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European Urology Apr 2022New imaging techniques are more sensitive in prostate cancer and reveal sites of disease that may never have been seen with conventional imaging, resulting in stage...
New imaging techniques are more sensitive in prostate cancer and reveal sites of disease that may never have been seen with conventional imaging, resulting in stage migration and potentially a change in the clinical management. Until long-term data provide a better understanding of the natural history of the disease defined by more sensitive imaging, patients and clinicians should recognise the considerable uncertainty about whether these improve outcomes. It is hoped that the next iteration of the TNM classification will recognise the problem in some way.
Topics: Humans; Male; Neoplasm Staging; Prostatic Neoplasms
PubMed: 35094898
DOI: 10.1016/j.eururo.2022.01.002 -
Current Opinion in Oncology May 2020Summarize recent advances in the treatment of advanced prostate cancer. (Review)
Review
PURPOSE OF REVIEW
Summarize recent advances in the treatment of advanced prostate cancer.
RECENT FINDINGS
Recent randomized data suggest a survival advantage to early use of novel androgen receptor inhibitors in combination with androgen deprivation therapy both in the setting of hormone-sensitive metastatic prostate cancer and nonmetastatic castration-resistant disease. While ongoing analyses examine optimal sequencing of existing agents for treatment of advanced prostate cancer, additional research focuses on expanding treatment options through development of novel genomically targeted therapies, antibody-drug conjugates, and immune therapy combinations.
SUMMARY
In this review, we summarize the recent data supporting the early use of novel androgen receptor inhibitors in advanced prostate cancer and aim to also frame how these drugs may fit within the existing context of docetaxel and abiraterone. We present recent series examining sequencing of approved therapies while searching for predictive biomarkers. Finally, we examine trials evaluating novel agents that target certain biological pathways to highlight the likely future directions for progress in the clinical management of advanced prostate cancer.
Topics: Androgen Receptor Antagonists; Humans; Immunotherapy; Male; Molecular Targeted Therapy; Neoplasm Metastasis; Prostatic Neoplasms; Prostatic Neoplasms, Castration-Resistant; Radiopharmaceuticals; Randomized Controlled Trials as Topic
PubMed: 32209821
DOI: 10.1097/CCO.0000000000000624 -
Surgical Pathology Clinics Dec 2018Large-gland proliferations of the prostate have gained considerable attention in the past decade. The differential diagnosis is quite broad but can be refined using... (Review)
Review
Large-gland proliferations of the prostate have gained considerable attention in the past decade. The differential diagnosis is quite broad but can be refined using histologic criteria and, sometimes, immunostains. Pathologists have come to realize that cribriform and intraductal as well as ductal carcinomas are particularly aggressive patterns, and should name them in diagnostic reporting when present.
Topics: Adenocarcinoma; Atrophy; Diagnosis, Differential; Humans; Hyperplasia; Male; Neoplasm Grading; Neoplasm Invasiveness; Prognosis; Prostate; Prostatic Neoplasms
PubMed: 30447836
DOI: 10.1016/j.path.2018.07.001 -
Prostate Cancer and Prostatic Diseases Sep 2019Prostate cancer is the most common cancer in American men that ranges from low risk states amenable to active surveillance to high-risk states that can be lethal... (Review)
Review
BACKGROUND
Prostate cancer is the most common cancer in American men that ranges from low risk states amenable to active surveillance to high-risk states that can be lethal especially if untreated. There is a critical need to develop relatively non-invasive and clinically useful methods for screening, detection, prognosis, disease monitoring, and prediction of treatment efficacy. In this review, we focus on important advances as well as future efforts needed to drive clinical innovation in this area of urine biomarker research for prostate cancer detection and prognostication.
METHODS
We provide a review of current literature on urinary biomarkers for prostate cancer. We evaluate the strengths and limitations of a variety of approaches that vary in sampling strategies and targets measured; discuss reported urine tests for prostate cancer with respect to their technical, analytical, and clinical parameters; and provide our perspectives on critical considerations in approaches to developing a urine-based test for prostate cancer.
