-
European Review For Medical and... Aug 2014Though the external beam radiation therapy is a standard treatment option for both organ-confined and regionally advanced prostate cancer, unluckily, despite more and... (Review)
Review
OBJECTIVES
Though the external beam radiation therapy is a standard treatment option for both organ-confined and regionally advanced prostate cancer, unluckily, despite more and more effective advances in radiation delivery procedures, the prostate cancer radioresistance still occurs in a significant amount of patients undergone radiotherapy. This review aims to highlight the molecular aberrations of prostate cancer cell growth- and apoptosis signaling pathways that might induce, together with both prostate cancer cell/cancer stem cells gene- and surrounding microenvironment crucial implications, the tumor radioresistance.
METHODS
An up-dated review of several thorough studies on such matter.
RESULTS
The plenty of intriguing knowledge acquisitions about the prostate cancer radioresistance depending on cancer cell growth/ apoptosis signaling pathway-related molecular aberrations together with prostate cancer cell/cancer stem cell abnormal gene profile, may be the premise leading--on the basis of preclinical research in animal models--to clinically overcome the tumor radioresistance.
CONCLUSIONS
Current developments of radiosensitizer agents focusly targeting prostate cancer cell radioresistance-associated specific molecular/gene aberrations are directed to improve, by implementing customized tumor radiosensitization modalities, the radiation therapy outcomes.
Topics: Animals; Biomarkers, Tumor; Humans; Male; Neoplastic Stem Cells; Prostatic Neoplasms; Radiation Tolerance; Radiation-Sensitizing Agents; Signal Transduction; Tumor Microenvironment
PubMed: 25219826
DOI: No ID Found -
Postgraduate Medical Journal Oct 2002It is a paradigm in cancer treatment that early detection and treatment improves survival. However, although screening measures lead to a higher rate of detection, for... (Review)
Review
It is a paradigm in cancer treatment that early detection and treatment improves survival. However, although screening measures lead to a higher rate of detection, for small bulk localised prostate cancer it remains unclear whether early detection and early treatment will lead to an overall decrease in mortality. The management options include surveillance, radiotherapy, and radical prostatectomy but there is no evidence base to evaluate the benefits of each approach. Advanced prostate cancer is managed by hormonal therapy. There have been major changes in treatment over the last two decades with the use of more humane treatment and developments in both chemotherapy and radiation. In this article we review the natural history and management of prostate cancer.
Topics: Humans; Male; Mass Screening; Neoplasm Recurrence, Local; Neoplasm Staging; Prostatic Neoplasms; Survival Analysis; Treatment Outcome
PubMed: 12415080
DOI: 10.1136/pmj.78.924.590 -
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 -
The American Journal of Medicine Dec 2013Reports suggest worse health-related outcomes among black (vs white) men diagnosed with prostate cancer, but appropriate cause-effect inferences are complicated by the... (Review)
Review
BACKGROUND
Reports suggest worse health-related outcomes among black (vs white) men diagnosed with prostate cancer, but appropriate cause-effect inferences are complicated by the relationship of race and other prognostic factors.
METHODS
We searched the literature to find contemporary articles focusing on mortality among black and white men with prostate cancer in equal-access healthcare systems. We also directly assessed the association of race and prostate cancer mortality by conducting an observational cohort analysis of 1270 veterans diagnosed with prostate cancer and followed for 11 to 16 years at 9 medical centers within the Veterans Health Administration.
RESULTS
Among 5 reports providing quantitative results for the association of race and mortality among men with prostate cancer in equal-access systems, outcomes were similar for black and white men. Race also was not a prognostic factor in the observational cohort analysis of US veterans, with an adjusted hazard ratio for black (vs white) men and prostate cancer mortality of 0.90 (95% confidence interval, 0.58-1.40; P = .65).
CONCLUSIONS
Mortality among black and white patients with prostate cancer is similar in equal-access healthcare systems. Studies that find racial differences in mortality (including cause-specific mortality) among men with prostate cancer may not account fully for socioeconomic and clinical factors.
Topics: Black or African American; Cohort Studies; Delivery of Health Care; Humans; Male; Prostatic Neoplasms; United States; White People
PubMed: 24262722
DOI: 10.1016/j.amjmed.2013.08.012 -
Endocrine-related Cancer Jul 2021The landscape of cancer treatment has been transformed over the past decade by the success of immune-targeting therapies. However, despite sipuleucel-T being the...
The landscape of cancer treatment has been transformed over the past decade by the success of immune-targeting therapies. However, despite sipuleucel-T being the first-ever approved vaccine for cancer and the first immunotherapy licensed for prostate cancer in 2010, immunotherapy has since seen limited success in the treatment of prostate cancer. The tumour microenvironment of prostate cancer presents particular barriers for immunotherapy. Moreover, prostate cancer is distinguished by being one of only two solid tumours where increased T cell-infiltration correlates with a poorer, rather than improved, outlook. Here, we discuss the specific aspects of the prostate cancer microenvironment that converge to create a challenging microenvironment, including myeloid-derived immune cells and cancer-associated fibroblasts. By exploring the immune microenvironment of defined molecular subgroups of prostate cancer, we propose an immunogenomic subtyping approach to single-agent and combination immune-targeting strategies that could lead to improved outcomes in prostate cancer treatment.
