Articles related to PROSTATE CANCER

In this 3rd case in a short series, the author describes integration of next-generation PSMA imaging with conventional imaging, including CT and bone scans. The author reviews the rationale for triple therapy with darolutamide, ADT, and docetaxel, and reviews the key phase III studies on triple therapy in prostate cancer: the ENZAMET, PEACE-1 and ARASENS trials.

This large surgically staged cohort of high-risk patients with preoperative PSMA PET evaluated the accuracy of Ga-68-PSMA-PET/CT for primary nodal staging. The findings suggest that total lesion uptake values could provide valuable presurgical staging information and might aid in predicting risk of lymph node metastasis in patients with prostate cancer.

In this case, the second in a three-part series, a man was diagnosed with prostate cancer based on a prostate-specific antigen (PSA) level of 6.5 ng/mL. The initial diagnosis was stage 3 disease (T3, N0, M0), with a Gleason score of 3+4=7. The rationale for the treatment decisions is explained, along with the trials (ARAMIS, SPARTAN, PROSPER) that influenced the decisions.

Some physicians believe that Gleason 6 should be reclassified as something other than cancer, which could be a valid argument because Gleason 6 isn’t going to cause any harm and therefore can be safely observed. This commentary provides arguments as to why that reclassification idea is a flawed concept.

The study was comprised of 17,913 men with a median age of 64 years with pT2-4N1M0 prostate cancer (PC) consecutively treated between 1995 and 2017, with postradical prostatectomy (RP) and pelvic lymph node (LN) assessment. The patients were then followed for possible treatment with adjuvant radiation therapy (aRT) or early salvage radiation therapy (sRT). It was determined that men with pN1 PC and 4 or more as compared with 1-3 positive pelvic LNs appear to benefit the most from the use of aRT.

To date, FDA has approved three next-generation AR inhibitors for nonmetastatic CRPC: apalutamide, enzalutamide, and darolutamide. All three agents improve metastasis-free survival and overall survival. Selection of treatment can be guided by factors such as the patient’s overall health and frailty, potential drug-drug interactions, and the safety profile associated with each agent. This review summarizes the data from the practice-changing SPARTAN, PROSPER, and ARAMIS trials and provides insights on implementation in practice and promotes early intervention with AR inhibitors as standard of care for patients with high-risk nonmetastatic CRPC.