RESULTS
There has been an extensive history of exploring urine as a source of biomarkers for prostate cancer that has resulted in a variety of urine tests that are in current clinical use. Importantly, at least three tests have demonstrated high sensitivity (~90%) and negative predictive value (~95%) for clinically significant tumors; however, there has not been widespread adoption of these tests.
CONCLUSIONS
Conceptual and methodological advances in the field will help to drive the development of novel urinary tests that in turn may lead to a shift in the clinical paradigm for prostate cancer diagnosis and management.
Topics: Biomarkers, Tumor; Disease Progression; Early Detection of Cancer; Humans; Male; Mass Screening; Neoplasm Recurrence, Local; Neoplasm Staging; Prognosis; Prostate; Prostatic Neoplasms
PubMed: 30655600
DOI: 10.1038/s41391-019-0127-4 -
Cancer Letters Jan 2022Prostate cancer is the most commonly diagnosed cancer and the second leading cause of cancer-related death among men in western countries. Androgen deprivation therapy... (Review)
Review
Prostate cancer is the most commonly diagnosed cancer and the second leading cause of cancer-related death among men in western countries. Androgen deprivation therapy (ADT) is considered the standard therapy for recurrent prostate cancer; however, this therapy may lead to ADT resistance and tumor progression, which seems to be regulated by epithelial-mesenchymal transition (EMT) and/or neuroendocrine differentiation (NED). In addition, recent data suggested the involvement of either adaptive or innate infiltrated immune cells in the initiation, progression, metastasis, and treatment of prostate cancer. In this review, we outlined the characteristics and roles of these immune cells in the initiation, progression, metastasis, and treatments of prostate cancer. We also summarized the current therapeutic strategies in targeting immune cells of the prostate tumor microenvironment.
Topics: Androgen Antagonists; Androgens; Disease Progression; Drug Resistance, Neoplasm; Epithelial-Mesenchymal Transition; Humans; Male; Neoplasm Metastasis; Prostate; Prostatic Neoplasms; Tumor Microenvironment
PubMed: 34715253
DOI: 10.1016/j.canlet.2021.10.027 -
Histology and Histopathology Dec 2015In the last decade, microRNAs (miRNAs) have emerged as biomarkers for cancer diagnosis, prognosis, therapy and prediction of treatment response and have earned a... (Review)
Review
In the last decade, microRNAs (miRNAs) have emerged as biomarkers for cancer diagnosis, prognosis, therapy and prediction of treatment response and have earned a promising role in prostate cancer (PCa) management. A plethora of studies has been conducted on miRNA expression in PCa compared to non-neoplastic prostatic tissue, in PCa of different histologic grades and pathologic stages, in castration resistance prostate cancer (CRPC), in metastatic disease and in response to therapy, with evidence pointing towards distinctive miRNAs differentially expressed in each of these phases. In addition to tissue, miRNA can be detected in blood, serum, and urine. The aim of this review is to survey studies conducted on human prostate tissue and biofluids and to consolidate trustworthy data on the role of miRNA in the occurrence and progression of PCa, with a delineation of differentially expressed miRNAs and an analysis of their association with PCa prognosis, progression to CRPC and metastatic disease, as well as their correlation with response to chemotherapy and hormonal therapy. Changes in circulating miRNAs may represent potentially useful non-invasive biomarkers for PCa diagnosis, staging and prediction of outcome.
Topics: Biomarkers, Tumor; Gene Expression Regulation, Neoplastic; Humans; Male; MicroRNAs; Prostatic Neoplasms; Prostatic Neoplasms, Castration-Resistant; RNA, Neoplasm
PubMed: 26186079
DOI: 10.14670/HH-11-647 -
Archivos Espanoles de Urologia Mar 2019The major goal of prostate cancer imaging in the next decade will be more accurate disease diagnostic, characterization and staging through the synthesisof anatomic,... (Review)
Review
The major goal of prostate cancer imaging in the next decade will be more accurate disease diagnostic, characterization and staging through the synthesisof anatomic, functional and molecular imaging.Changes are happening regarding the use of prostate MRI for evaluating primary prostate cancer and PET CT for the staging and recurrence staging of prostate cancer.This review presents a multidisciplinary perspective of the role of prostate MRI and molecular imaging in prostate cancer.
