scholarly journals Optimal Treatment for Patients with Oligometastatic Prostate Cancer

2021 ◽  
pp. 1-10
Author(s):  
Bulent Cetin ◽  
Chiara A. Wabl ◽  
Ozge Gumusay
Keyword(s):  
Prostate Cancer ◽  
Metastatic Disease ◽  
De Novo ◽  
Optimal Treatment ◽  
Survival Outcomes ◽  
Appendicular Skeleton ◽  
Oncological Outcomes ◽  
Oligometastatic Prostate Cancer

Oligometastatic prostate cancer (PCa) can be defined as cancer with a limited number of metastases, typically fewer than 5 lesions, and involves lesions contained within the axial versus the appendicular skeleton. Patients can present with de novo oligometastatic, oligorecurrent, or oligoprogressive PCa. Oligometastatic PCa patients demonstrate considerable improvements in survival outcomes, with a better prognosis than patients with extensive metastatic disease. However, the management of patients that present with nonsymptomatic oligometastatic PCa remains difficult. In the oligometastatic setting, the benefit of local therapies such as prostatectomy and radiotherapy on survival outcomes is an intriguing topic; however, their impact on oncological outcomes is still unknown.

scholarly journals Racial/ethnic disparities in de novo metastases sites and survival outcomes for patients with primary breast, colorectal, and prostate cancer

2018 ◽  
Vol 7 (4) ◽  
pp. 1183-1193 ◽  
Author(s):  
Tomi Akinyemiju ◽  
Swati Sakhuja ◽  
John Waterbor ◽  
Maria Pisu ◽  
Sean F. Altekruse
Keyword(s):  
Prostate Cancer ◽  
De Novo ◽  
Ethnic Disparities ◽  
Survival Outcomes ◽  
Racial Ethnic

scholarly journals Clinical Outcomes of Combined Prostate- and Metastasis-Directed Radiation Therapy for the Treatment of De Novo Oligometastatic Prostate Cancer

2020 ◽  
Vol 5 (6) ◽  
pp. 1213-1224
Author(s):  
Brandon S. Imber ◽  
Melissa Varghese ◽  
Debra A. Goldman ◽  
Zhigang Zhang ◽  
Richard Gewanter ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Clinical Outcomes ◽  
De Novo ◽  
Oligometastatic Prostate Cancer

Impact of the USPSTF recommendations on prostate cancer stage migration and de-novo metastatic prostate cancer.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 166-166 ◽  
Author(s):  
Yu-Wei Chen ◽  
Ruby Gupta ◽  
Moshe Chaim Ornstein ◽  
Brian I. Rini ◽  
Timothy D. Gilligan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Metastatic Disease ◽  
De Novo ◽  
Task Force ◽  
Specific Antigen ◽  
P Value ◽  
Stage Migration ◽  
Nodal Disease ◽  
Psa Screening ◽  
The Impact

166 Background: The US Preventive Services Task Force (USPSTF) recommended against prostate specific antigen (PSA) screening for men aged≥75 in 2008 and all men in 2012 in an effort to reduce overdiagnosis and overtreatment of men with prostate cancer (PCa). This recommendation may delay diagnosis of clinically significant PCa. Methods: The Surveillance, Epidemiology and End Results Program (SEER) was used to identify men diagnosed with PCa between 2004-2015. PCa stage was categorized as localized (N0M0), nodal (N1M0) and metastatic (NxM1). Trend analysis was stratified on age group (PSA screening eligible was defined as age 55-69 according to the 2018 updated USPSTF recommendation). Multivariable logistic regression was used to identify predictors for nodal and metastatic disease. Results: Between 2004-2015, there were 603,323 men with PCa identified. Metastatic disease accounted for 2.8% of PCa in 2004-2008, 3.7% in 2009-2012, and 6.1% in 2013-2015. In men eligible for PCa screening, metastatic disease increased from 1.9% in 2004-2008, to 2.6% in 2009-2012, to 4.2% in 2013-2015; nodal disease increased from 1.4% to 1.6% to 2.6%, respectively (both p-value for trend< 0.0001). This stage migration was also observed in non-screening eligible groups (age >70 and <55). Compared with PCa diagnosed in 2009-2012, PCa diagnosed in 2013-2015 had higher odds of metastatic disease (AOR: 1.70, p-value<0.0001) or nodal disease (AOR: 1.71, p-value<0.0001). Conclusions: Men diagnosed with PCa in 2013-2015 were more likely to have metastatic or nodal disease, suggesting PCa stage migration since PSA screening was recommended to be discontinued in 2012. Although the impact of PSA screening on PCa mortality remains debatable, the reduced quality of life with advanced Pca should not be overlooked. Future population studies are warranted to investigate the influence of the updated 2018 USPSTF recommendation. [Table: see text]

