidence and integration with imaging can tremendously aid diagnosis and monitoring.
Topics: Antigens, Neoplasm; Biomarkers, Tumor; Humans; Male; Prostatic Neoplasms; Watchful Waiting
PubMed: 31436568
DOI: 10.1097/MOU.0000000000000670 -
Abdominal Radiology (New York) May 2016Recurrent prostate cancer following primary treatment is common, and the population of men with biochemical recurrence is complex. Conventional management of recurrent... (Review)
Review
Recurrent prostate cancer following primary treatment is common, and the population of men with biochemical recurrence is complex. Conventional management of recurrent prostate cancer involves nontargeted and/or systemic therapies, without defining an individual patient's specific disease. However, recent advances in imaging enable a shift in the management of recurrent prostate cancer to targeted, patient-specific approaches. Specifically, MRI can detect and define local prostate cancer recurrence early in the course of disease, and prostate-specific PET imaging greatly improves nodal staging and can detect previously unknown distant metastases. The significant advances in the imaging of both local and distant tumor recurrences allows for specific selection of treatment options tailored to patients and their disease with less associated morbidity.
Topics: Contrast Media; Humans; Lymphatic Metastasis; Magnetic Resonance Imaging; Male; Neoplasm Recurrence, Local; Neoplasm Staging; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms; Radiopharmaceuticals; Risk Factors
PubMed: 27193788
DOI: 10.1007/s00261-015-0562-1 -
European Urology Focus Mar 2019Advanced prostate cancer patients can present with both widely metastatic or oligometastatic disease. Accumulating clinical evidence suggests that patients with... (Review)
Review
Advanced prostate cancer patients can present with both widely metastatic or oligometastatic disease. Accumulating clinical evidence suggests that patients with oligometastatic disease have improved clinical responses from metastasis-directed therapy. This suggests that tumours that give rise to the oligometastatic state are distinct biologically and genetically from those that induce widely metastatic lesions. Detailed genomic analysis of the oligometastatic state will identify the molecular events that distinguish localised from metastatic disease, defining the molecular signatures of curability. The GAP6 consortium is well poised to address this question. PATIENT SUMMARY: In this report, we have reviewed the evidence that prostate cancer patients with only a small number of distant tumour deposits have cancers that are driven by genetic and biological changes, which are distinct from those tumours that readily spread to many distant sites. So far, the evidence is not clear cut; however, in-depth studies to answer this question are underway.
Topics: Genomics; Humans; Male; Neoplasm Metastasis; Prognosis; Prostatic Neoplasms; Radiosurgery
PubMed: 30642810
DOI: 10.1016/j.euf.2018.12.009 -
International Journal of Urology :... Mar 2018During the past decade, treatment strategies for patients with advanced prostate cancer involving stage IV (T4N0M0, N1M0 or M1) hormone-sensitive prostate cancer and... (Review)
Review
During the past decade, treatment strategies for patients with advanced prostate cancer involving stage IV (T4N0M0, N1M0 or M1) hormone-sensitive prostate cancer and recurrent prostate cancer after treatment with curative intent, as well as castration-resistant prostate cancer, have extensively evolved with the introduction and approval of several new agents including sipuleucel-T, radium-223, abiraterone, enzalutamide and cabazitaxel, all of which have shown significant improvement on overall survival. The appropriate use of these agents and the proper sequencing of these agents are still not optimized. The results of several recently reported randomized controlled trials and retrospective studies could assist in developing a treatment strategy for advanced prostate cancer. In addition, prospective studies and molecular characterization of tumors to address these issues are ongoing.
Topics: Algorithms; Antineoplastic Agents; Biomarkers, Tumor; Cancer Vaccines; Humans; Male; Neoplasm Recurrence, Local; Prognosis; Prostatic Neoplasms; Prostatic Neoplasms, Castration-Resistant; Radium; Tissue Extracts
PubMed: 29266472
DOI: 10.1111/iju.13512