MP50-07 CURRENT EVIDENCE DOES NOT SUPPORT THE HYPOTHESIS THAT STATIN USE REDUCES THE RISK OF PROSTATE CANCER

Abstract Background Due to improved imaging sensitivity, the term “oligometastatic” prostate cancer disease is diagnosed more often, leading to an increasing interest in metastasis-directed therapy (MDT). There are two types of radiation based MDT applied when treating oligometastatic disease: (1) stereotactic body radiation therapy (SBRT) generally used for bone metastases; or (2) SBRT for isolated nodal oligometastases combined with prophylactic elective nodal radiotherapy. This review aims to summarize current evidence data, which may shed light on the optimal management of this heterogeneous group of patients. Methods A systematic review of the Medline database through PubMed was performed according to PRISMA guidelines. All relevant studies published up to November 2020 were identified and screened. Fifty-six titles were included. Besides outcome parameters, different prognostic and predictive factors were assessed, including site of metastases, time between primary treatment and MDT, use of systemic therapies, hormone sensitivity, as well as pattern of recurrence. Findings Evidence consists largely of retrospective case series and no consistent precise definition of oligometastasis exists, however, most investigators seem to acknowledge the need to distinguish between patients presenting with what is frequently called “synchronous” versus “metachronous” oligometastatic disease. Available data on radiotherapy as MDT demonstrate high local control rates and a small but relevant proportion of patients without progressive disease after 2 years. This holds true for both hormone sensitive and castration resistant prostate cancer diseases. The use of 68Ga-PSMA PET/CT for staging increased dramatically. Radiation doses and field sizes varied considerably among the studies. The search for relevant prognostic and predictive factors is ongoing. Conclusions To our best knowledge this review on oligometastatic prostate cancer included the largest number of original articles. It demonstrates the therapeutic potential and challenges of MDT for oligometastatic prostate cancer. Prospective studies are under way and will provide further high-level evidence.

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Prostate-specific antigen: does the current evidence support its use in prostate cancer screening?

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1258/acb.2011.010273 ◽

2011 ◽

Vol 48 (4) ◽

pp. 310-316 ◽

Cited By ~ 11

Author(s):

M. J. Duffy

Keyword(s):

Prostate Cancer ◽

Cancer Screening ◽

Prostate Specific Antigen ◽

Prostate Cancer Screening ◽

Specific Antigen ◽

Current Evidence

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Natural Killer Cell Mobilization in Breast and Prostate Cancer Survivors: The Implications of Altered Stress Hormones Following Acute Exercise

Endocrines ◽

10.3390/endocrines2020012 ◽

2021 ◽

Vol 2 (2) ◽

pp. 121-132

Author(s):

Erik D. Hanson ◽

Lauren C. Bates ◽

Kaileigh Moertl ◽

Elizabeth S. Evans

Keyword(s):

Prostate Cancer ◽

Immune System ◽

Cancer Survivors ◽

Nk Cells ◽

Natural Killer ◽

Acute Exercise ◽

Nk Cell ◽

Killer Cell ◽

Current Evidence ◽

Cell Mobilization

Natural killer (NK) cells from the innate immune system are integral to overall immunity and also in managing the tumor burden during cancer. Breast (BCa) and prostate cancer (PCa) are the most common tumors in U.S. adults. Both BCa and PCa are frequently treated with hormone suppression therapies that are associated with numerous adverse effects including direct effects on the immune system. Regular exercise is recommended for cancer survivors to reduce side effects and improve quality of life. Acute exercise is a potent stimulus for NK cells in healthy individuals with current evidence indicating that NK mobilization in individuals with BCa and PCa is comparable. NK cell mobilization results from elevations in shear stress and catecholamine levels. Despite a normal NK cell response to exercise, increases in epinephrine are attenuated in BCa and PCa. The significance of this potential discrepancy still needs to be determined. However, alterations in adrenal hormone signaling are hypothesized to be due to chronic stress during cancer treatment. Additional compensatory factors induced by exercise are reviewed along with recommendations on standardized approaches to be used in exercise immunology studies involving oncology populations.

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Prostate cancer prognosis after initiation of androgen deprivation therapy among statin users. A population-based cohort study

Prostate Cancer and Prostatic Diseases ◽

10.1038/s41391-021-00351-2 ◽

2021 ◽

Author(s):

A. I. Peltomaa ◽

P. Raittinen ◽

K. Talala ◽

K. Taari ◽

T. L. J. Tammela ◽

...

