Hydrogel spacer use during prostate radiation therapy – Community Experience

Reported in Urology Times:

For urologists and radiation oncologists alike, when treating prostate cancer, one recurring theme is “protect the rectum.” As surgeons, we learn meticulous techniques to avoid rectal injuries, and our radiation colleagues have long strategized on how to optimally deliver the maximum dose of tolerable radiation while minimizing radiation exposure to “organs at risk” such as the bladder, rectum, urethra, and penile bulb. In this era of dose escalation and hypofractionation, rectal toxicity is of paramount consideration.

In this article, we discuss one particular new product and how it may herald a significant change in the landscape of radiation therapy for prostate cancer.

Read the entire article on urologytimes.com HERE

Clinical Trials Using Enzalutamide (Xtandi)

Enzalutamide (XTANDI) is a prescription medicine used to treat men with prostate cancer that no longer responds to a medical or surgical treatment that lowers testosterone.  XTANDI is now approved to treat men with prostate cancer that no longer responds to treatment that lowers testosterone and has not spread to other parts of the body. This is also known as non-metastatic castration-resistant prostate cancer (CRPC).

This web page, published by the National Cancer Institute, lists the clinical trials using Enzalutamide.  Click here to view the article.

AR-V7 Liquid Biopsy Coming of Age

Once a man is castrate resistant and moves on a second line hormone therapy drug like Zytiga or Xtandi (aka AR inhibitors) it is inevitable that the Zytiga or Xtandi will also become ineffective.

When this happens, the question that comes is what should be the next treatment?  Generally, the options currently available are either to move to the drug not initially used ( Zytiga if Xtandi was first used or Xtandi if Zytiga was used) or instead to use taxane chemotherapy (Taxotere aka docetaxel).

Knowing which of these two options is best has been nothing but guesswork.  But, things are improving.  There is an investigational test that detects the expression of a protein called AR-V7 in the nuclei of circulating tumor cells taken from a vial of blood cells (liquid biopsy).  This test can help guide this decision.

A recent study (published in JAMA Oncology) evaluating this test has shown that a blood test can detect the protein called AR-V7 in circulating tumor cells and that the presence of this protein accurately predicts how well certain men will respond to AR inhibitors (Zytiga and Xtandi).

Read the complete blog on CancerABCs.org HERE

FDA Approves Enzalutamide (Xtandi) for the treatment of non-metastatic castration-resistant prostate cancer (non-metastatic CRPC)

The U.S. Food and Drug Administration (FDA) approved a new use for enzalutamide (Xtandi) for the treatment of non-metastatic castration-resistant prostate cancer (non-metastatic CRPC). Enzalutamide was previously approved only for patients with metastatic CRPC. Prior to this past February – when the FDA also approved apalutamide (Erleada) for non-metastatic CRPC – there were no FDA-approved treatments for these men.

Read more on PCF.org HERE

A Generic Version of Zytiga Has Been Approved by the FDA

It has just been recently announced that the U.S. Food and Drug Administration (FDA) has approved a generic version of Zytiga, the new drug’s name is Yonsa.  It is a novel formulation of abiraterone acetate that needs to be used in combination with methylprednisolone for the treatment of men with metastatic castration-resistant prostate cancer (mCRPC).

Read the complete article on CancerABCs.org HERE

LuPSMA treatment (Lutetium-177 PSMA-617)​

An exciting proof-of-concept study of Lutetium-177 PSMA (Lu PSMA) was published in the journal Lancet Oncology. Lu-PSMA has been described as “a disruptive therapy and has the potential to change practice” in the future treatment of men with end-stage prostate cancer.

Lu-PSMA, a nuclear therapy, has been used in Germany for many years under compassionate use basis.  This particular study was conducted in Australia. The study results offer hope for men with end-stage prostate cancer who have exhausted all their treatment options.

Read more on Prostate Cancer Foundation HERE
and CancerABCs.org HERE
and SBS News HERE

Research finds ‘Achilles heel’ for aggressive prostate cancer. Drug makes prostate cancer cells self destruct

UC San Francisco researchers have discovered a promising new line of attack against lethal, treatment-resistant prostate cancer. Analysis of hundreds of human prostate tumors revealed that the most aggressive cancers depend on a built-in cellular stress response to put a brake on their own hot-wired physiology. Experiments in mice and with human cells showed that blocking this stress response with an experimental drug—previously shown to enhance cognition and restore memory after brain damage in rodents—causes treatment-resistant cancer cells to self-destruct while leaving normal cells unaffected.​

The new study was published online May 2, 2018 in Science Translational Medicine.​

Read the entire article on MedicalXpress.com HERE
and technologyneworks.com HERE

Sequencing and Combining CRPC Therapies – What Does the Future Hold?

Since 2010, many new agents have joined our armamentarium for treating metastatic CRPC, raising the question of how best to sequence them. For men with newly diagnosed, presumably hormone-sensitive mPC, we usually start treatment with either abiraterone acetate or docetaxel. Therefore, although we have five or six approved treatments for mCRPC, not every patient should receive all of them.

Click here to read more…….

Genetics & Genomic Testing – UsTOO

While not appropriate for every prostate cancer patient, genomic testing can provide a man and his care team with valuable information at various stages of disease management specific to whether the cancer is likely to be aggressive or indolent, thereby helping him to make an informed decision on how to best address his prostate cancer.

Read more about Genetics vs. Genomics, Tools and Tests available here