Metastatic Castration-Sensitive Prostate Cancer: Optimizing Patient Selection and Treatment

2018 ◽  
pp. 363-371 ◽  
Author(s):  
Andrew W. Hahn ◽  
Celestia S. Higano ◽  
Mary-Ellen Taplin ◽  
Charles J. Ryan ◽  
Neeraj Agarwal
Keyword(s):  
Prostate Cancer ◽  
De Novo ◽  
Treatment Options ◽  
Standard Of Care ◽  
Abiraterone Acetate ◽  
Multiple Treatment ◽  
High Risk Prostate Cancer ◽  
Oligometastatic Prostate Cancer ◽  
Risk Prostate Cancer ◽  
Treatment Plans

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.

SPOP mutations in prostate cancer: Clinical and genomic features.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 151-151
Author(s):  
Mari Nakazawa ◽  
Mike Fang ◽  
Pedro Issacsson Velho ◽  
Emmanuel S. Antonarakis
Keyword(s):  
Prostate Cancer ◽  
Clinical Outcomes ◽  
Metastatic Disease ◽  
Wnt Pathway ◽  
Zinc Finger Protein ◽  
De Novo ◽  
First Line ◽  
Primary Tumors ◽  
Pathway Activation ◽  
Prostate Cancers

151 Background: Point mutations in the gene encoding speckle-type pox virus and zinc finger protein (SPOP) are the most frequently identified mutations in prostate cancer, occurring at a frequency of 6-15% across localized and disseminated cancers. Recently, SPOP gene alterations have gained attention as they appear to define a novel subclass of prostate cancers. Previous studies show that patients with mutant SPOP (mtSPOP) had superior responses to androgen deprivation therapy (ADT) and exhibit more favorable responses to abiraterone compared to wild type SPOP (wtSPOP). Methods: We retrospectively identified 59 prostate cancer patients at a single institution (Johns Hopkins) with somatic SPOP mutations from genomic testing of primary tumors (n=45), metastatic lesions (n=12), or liquid biopsies (n=2). Patient records were reviewed to determine baseline characteristics, therapies received, and clinical outcomes. The primary outcomes included best PSA response and progression-free survival (PFS) on ADT in the hormone sensitive prostate cancer (HSPC) setting and on abiraterone and/or enzalutamide in the first-line castration resistant prostate cancer (CRPC) setting. PFS was defined as either PSA, radiographic, or clinical progression. Results: The median age at diagnosis was 64 years (range 46 to 85). 17/59 (28.8%) were Black. F133 was the most frequently mutated residue, occurring in 33 (55.9%) instances (Table). There were two patients who harbored two mutations in the SPOP gene. The most frequently co-occurring mutation was in APC (15/59 [25.4%] patients), resulting in Wnt pathway activation. Concurrent ERG fusions were not observed with this cohort (0/59 [0%] patients). 41/59 (69.4%) were diagnosed with Gleason 8-10 disease. 21/59 (35.5%) were diagnosed with de novo metastatic disease. 50/59 (84.7%) patients received ADT for recurrent or metastatic disease. Median PFS on ADT was 40.7 (95% CI 23.4-71.9) months. Of the 27/59 (45.8%) patients who progressed to CRPC, 20/59 (33.9%) patients received abiraterone and 13/59 (22.0%) received enzalutamide; 9/59 (15.3%) patients received both agents. Median PFS was 7.8 (95% CI 6.7-NR) months on abiraterone and 7.3 (95% CI 3.2-NR) months on enzalutamide. Other notable therapies received in the CRPC setting include docetaxel (5/59 [8.5%] patients), cabazitaxel (5/59 [8.5%] patients), and PARP inhibitor olaparib or rucaparib (4/59 [6.8%] patients). Conclusions: SPOP mutations define a unique subset of prostate cancers enriched for black patients, high Gleason scores, absence of ERG fusions, and Wnt pathway activation. Clinical outcomes to first-line ADT appear longer than expected for genomically-unselected patients. [Table: see text]