Topics: Humans; Magnetic Resonance Imaging; Male; Molecular Imaging; Neoplasm Recurrence, Local; Neoplasm Staging; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Prostatic Neoplasms
PubMed: 30855016
DOI: No ID Found -
Urology Sep 2021Intraductal cribriform (IDC) and invasive cribriform morphologies are associated with worse prostate cancer outcomes. Limited retrospective studies have associated IDC... (Review)
Review
Intraductal cribriform (IDC) and invasive cribriform morphologies are associated with worse prostate cancer outcomes. Limited retrospective studies have associated IDC and cribriform morphology with germline mutations in DNA repair genes, particularly BRCA2. These findings, which prompted the National Comprehensive Cancer Network (NCCN) Guidelines for Prostate Cancer and Genetic/Familial High- Risk Assessment to consider germline testing for individuals with IDC/cribriform histology, have been questioned in a recent prospective study. A deepened understanding of the molecular mechanisms driving disease aggressiveness in cribriform morphology is critical to provide more clarity in clinical decision making. This review summarizes the current understanding of IDC and cribriform prostate cancer, with an emphasis on clinical outcomes and molecular alterations.
Topics: Humans; Male; Molecular Diagnostic Techniques; Neoplasm Grading; Prostatic Neoplasms
PubMed: 34058243
DOI: 10.1016/j.urology.2021.05.028 -
Urologia Feb 2020Prostate cancer is the most frequent non-cutaneous malignancy in men in the United States. In the last few years, many recommendations have been made available from the... (Review)
Review
Prostate cancer is the most frequent non-cutaneous malignancy in men in the United States. In the last few years, many recommendations have been made available from the 2014 International Society of Urologic Pathology consensus conference, 2016 World Health Organization blue book and 2018 8th edition of American Joint Committee on Cancer Staging System. Here, we focus on four topics which are considered relevant on the basis of their common appearance in routine practice, clinical importance and 'need to improve communication between pathology reports and clinicians': prostate cancer classification, prostate cancer grading, prostate cancer staging, and current definition of clinically significant prostate cancer. Tissue biomarkers that can predict significant disease and/or upgrading and tissue-based genomics for the purpose of diagnosis and prognosis are mentioned briefly.
Topics: Humans; Male; Neoplasm Grading; Neoplasm Staging; Prostatic Neoplasms; Time Factors
PubMed: 31545701
DOI: 10.1177/0391560319876821 -
Progres En Urologie : Journal de... Oct 2017The aim of this study was to assess the impact of the aggressiveness of cancer cells at the level of positive surgical margins (PSM) on the biochemical recurrence rate...
OBJECTIVES
The aim of this study was to assess the impact of the aggressiveness of cancer cells at the level of positive surgical margins (PSM) on the biochemical recurrence rate (BRR) by studying the Gleason score (GS) at this level.
METHODS
We included all radical prostatectomy (RP) procedures performed from January 2007 to November 2011. All of the RP specimens with PSM were reviewed to determine the GS at the level of PSM. We compared the GS at PSM with BRR.
RESULTS
A total of 658 RP were analysed, among which 16% had PSM. From the 101 patients with PSM included, 32% had biochemical recurrence (BR) with a median follow-up of 38 months. GS at PSM was significantly associated with earlier BR (P=0.008). Univariate analysis showed that GS at PSM (P=0.013), initial PSA (P<0.0001), pathologic GS (P<0.001), length of PSM (P=0.013), and seminal vesicle invasion (P<0.0001) were predictors of BR. Multivariate analysis confirmed that PSA greater than 10ng/mL and length of PSM greater than 3mm were independent prognostic factors for BR, but GS at the level of PSM was not.
CONCLUSION
GS at PSM was not confirmed as an independent risk factor for BR. Initial PSA greater than 10ng/mL and length of PSM greater than 3mm were the sole independent predictors for BR.
LEVEL OF PROOF
4.
Topics: Humans; Male; Margins of Excision; Middle Aged; Neoplasm Grading; Neoplasm Recurrence, Local; Prostatectomy; Prostatic Neoplasms; Retrospective Studies
PubMed: 28869168
DOI: 10.1016/j.purol.2017.07.239