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Discovery Medicine Sep 2011Prostate cancer is the most common cancer and the second most common cause of cancer-related death in men. Screening with prostate specific antigen (PSA) has led to a... (Review)
Review
Prostate cancer is the most common cancer and the second most common cause of cancer-related death in men. Screening with prostate specific antigen (PSA) has led to a clinical and pathological stage migration such that currently most men diagnosed with prostate cancer have clinically localized disease potentially offering opportunity for curative intervention. On the other hand, the benefit of radical therapy in terms of reducing overall mortality in PSA-screened populations has been controversial with concerns being raised about over-diagnosis and over-treatment. Treatment of prostate cancer is associated with risk and complications that negatively affect the quality of life of men with localized disease. Recently, a new treatment paradigm has been proposed which is called focal therapy, defined as an individualized treatment by which only known disease is targeted and ablated while preserving normal tissue. This review will attempt to describe the opportunities and uncertainties behind this proposed paradigm shift.
Topics: Humans; Male; Precision Medicine; Prostatic Neoplasms; Uncertainty
PubMed: 21955852
DOI: No ID Found -
Current Opinion in Oncology May 2016In recent clinical trials, immunotherapeutic agents have demonstrated promising results for the treatment of prostate cancer. This review discusses emerging... (Review)
Review
PURPOSE OF REVIEW
In recent clinical trials, immunotherapeutic agents have demonstrated promising results for the treatment of prostate cancer. This review discusses emerging immunotherapies for prostate cancer and their evolving role in sequencing and combination therapy.
RECENT FINDINGS
Therapeutic vaccines including PROSTVAC and DCVAC/PCa have completed promising phase 2 trials for the treatment of prostate cancer and phase 3 trials are underway. Recent evidence supports a synergistic relationship between immunotherapy agents themselves, antiandrogens and with cytotoxic chemotherapy. Prostate cancer patients with good prognostic factors, such as minimal disease burden, appear to achieve the optimal benefit from immunotherapy.
SUMMARY
Therapeutic cancer vaccines and immunomodulating agents have demonstrated activity in the treatment of prostate cancer. Immunotherapies may alter the prostate tumor microenvironment and ongoing studies aim to provide guidance on effective sequencing and combination strategies.
Topics: Animals; Humans; Immunotherapy; Male; Prostatic Neoplasms; Prostatic Neoplasms, Castration-Resistant
PubMed: 26977847
DOI: 10.1097/CCO.0000000000000281 -
Archivos Espanoles de Urologia Jun 2014Prostate cancer screening is an absolutely controversial topic and under debate. The points of view from which the problem is analyzed also influence this issue;... (Review)
Review
Prostate cancer screening is an absolutely controversial topic and under debate. The points of view from which the problem is analyzed also influence this issue; patient, physician and Health Care authorities have different interests that most of the times are not comprehensively analyzed. Currently, no clinical guideline supports the performance of a population screening with active recruitment, but they do support the credible information to the man who desires its performance of potential benefits and risks (opportunistic screening), as well as its performance in certain risk groups. Nevertheless, what is inherent to any screening program is the overdiagnosis of clinically irrelevant disease, which in prostate cancer has been calculated around 50%, and that, from our point of view, gives cause to the correct implementation of active surveillance programs to tamponade the potential deleterious effects of active therapies of prostate cancer.
Topics: Early Detection of Cancer; Humans; Male; Mass Screening; Prostatic Neoplasms; Watchful Waiting
PubMed: 24914837
DOI: No ID Found -
The Prostate Jul 2017The 23rd Annual Prostate Cancer Foundation (PCF) Scientific Retreat was convened October 27-29, 2016, in Carlsbad, CA. (Review)
Review
INTRODUCTION
The 23rd Annual Prostate Cancer Foundation (PCF) Scientific Retreat was convened October 27-29, 2016, in Carlsbad, CA.
METHODS
This event focuses on the latest advances in basic, translational, and clinical prostate cancer research with the greatest promise for advancing our understanding of prostate cancer biology and improving patient outcomes and quality of life.
RESULTS
Themes highlighted at this year's meeting included: i) targeting DNA repair deficiency in prostate cancer; ii) optimizing the use of Radium-223 and bone-targeting agents; iii) advances in cancer immunotherapeutic approaches; iv) targeting developmental pathways in prostate cancer; v) advances in circulating tumor DNA technology and applications; vi) precision survivorship; and vii) novel treatments and treatment strategies in prostate cancer.
