HCN Oncology Year-in-Review: Prostate CancerDecember 21, 2021 | Oncology Cardiology Effects of Exercise on Cardiorespiratory Fitness and Biochemical Progression in Men With Localized Prostate Cancer Under Active Surveillance In this clinical trial, the authors attempt to answer the question of whether a high-intensity interval training program can improve cardiorespiratory fitness and delay the biochemical progression of prostate cancer in patients who are undergoing active surveillance. One group was asked to complete 12 weeks of thrice-weekly, supervised aerobic sessions on a treadmill at 85% to 95% of peak oxygen consumption (V̇o2). The usual care group maintained their normal exercise levels. Read full article Internal Medicine Docs Disagree with Update to NCCN Guidelines for Prostate Cancer The updated NCCN guidelines no longer say that active surveillance is “preferred” for low-risk prostate cancer, prompting some physicians to claim this recommendation may encourage overtreatment and is a “step back” from progress made over the last decade, which has been defined by active surveillance as the preferable care option for most low-risk localized prostate cancer patients. Read full article Hematology/Oncology Radiation and Androgen Deprivation Therapy With or Without Docetaxel in the Management of Nonmetastatic Unfavorable-Risk Prostate Cancer Directly from this Journal of Clinical Oncology Original Report: “Among men randomly assigned to receive ADT + RT + docetaxel versus ADT + RT, significantly less RT-induced cancers were observed. The treatment effect of adding docetaxel to ADT + RT on overall survival in men with a prostate-specific antigen (PSA) < 4 ng/mL was driven by the absence of PC death, providing evidence to support a distinct biology in low PSA-producing, unfavorable-risk PC that is docetaxel-sensitive.” Read full article Hematology/Oncology Olaparib vs Cabazitaxel in Metastatic Castration-Resistant Prostate Cancer From JAMA Network Open comes this conclusion: “In this study, the benefit associated with olaparib was reduced, eliminated, or inferior in specific subgroups of patients when treatment outcomes were compared with a more active standard of care, ie, cabazitaxel. While treatment with olaparib was associated with superior rPFS in patients with BRCA1/2 variants, those with other HRR variants may have worse outcomes with this approach, which should be reassessed by national guidelines. Numerous active studies…will add to the data regarding the role of PARP inhibitors in mCRPC.” Read full article Hematology/Oncology Controversy Prompts Another Update to the NCCN Guidelines for Prostate Cancer Bowing to criticism from doctors, the National Comprehensive Cancer Network (NCCN) has again updated its guidelines for prostate cancer. The previous update, released this past September, had changed the recommendation about active surveillance for low-risk prostate cancer to state that active surveillance was no longer the “preferred” management option for patients with low-risk prostate cancer and a life expectancy of 10 years or more. Many physicians criticized this change, saying it could lead to overtreatment of low-risk patients by implying that active surveillance, surgery, and radiation are equivalent management options. As a result, NCCN has further revised its guidelines to now state that active surveillance is preferred for most patients with low-risk prostate cancer and a life expectancy of 10 years or more. Read full article
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