Advanced Prostate Cancer: AUA/ASTRO/SUO Guideline PART II

Lowrance, * William T.; Breau, Rodney H.; Chou, Roger; Chapin, Brian F.; Crispino, Tony; Dreicer, Robert; Jarrard, David F.; Kibel, Adam S.; Morgan, Todd M.; Morgans, Alicia K.; Oh, William; Resnick, Matthew J.; Zietman, Anthony L.; Cookson, Michael S.

doi:10.1097/ju.0000000000001376

Cited by 104 publications

(61 citation statements)

References 31 publications

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“…Anderson &Rowe Urologists' opinions on castration for PCa management 5 © 2020 Canadian Urological Association address surgical castration as a durable form of baseline ADT. It is also important to note that surgical castration does not preclude, and can be used in conjunction with, chemotherapy and/or novel second-generation hormonal agents for control of metastatic disease (21).…”

Section: Cuaj -Research Lettermentioning

confidence: 99%

Current attitudes of Canadian urologists towards surgical castration in the treatment of prostate cancer

Anderson

Rowe

2020

CUAJ

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Anderson &Rowe Urologists' opinions on castration for PCa management 2 © 2020 Canadian Urological Association treatment effect of surgical castration in mPC and the potential for significant cost-savings, it is important to identify barriers preventing wider use of this treatment. Here, we aimed to identify current practice patterns and attitudes of urologists practicing in Canada towards surgical castration in the treatment of prostate cancer. CUAJ -Research LetterAnderson &Rowe Urologists' opinions on castration for PCa management 6

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Section: Cuaj -Research Lettermentioning

confidence: 99%

Current attitudes of Canadian urologists towards surgical castration in the treatment of prostate cancer

Anderson

Rowe

2020

CUAJ

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“…Imaging should provide a step-by-step multimodal approach that facilitates both local and systemic staging, depending on clinical priorities and primary therapy. Clinical guidelines recommend the use of both nuclear medicine imaging (positron emission tomography [PET]/ computed tomography [CT] scans) and magnetic resonance imaging (MRI) to assess local recurrence and distant metastases [1,2].…”

Section: Introductionmentioning

confidence: 99%

Prostate Magnetic Resonance Imaging for Local Recurrence Reporting (PI-RR): International Consensus -based Guidelines on Multiparametric Magnetic Resonance Imaging for Prostate Cancer Recurrence after Radiation Therapy and Radical Prostatectomy

Panebianco

Villeirs

Weinreb

et al. 2021

European Urology Oncology

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Background: Imaging techniques are used to identify local recurrence of prostate cancer (PCa) for salvage therapy and to exclude metastases that should be addressed with systemic therapy. For magnetic resonance imaging (MRI), a reduction in the variability of acquisition, interpretation, and reporting is required to detect local PCa recurrence in men with biochemical relapse after local treatment with curative intent. Objective: To propose a standardised method for image acquisition and assessment of PCa local recurrence using MRI after radiation therapy (RP) and radical prostatectomy (RT). Evidence acquisition: Prostate Imaging for Recurrence Reporting (PI-RR) was formulated using the existing literature. An international panel of experts conducted a nonsystematic review of the literature. The PI-RR system was created via consensus through a combination of face-to-face and online discussions. Evidence synthesis: Similar to with PI-RADS, based on the best available evidence and expert opinion, the minimum acceptable MRI parameters for detection of

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“…Treatment options to extend disease control and survival in patients with metastatic castration-resistant prostate carcinoma (mCRPC) have expanded dramatically in the past two decades [1][2][3][4]. Nonetheless, mCRPC remains lethal and new therapies continue to be much-needed [5].…”

Section: Introductionmentioning

confidence: 99%

177 Lu-PSMA-617 radioligand therapy of metastatic castration-resistant prostate cancer: Initial 254-patient results from a prospective registry (REALITY Study)

Khreish

Ghazal

Marlowe³

et al. 2021

Eur J Nucl Med Mol Imaging

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Purpose Preliminary data from retrospective analyses and recent data from large randomized controlled trials suggest safety and efficacy of radioligand therapy (RLT) targeting prostate-specific membrane antigen (PSMA) in men with metastatic castration-resistant prostate cancer (mCRPC). Limited data on this modality have been published regarding large samples treated in everyday practice. Methods We analyzed prospectively collected registry data regarding lutetium-177 (177Lu)-PSMA-617 RLT of 254 consecutive men with mCRPC seen in everyday academic practice. Since 177Lu-PSMA-617 was experimental salvage treatment following failure of individually appropriate conventional therapies, patients were generally elderly and heavily pretreated (median age 70 years; prior taxanes 74.0%, 188/254), with late–end-stage disease (visceral metastasis in 32.7%, 83/254). Primary endpoints were response to RLT, defined by changes from baseline serum prostate-specific antigen (PSA) concentration, PSA progression-free survival (PSA-PFS), and overall survival (OS), estimated with Kaplan–Meier statistics, and caregiver-reported and patient-reported safety. Unless noted, median (minimum–maximum) values are given. Results Patients received 3 (1–13) 177Lu-PSMA-617 activities (6.5 [2.5–11.6] GBq/cycle) every 5.7 (3.0–11.0) weeks. Best response was ≥ 50% PSA reduction in 52.0% of patients (132/254). PSA-PFS was 5.5 (95% confidence interval [95%CI] 4.4–6.6) months and OS, 14.5 (95%CI 11.5–17.5) months. In multivariable Cox proportional-hazards modeling, response to the initial ≤ 2 RLT administrations was the strongest significant prognosticator related to OS (hazard ratio 3.7 [95%CI 2.5–5.5], p < 0.001). No RLT-related deaths or treatment discontinuations occurred; the most frequent RLT-related Grade 3/4 adverse events were anemia (18/254 patients, 7.1%), thrombocytopenia (11/254, 4.3%), and lymphopenia (7/254, 2.8%). RLT-related xerostomia, all grade 1/2, was noted in 53/254 (20.9%). Conclusions In a large, prospectively observed “real-world” cohort with late-stage/end-stage mCRPC and conventional treatment failure, 177Lu-PSMA-617 RLT was effective, safe, and well-tolerated. Early biochemical disease control by such therapy was associated with better OS. Prospective study earlier in the disease course may be warranted.

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Advanced Prostate Cancer: AUA/ASTRO/SUO Guideline PART II

Cited by 104 publications

References 31 publications

Current attitudes of Canadian urologists towards surgical castration in the treatment of prostate cancer

Current attitudes of Canadian urologists towards surgical castration in the treatment of prostate cancer

Prostate Magnetic Resonance Imaging for Local Recurrence Reporting (PI-RR): International Consensus -based Guidelines on Multiparametric Magnetic Resonance Imaging for Prostate Cancer Recurrence after Radiation Therapy and Radical Prostatectomy

177 Lu-PSMA-617 radioligand therapy of metastatic castration-resistant prostate cancer: Initial 254-patient results from a prospective registry (REALITY Study)

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