Characterization of Differences Between Prostate Cancer Patients Presenting With De Novo Versus Primary Progressive Metastatic Disease

2018 ◽  
Vol 16 (1) ◽  
pp. 85-89 ◽  
Author(s):  
Antoine Finianos ◽  
Kanika Gupta ◽  
Brandon Clark ◽  
Samuel J. Simmens ◽  
Jeanny B. Aragon-Ching
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Metastatic Disease ◽  
De Novo ◽  
Primary Progressive

scholarly journals Local and metastatic curative radiotherapy in patients with de novo oligometastatic prostate cancer

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
C. Reverberi ◽  
M. Massaro ◽  
M. F. Osti ◽  
D. Anzellini ◽  
L. Marinelli ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
De Novo ◽  
Univariate Analysis ◽  
Metastatic Tumour ◽  
Biochemical Relapse ◽  
Tumour Burden ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Oligometastatic Prostate Cancer

Abstract The aim of this observational study is to investigate whether local consolidative treatment delivered to the primary site and metastatic tumour burden may add survival benefit to de novo oligometastatic prostate cancer (Oligo-PCa) patients. We retrospectively reviewed all Oligo-PCa patients treated with radiotherapy to the primary tumor sites and metastatic tumor burden at our institution between March 2010 and June 2019. All patients having ≤ 5 metastases involving nodes and/or bones, loco-regional and/or extra-pelvic sites, were included. Most of the patients had started androgen deprivation therapy with or without docetaxel as standard of care before radiotherapy. The Kaplan Meier analysis was performed to estimate survival outcomes. The univariate analysis tested possible prognostic factors increasing the rate of biochemical relapse. We analysed 37 Oligo-PCa patients. Twenty-eight (75.7%) had loco-regional metastases, in 9 patients (24.3%) the metastatic tumour burden was extra-pelvic. Nineteen (51.4%) had bone metastases, 21 (56.8%) nodal involvement and 7 (18.9%) both. Twenty (54.1%) had a single metastasis. The median follow-up was 55.5 months. The median overall survival (OS) was 68.8 months, the 2- and 5-year OS rates were 96.9% and 65.4%. The median biochemical relapse free survival (b-RFS) was 58 months and the 2- and 5-year b-RFS rates were 73.3% and 39.3%. The 2- and 5-year local relapse free survival rates were 93.9% and 83.7%. On the univariate analysis post-treatment PSA level ≤ 1 ng/ml was significantly related with the b-RFS (p = 0.004). Curative approach in Oligo-PCa patients involving both the primary tumor and metastatic sites may be feasible and well tolerate. Many patients presented longer survival and PSA at first follow-up was the most important prognostic factor. Further trials are needed to confirm our results and to evaluate if patients with PSA at first follow-up > 1 ng/ml may benefit from further treatments.

Sign in / Sign up

Export Citation Format

Share Document