Keyword(s):

Prostate Cancer ◽

Androgen Deprivation Therapy ◽

Cancer Prognosis ◽

Cancer Death ◽

Psa Relapse ◽

Prostate Cancer Death ◽

Study Population ◽

Statin Use ◽

Prostate Cancer Prognosis

Abstract Purpose Statins’ cholesterol-lowering efficacy is well-known. Recent epidemiological studies have found that inhibition of cholesterol synthesis may have beneficial effects on prostate cancer (PCa) patients, especially patients treated with androgen deprivation therapy (ADT). We evaluated statins’ effect on prostate cancer prognosis among patients treated with ADT. Materials and methods Our study population consisted of 8253 PCa patients detected among the study population of the Finnish randomized study of screening for prostate cancer. These were limited to 4428 men who initiated ADT during the follow-up. Cox proportional regression model adjusted for tumor clinical characteristics and comorbidities was used to estimate hazard ratios for risk of PSA relapse after ADT initiation and prostate cancer death. Results During the median follow-up of 6.3 years after the ADT initiation, there were 834 PCa deaths and 1565 PSA relapses in a study cohort. Statin use after ADT was associated with a decreased risk of PSA relapse (HR 0.73, 95% CI 0.65–0.82) and prostate cancer death (HR 0.82; 95% CI 0.69–0.96). In contrast, statin use defined with a one-year lag (HR 0.89, 95% CI 0.76–1.04), statin use before ADT initiation (HR 1.12, 95% CI 0.96–1.31), and use in the first year on ADT (HR 1.02, 95% CI 0.85–1.24) were not associated with prostate cancer death, without dose dependency. Conclusion Statin use after initiation of ADT, but not before, was associated with improved prostate cancer prognosis.

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Statin use after radical prostatectomy reduces biochemical recurrence in men with prostate cancer

The Prostate ◽

10.1002/pros.22907 ◽

2014 ◽

Vol 75 (2) ◽

pp. 211-217 ◽

Cited By ~ 14

Author(s):

Cheryn Song ◽

Sejun Park ◽

Jinsung Park ◽

Myungsun Shim ◽

Aram Kim ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Biochemical Recurrence ◽

Statin Use

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Neuroendocrine differentiation in prostate cancer

Vojnosanitetski pregled ◽

10.2298/vsp0405513c ◽

2004 ◽

Vol 61 (5) ◽

pp. 513-518 ◽

Cited By ~ 4

Author(s):

Snezana Cerovic ◽

Goran Brajuskovic ◽

Vinka Maletic-Vukotic ◽

Sava Micic

Keyword(s):

Prostate Cancer ◽

Clinical Stage ◽

Prognostic Significance ◽

Specific Antigen ◽

Neuron Specific Enolase ◽

Neuroendocrine Differentiation ◽

Current Evidence ◽

Gleason Grade ◽

Preoperative Serum ◽

Significant Expression

Background. In numerous recent studies attention has been focused to neuroendocrine differentiation (NED) in prostate cancer (PC). Focal NED is present in almost all PCs, but it is prominent in only 5-10% of the carcinomas. The prognostic significance of focal NED in PC is controversial, but current evidence suggests its influence on the onset and/or conversion of hormon resistant tumor phenotype. The aim of this study was to evaluate the relationship between NED status, based only on immunohistochemical use of neuroendocrine (NE) markers, with PC grade and stage, and preoperative serum levels of prostate-specific antigen (PSA). Methods. The study included the biopsy material of 73 untreated PC patients (pts.) obtained by transurethral resection (TUR) (37 pts.), and radical retropubic prostatectomy (RRP) (36 pts.). Two representative tissue samples (tipically the block containing the largest amount of neoplasm) were selected for immunohistochemical (IMM) staining. NE cells were identified using a panel of IMM markers: chromogranin A, neuron-specific enolase, and serotonin. The level of PC exocrine differentiation was detected by monoclonal antibodies against PSA. Results. Significant expression of NE cells was demonstrated in 26 (70.2%) pts. with PC after TUR. In this group, serum preoperative PSA values ranged from 0.1 to 9.6 ng/ml. The majority of pts. with NED had low differentiated PC with Gleason grade score (GGS) >7, and normal PSA values below 4 ng/ml (77%), in clinical stage D (54%). Statistically significant correlation (p<0.01) of positive NED with higher stage and grade and low PSA values was established. Among the pts. with localized PC in whom RRP was performed (n=36), significant expression of NE cells was found in 15 pts. (41.7%), 8 (53.3%) in pT2 stage, and 7 (46.7%) in pT3 stage. Significant correlation between NED with preoperative PSA values and stage of PC in pts. with RRP was not found. Conclusion. We demonstrated the significant NED in poorly differentiated PC in patients in the advanced stage of the disease. The expression of NED in organ-confined PC did not correlate with tumor stage, but it correlated with tumor grade (GGS?7).

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