DISCUSSION
This article reviews the key advances discussed at the Retreat for the purpose of disseminating this knowledge to accelerate the development of new treatments and improved outcomes for men suffering with prostate cancer.
Topics: Biomedical Research; Congresses as Topic; Humans; Information Dissemination; Male; Patient Care Management; Prostatic Neoplasms; Quality of Life
PubMed: 28503903
DOI: 10.1002/pros.23366 -
Revue Medicale Suisse May 2020For decades, androgen deprivation was the standard of care for metastatic prostate cancer. Chemotherapy, then novel anti-androgen therapies, changed the treatment... (Review)
Review
For decades, androgen deprivation was the standard of care for metastatic prostate cancer. Chemotherapy, then novel anti-androgen therapies, changed the treatment paradigm. Large phase III randomized clinical trials were conducted over the course of the last decade, first among patients with castration resistant prostate cancer, then among those with hormone-sensitive disease. Today, androgen deprivation therapy alone is no longer the gold standard and should be associated either with chemotherapy in high-volume disease, or novel anti-androgen therapy. As such, each case should be discussed with a specialist to choose the most appropriate treatment.
Topics: Androgen Antagonists; Androgens; Humans; Male; Prostatic Neoplasms; Prostatic Neoplasms, Castration-Resistant
PubMed: 32462838
DOI: No ID Found -
Advances in Genetics 2021Prostate cancer heritability is attributed to a combination of rare, moderate to highly penetrant genetic variants as well as commonly occurring variants conferring...
Prostate cancer heritability is attributed to a combination of rare, moderate to highly penetrant genetic variants as well as commonly occurring variants conferring modest risks [single nucleotide polymorphisms (SNPs)]. Some of the former type of variants (e.g., BRCA2 mutations) predispose particularly to aggressive prostate cancer and confer poorer prognoses compared to men who do not carry mutations. Molecularly targeted treatments such as PARP inhibitors have improved outcomes in men carrying somatic and/or germline DNA repair gene mutations. Ongoing clinical trials are exploring other molecular targeted approaches based on prostate cancer somatic alterations. Genome wide association studies have identified >250 loci that associate with prostate cancer risk. Multi-ancestry analyses have identified shared as well as population specific risk SNPs. Prostate cancer risk SNPs can be used to estimate a polygenic risk score (PRS) to determine an individual's genetic risk of prostate cancer. The odds ratio of prostate cancer development in men whose PRS lies in the top 1% of the risk profile ranges from 9 to 11. Ongoing studies are investigating the utility of a prostate cancer PRS to target population screening to those at highest risk. With the advent of personalized medicine and development of DNA sequencing technologies, access to clinical genetic testing is increasing, and oncology guidelines from bodies such as NCCN and ESMO have been updated to provide criteria for germline testing of "at risk" healthy men as well as those with prostate cancer. Both germline and somatic prostate cancer research have significantly evolved in the past decade and will lead to further development of precision medicine approaches to prostate cancer treatment as well as potentially developing precision population screening models.
Topics: Early Detection of Cancer; Genetic Predisposition to Disease; Genetic Testing; Genome-Wide Association Study; Germ-Line Mutation; Humans; Male; Prostatic Neoplasms
PubMed: 34844712
DOI: 10.1016/bs.adgen.2021.08.006 -
Cancer Surveys 1995The age adjusted death rate from prostate cancer in Japan is one of the lowest in the world but is rising steadily. The vast majority of cases of prostate cancer remain... (Review)
Review
The age adjusted death rate from prostate cancer in Japan is one of the lowest in the world but is rising steadily. The vast majority of cases of prostate cancer remain undetected during life, the prevalence of prostate cancer detected at autopsy being 2800 times that of lethal cancer in Japanese in Japan, 570 times in whites in the USA and 470 times in blacks in the USA. A case-control study of prostate cancer carried out in Japan and the Netherlands revealed a number of statistically significant risk factors, including rural residence, more brothers, colon neoplasms in relatives, no morning erections, frequent sexual intercourse in 30s, episodes of sexually transmitted disease, lower plasma testosterone and dihydrotestosterone concentrations and lower beta-carotene intake.