Topics: Humans; Immunity; Immunotherapy; Male; Prostatic Neoplasms; Tumor Microenvironment
PubMed: 34128831
DOI: 10.1530/ERC-21-0149 -
The Canadian Journal of Urology Apr 2014Newer approaches to the management of advanced prostate cancer have rapidly evolved. While basic androgen deprivation remains as the first line in newly diagnosed...
INTRODUCTION
Newer approaches to the management of advanced prostate cancer have rapidly evolved. While basic androgen deprivation remains as the first line in newly diagnosed hormone naïve metastatic prostate cancer, the agents used and strategies followed have undergone significant changes. Numerous new agents such as sipuleucel-T, abiraterone, enzalutamide, cabazitaxel and radium 223 have all been approved since 2010 to treat metastatic castration resistant prostate cancer (CRPC). New imaging techniques to detect advanced disease such as F-18 PET, 11 C-choline PET and other modalities are becoming available. The concepts of "bone health" and the management of side effects related to androgen deprivation therapy are also gaining attention as men are being treated with longer courses of androgen deprivation. Understanding the theory behind these new agents and management approaches while focusing on the practical clinical considerations are essential to improve outcomes in advanced prostate cancer.
MATERIALS AND METHODS
A review of the current state of the art in the management of advanced and castration resistant prostate cancer presented in this Canadian Journal of Urology International supplement was performed. Key findings are summarized and presented along with critical updates based on recent publications and meeting presentations.
RESULTS
Key concepts identified in the management of advanced prostate cancer included the new understanding of prostate cancer based on translational discoveries, applications of various hormonally based strategies in advanced disease including traditional and recently approved agents. The use of new imaging modalities to identify metastatic disease, immunotherapy approaches and discussions of sequencing and which new agents are likely to be available in the future in the management of CRPC were identified. Bone targeted strategies are also addressed in the setting of androgen deprivation and metastatic disease.
CONCLUSIONS
The management of men with advanced prostate cancer has become more multidisciplinary as treatment options have expanded. As the use of these agents and new strategies expand, urologists, medical oncologists and radiation oncologists must all become familiar with this rapidly changing field in order to maximize the outcome of patients with advanced and castration resistant prostate cancer.
Topics: Androgen Antagonists; Diagnostic Imaging; Disease Management; Disease Progression; Drug Therapy; Humans; Immunotherapy; Male; Neoplasm Staging; Prostatic Neoplasms; Prostatic Neoplasms, Castration-Resistant; Translational Research, Biomedical
PubMed: 24775717
DOI: No ID Found -
American Society of Clinical Oncology... May 2023The majority of men with prostate cancer are diagnosed when they are older than 65 years; however, clinical trial participants are disproportionately younger and more... (Review)
Review
The majority of men with prostate cancer are diagnosed when they are older than 65 years; however, clinical trial participants are disproportionately younger and more fit than the real-world population treated in typical clinical practices. It is, therefore, unknown whether the optimal approach to prostate cancer treatment is the same for older men as it is for younger and/or more fit men. Short screening tools can be used to efficiently assess frailty, functional status, life expectancy, and treatment toxicity risk. These risk assessment tools allow for targeted interventions to increase a patient's reserve and improve treatment tolerance, potentially allowing more men to experience the benefit of the significant recent treatment advances in prostate cancer. Treatment plans should also take into consideration each patient's individual goals and values considered within their overall health and social context to reduce barriers to care. In this review, we will discuss evidence-based risk assessment and decision tools for older men with prostate cancer, highlight intervention strategies to improve treatment tolerance, and contextualize these tools within the current treatment landscape for prostate cancer.
Topics: Male; Humans; Aged; Prostatic Neoplasms; Risk Assessment
PubMed: 37207299
DOI: 10.1200/EDBK_390396 -
The Journal of Urology May 1997
Topics: Humans; Male; Postoperative Complications; Prostatectomy; Prostatic Neoplasms
PubMed: 9112524
DOI: 10.1016/s0022-5347(01)64860-2 -
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 -
Molecular mechanisms and genetic alterations in prostate cancer: From diagnosis to targeted therapy.Cancer Letters May 2022Prostate cancer remains one of the most lethal malignancies among men worldwide. Although the primary tumor can be successfully managed by surgery and radiotherapy,... (Review)
Review
Prostate cancer remains one of the most lethal malignancies among men worldwide. Although the primary tumor can be successfully managed by surgery and radiotherapy, advanced metastatic carcinoma requires better therapeutic approaches. In this context, a deeper understanding of the molecular mechanisms that underlie the initiation and progression of this disease is urgently needed, leading to the identification of new diagnostic/prognostic markers and the development of more effective treatments. Herein, the current state of knowledge of prostate cancer genetic alterations is discussed, with a focus on their potential in tumor detection and staging as well as in the screening of novel therapeutics.
Topics: Carcinoma; Humans; Male; Mutation; Prognosis; Prostatic Neoplasms; Radiopharmaceuticals
PubMed: 35276289
DOI: 10.1016/j.canlet.2022.215619