Management of Biochemical Recurrence After Primary Treatment of Prostate Cancer: A Systematic Review of the Literature

Punnen, Sanoj; Cooperberg, Matthew R.; D’Amico, Anthony V.; Karakiewicz, Pierre I.; Moul, Judd W.; Scher, Howard I.; Schlomm, Thorsten; Freedland, Stephen J.

doi:10.1016/j.eururo.2013.05.025

Cited by 132 publications

(92 citation statements)

References 57 publications

(60 reference statements)

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“…However, local treatment failures occur in many patients after the initial response to radiation therapy. Such recurrent diseases are noted to be more aggressive, to be more resistant to therapy, and to have poorer prognoses (Punnen et al 2013). Recurrence has been partly attributed to subsequent improvements in the tumor vasculature being induced by radiation treatment.…”

Section: Effect Of Radiation Therapy On Angiogenesismentioning

confidence: 99%

Regulation of vascular endothelial growth factor in prostate cancer

Brot¹,

Ntekim²,

Cardenas³

et al. 2015

Endocrine-Related Cancer

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Prostate cancer (PCa) is the most common malignancy affecting men in the western world. Although radical prostatectomy and radiation therapy can successfully treat PCa in the majority of patients, up to w30% will experience local recurrence or metastatic disease. Prostate carcinogenesis and progression is typically an androgen-dependent process. For this reason, therapies for recurrent PCa target androgen biosynthesis and androgen receptor function. Such androgen deprivation therapies (ADT) are effective initially, but the duration of response is typically %24 months. Although ADT and taxane-based chemotherapy have delivered survival benefits, metastatic PCa remains incurable. Therefore, it is essential to establish the cellular and molecular mechanisms that enable localized PCas to invade and disseminate. It has long been accepted that metastases require angiogenesis. In the present review, we examine the essential role for angiogenesis in PCa metastases, and we focus in particular on the current understanding of the regulation of vascular endothelial growth factor (VEGF) in localized and metastatic PCa. We highlight recent advances in understanding the role of VEGF in regulating the interaction of cancer cells with tumor-associated immune cells during the metastatic process of PCa. We summarize the established mechanisms of transcriptional and post-transcriptional regulation of VEGF in PCa cells and outline the molecular insights obtained from preclinical animal models of PCa. Finally, we summarize the current state of anti-angiogenesis therapies for PCa and consider how existing therapies impact VEGF signaling.

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Section: Effect Of Radiation Therapy On Angiogenesismentioning

confidence: 99%

Regulation of vascular endothelial growth factor in prostate cancer

Brot¹,

Ntekim²,

Cardenas³

et al. 2015

Endocrine-Related Cancer

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“…Although external-beam radiotherapy is a well-established salvage therapy in biochemically recurrent prostate cancer after prostatectomy, it achieves a better response if initiated below a PSA level of 1 ng/ml (24). The median PSA level of 2.75 ng/ml in the present analysis was much higher.…”

Section: Discussionmentioning

confidence: 46%

68Ga-PSMA Ligand PET/CT-based Radiotherapy for Lymph Node Relapse of Prostate Cancer After Primary Therapy Delays Initiation of Systemic Therapy

Henkenberens

Klot

Roß

et al. 2017

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Among patients with prostate cancer, tumor relapse after primary therapy particularly occurs in high-risk groups. The standard of care for distant relapse of prostate cancer is androgen-deprivation therapy (ADT), which has a negative impact on the patient's quality of life (1). Recently alternative local treatment strategies have been proposed for patients with oligometastatic disease, who have a better prognosis than patients with extensive disease (2). Local therapies such as radiotherapy could provide effective local control, delay disease progression and therefor reduce the need to initiate systemic therapies (3). The identification of patients with oligometastatic prostate cancer is challenging due to the lack of sufficiently sensitive imaging for detection of low-volume recurrent and metastatic disease in patients with low prostatespecific antigen (PSA) levels (2). In general, positronemission tomography-computed tomography (PET/CT) for radiotherapy has proven helpful in patient selection and target volume delineation, with promising results regarding clinical outcome and toxicity (4, 5). A new diagnostic option in this context is the use of prostate-specific membrane antigen (PSMA) ligands for PET/CT. 68 Ga-PSMA ligand PET/CT has been reported to have a substantially higher diagnostic accuracy for the detection of prostate cancer metastases than choline-based PET/CT, particularly in the case of lymph node metastases (6-10). Data on the effectiveness of 68 Ga-PSMA ligand PET/CT-based radiotherapy for prostate cancer lymph node metastases after primary therapy are limited.The aim of the present study was to assess the clinical outcome and time of initiation of systemic therapies (ADT or chemotherapy) of patients with isolated prostate cancer lymph node metastases after primary therapy treated with 68 Ga-labelled PSMA ligand PET/CT-guided 3D conformal radiotherapy. Patients and MethodsStudy population. Between June 2014 and March 2016, 23 patients with biochemical failure and a PSA above 0.5 ng/ml after primary therapy of prostate cancer underwent 68 Ga-PSMA ligand PET/CT for restaging purposes and were treated with radiotherapy of the 68 Ga-PSMA ligand PET/CT-positive lymph nodes. All cases were discussed 1273

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“…The variable clinical course of these patients leaves much uncertainty about how and when to appropriately manage them. 1 We present a patient with a high PSA value who was successfully treated with salvage RT 11 years after a RP.…”

Section: Introductionmentioning

confidence: 99%

“…The natural history of clinical progression after BCR is variable. 1 However according to available data, about 20% of these patients will die from prostate cancer. 2,3 As such, there has been considerable research to identify clinically significant markers to determine which patients may benefit from salvage radiation therapy (RT) after BCR.…”

Section: Introductionmentioning

confidence: 99%