Topics: Humans; Japan; Male; Prostatic Neoplasms; Risk Factors; United States
PubMed: 7621463
DOI: No ID Found -
Current Opinion in Urology Jan 2020The successful development of effective cancer immunotherapy, in particular immune checkpoint inhibitors, has changed the treatment paradigm of many tumor types. In... (Review)
Review
PURPOSE OF REVIEW
The successful development of effective cancer immunotherapy, in particular immune checkpoint inhibitors, has changed the treatment paradigm of many tumor types. In light of the limited efficacy of checkpoint inhibitors demonstrated in recent clinical trials in refractory prostate cancer, this review highlights important recent and ongoing studies that are shaping the pursuit of effective immunotherapy for prostate cancer.
RECENT FINDINGS
We review two overarching themes with respect to recent studies of prostate cancer immunotherapy: evolving therapeutic strategies and novel biological findings, including the landscape of predictive biomarkers of immunotherapy response.
SUMMARY
Novel and combinatorial immunotherapy strategies are being implemented across the clinical spectrum of prostate cancer. Greater understanding of complex tumor-immune interactions and the determinants of therapy response in prostate cancer is an area of intense investigation, and will inform both translational and clinical immuno-oncology research in the field.
Topics: Humans; Immunotherapy; Male; Medical Oncology; Prostatic Neoplasms
PubMed: 31609776
DOI: 10.1097/MOU.0000000000000682 -
JPMA. the Journal of the Pakistan... Aug 2023Prostate cancer is the second most commonly diagnosed malignancy in men worldwide. The prevalence has been increasing with significant differences between regions. This...
Prostate cancer is the second most commonly diagnosed malignancy in men worldwide. The prevalence has been increasing with significant differences between regions. This study assesses the prevalence of incidental prostate cancer detected in specimens removed during bladder outlet obstruction operation. A retrospective analysis of the records of patients who had either endoscopic or open prostatectomy from January 1998 to December 2021 was conducted. The variables analysed were age, procedure, date of surgery, and Gleason score. A total of 2,842 patients underwent surgery on the prostate gland during the study period. Most of the patients, i.e. 2,733 (96.2%), were pathologically diagnosed with benign prostatic hyperplasia, while only 110 (3.9%) had prostate cancer. The frequency of incidental prostate cancer following surgery for bladder outlet obstruction has decreased over the last two decades at our centre, possibly because of an increase in PSA testing.
Topics: Male; Humans; Retrospective Studies; Tertiary Care Centers; Urinary Bladder Neck Obstruction; Prostatic Neoplasms; Prostate; Neoplasms, Second Primary
PubMed: 37697767
DOI: 10.47391/JPMA.7660 -
World Journal of Urology Oct 2008This article reviews the definition, incidence, pathological characteristics and natural history of low risk localised prostate cancer. Low risk disease is typically... (Review)
Review
This article reviews the definition, incidence, pathological characteristics and natural history of low risk localised prostate cancer. Low risk disease is typically defined as clinical stage T1/T2a, biopsy Gleason score =6, PSA < 10. This risk classification has provided a useful system for reporting of outcomes and for the production of clinical guidelines. However, the low-risk disease is a broad category with a range of pathological characteristics and clinical behaviour. Many, but not all, low-risk prostate cancers are clinically insignificant, destined never to cause any harm. The challenge of managing low risk localized prostate cancer is to distinguish patients with clinically relevant cancers, who may benefit from radical treatment, from the remainder who do not need any intervention. The natural history of untreated low-risk localised prostate cancer has not been well studied, partly because it is a relatively recent entity, and partly because it has been standard practice for men with low risk disease to receive treatment. Data from watchful waiting in the pre-PSA era, modelling studies to take account of the lead time and overdiagnosis associated with PSA testing, and the early results of active surveillance can all provide insights into the likely natural history of low risk disease. There remains a major unmet need for markers of individual prostate cancer behaviour within the low-risk category. Such markers could be used to distinguish those men with truly indolent disease, suitable for observation, from those with significant prostate cancer that stand to benefit from treatment.
Topics: Humans; Male; Prostatic Neoplasms; Risk Factors
PubMed: 18568350
DOI: 10.1007/s00345-008-0277-9