Focal therapy for the treatment of localized prostate cancer

Ward, John F.; Rewcastle, John C.; Ukimura, Osamu; Gill, Inderbir S.

doi:10.1097/mou.0b013e3283501813

Cited by 12 publications

(6 citation statements)

References 21 publications

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“…2 Focal therapies have demonstrated their effectiveness to treat prostate cancer, from indolent to aggressive, with minimal side effects. 1 While attractive due to their low side effects, focal therapies are currently constrained by inadequate tools for accurate intraprostatic imaging. For planning proper disease management, clinicians require a means that accurately depicts the extent of cancer within a diseased prostate.…”

Section: Discussionmentioning

confidence: 99%

“…1−4 Alternative, nonradical, treatment strategies include active surveillance of indolent cancers and intraprostatic focal therapies (rather than treating the entire gland to preclude or minimize side effects of treatment). 2,5−8 At the other end of the spectrum, for advanced stage disease, there is a great need to triage patients with occult micrometastatic disease to better systemic therapies to cure patients that have minimal systemic burden to decrease prostate cancer-related deaths in men.…”

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confidence: 99%

“…Unfortunately, all three have unsatisfactorily low accuracies in detecting clinically significant disease, as cancerous tissue is often indistinguishable from healthy tissues. 1,10−16 Therefore, to personalize medicine, clinicians have three critical needs for prostate cancer imaging: (1) accurate intraprostatic imaging at early stages; (2) monitoring treatment response and imaging early recurrence; and (3) imaging of prostate cancer bone micrometastases. An imaging modality that could accurately describe the disease in these three states would give clinicians the information necessary to properly classify disease extent and prognosis and plan treatment based on initial and intratreatment response.…”

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confidence: 99%

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Inherently Multimodal Nanoparticle-Driven Tracking and Real-Time Delineation of Orthotopic Prostate Tumors and Micrometastases

et al. 2013

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Prostate cancer is the most common cancer among men and the second cause of male cancer-related deaths. There are currently three critical needs in prostate cancer imaging to personalize cancer treatment: (1) accurate intraprostatic imaging for multiple foci and extra-capsular extent; (2) monitoring local and systemic treatment response and predicting recurrence; and (3) more sensitive imaging of occult prostate cancer bone metastases. Recently, our lab developed porphysomes, inherently multimodal, all-organic nanoparticles with flexible and robust radiochemistry. Herein, we validate the first in vivo application of 64Cu-porphysomes in clinically relevant orthotopic prostate and bony metastatic cancer models. We demonstrate clear multimodal delineation of orthotopic tumors on both the macro- and the microscopic scales (using both PET and fluorescence) and sensitively detected small bony metastases (<2 mm). The unique and multifaceted properties of porphysomes offers a promising all-in-one prostate cancer imaging agent for tumor detection and treatment response/recurrence monitoring using both radionuclide- and photonic-based strategies.

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Section: Discussionmentioning

confidence: 99%

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Inherently Multimodal Nanoparticle-Driven Tracking and Real-Time Delineation of Orthotopic Prostate Tumors and Micrometastases

et al. 2013

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“…In one investigation of post prostatectomy pathological findings, only a small number of patients with pT2a would have been eligible for focal therapy, however, accurate selection of these patients was challenging [18]. Improved imaging methods can play a pivotal role in all these decision points [19, 20]. …”

Section: Focal Therapy Of Localized Prostate Cancermentioning

confidence: 99%

Multimodal imaging in focal therapy planning and assessment in primary prostate cancer

Jadvar

2017

Clin Transl Imaging

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Purpose There is increasing interest in focal therapy (male lumpectomy) of localized low-intermediate risk prostate cancer. Focal therapy is typically associated with low morbidity and provides the possibility of retreatment. Imaging is pivotal in stratification of men with localized prostate cancer for active surveillance, focal therapy or radical intervention. This article provides a concise review of focal therapy and the evolving role of imaging in this clinical setting. Methods We performed a narrative and critical literature review by searching PubMed/Medline database from January 1997 to January 2017 for articles in the English language and the use of search keywords “focal therapy”, “prostate cancer”, and “imaging”. Results Most imaging studies are based on multiparametric magnetic resonance imaging. Transrectal ultrasound is inadequate independently but multiparametric ultrasound may provide new prospects. Positron emission tomography with radiotracers targeted to various underlying tumor biological features may provide unprecedented new opportunities. Multimodal Imaging appears most useful in localization of intraprostatic dominant index lesions amenable to focal therapy, in early assessment of therapeutic efficacy and potential need for additional focal treatments or transition to whole-gland therapy, and in predicting short-term and long-term outcomes. Conclusion Multimodal imaging is anticipated to play an increasing role in the focal therapy planning and assessment of low-intermediate risk prostate cancer and thereby moving this form of treatment option forward in the clinic.

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“…These include the use of ultrasound (Doppler, contrast, characterisation algorithms) and multi-parameter magnetic resonance imaging (MRI). However, up to now there is no standardised technique that offers better results in terms of sensitivity, specificity, predictive value, and reproducibility [17]. …”

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confidence: 99%

ecancermedicalscience

Jácome-Pita

Sánchez-Salas

Barret

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Prostate cancer is one of the most significant pathologies in the field of urology. The adoption of screening strategies and improvements in biopsies have resulted in an increase in early-stage tumour detection.Radical global therapies provide very good oncological results in localised prostate cancer. However, excess treatment in low- and, in some cases, intermediate-risk groups affects the quality of life of these patients.In the case of localised prostate cancer, focal therapies offer a minimally invasive option with good results with respect to established treatments. Although this is currently not a standard treatment, it represents the therapeutic approach with the greatest potential.This literature review has the following objectives: to define selection criteria for patients who are candidates for focal therapy, to assess the current situation and results of the different therapeutic options, and to define procedures in cases of recurrence and for follow-ups.We concluded that focal therapy is a viable therapeutic alternative for localised prostate cancer, specifically cryosurgery and high-intensity targeted ultrasound, which have acceptable oncologic results and a lower comorbidity compared with global treatments. Studies with a high level of scientific evidence are still needed to validate these results.Acquisition of evidenceA search was carried out on the Medline (PubMed), EMBASE, Web of Science and Cochrane databases of all papers published before 31 July 2013. We included clinical studies and literature reviews that evaluated primary focal therapy for prostate cancer confirmed by biopsy and excluded focal rescue therapy studies. The keywords used were focal therapy and prostate cancer.Initially, we found 42 articles; 15 studies were excluded because they did not meet the minimum criteria for inclusion. A total of 1350 cases were treated throughout 27 studies.

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Focal therapy for the treatment of localized prostate cancer

Cited by 12 publications

References 21 publications

Inherently Multimodal Nanoparticle-Driven Tracking and Real-Time Delineation of Orthotopic Prostate Tumors and Micrometastases

Inherently Multimodal Nanoparticle-Driven Tracking and Real-Time Delineation of Orthotopic Prostate Tumors and Micrometastases

Multimodal imaging in focal therapy planning and assessment in primary prostate cancer

ecancermedicalscience

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