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Mixed Results for Immunotherapy in Metastatic Prostate Cancer


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An immunotherapy combination for metastatic castration-resistant prostate cancer (mCRPC) failed to hit a response target but still exceeded historical results, a small prospective study showed.
Ten of 35 (28.6%) patients responded to the combination of nivolumab (Opdivo) and ipilimumab (Yervoy). The activity fell short of the 40% threshold for a positive outcome but well above the historical response rate for immunotherapy in patients previously treated with docetaxel.
The safety profile of the combination was consistent with prior clinical experience, reported Mark Linch, MD, PhD, of University College London, at the American Association for Cancer Research virtual meeting.
Responders were enriched with patients with mismatch repair or BRCA 1 and 2, said Linch. We believe that further study of nivolumab and ipilimumab i biomarker-selected patients with metastatic castration-resistant prostate cancer is warranted. The rate of incomplete treat ....

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More Benefit With Taxane for Aggressive Metastatic Prostate Cancer


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Men with poor-prognosis metastatic castration-resistant prostate cancer (mCRPC) had better outcomes with cabazitaxel (Cabometyx) as initial therapy instead of an androgen-receptor inhibitor, a phase II randomized trial showed.
First-line taxane therapy led to a clinical benefit rate (CBR, response plus stable disease) of 80% as compared with 62% for patients treated with either enzalutamide (Xtandi) or abiraterone (Zytiga). Patients treated with cabazitaxel lived more than twice as long, although the difference did not reach statistical significance because of a small patient population.
Patients treated with cabazitaxel had higher rates of grade ≥3 neutropenia, diarrhea, and infection, reported Kim N. Chi, MD, of BC Cancer in Vancouver, and colleagues, in ....

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Androgen Cycling Shows Promise in Castration-Resistant Prostate Cancer


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A treatment strategy based on manipulation of testosterone levels showed promise as a potential aid for managing castration-resistant prostate cancer (CRPC), according to a randomized proof-of-principle trial.
Following disease progression with abiraterone (Zytiga), treatment with bipolar androgen therapy (BAT) or enzalutamide (Xtandi) led to a median progression-free survival (PFS) of 5.7 months (clinical or radiographic progression). A similar proportion of patients in each treatment arm had at least a 50% reduction in baseline PSA level (PSA50 response), and overall survival (OS) did not differ significantly between the groups, reported Samuel R. Denmeade, MD, of Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins in Baltimore, and colleagues. ....

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Op-Ed: Black Men, 'PSA Prison,' and the Tuskegee Legacy


Anthony Henry and Willie Underwood III have a lot in common.
Both are Black men whose gene pool originated in West Africa, suggesting higher risks for aggressive prostate cancer. Both of their fathers were diagnosed with prostate cancer. Henry s father was diagnosed at age 64 and died at 68 from prostate cancer, and Underwood s dad was diagnosed with prostate cancer in his early 70s and is still alive at 81.
Both sons were diagnosed with prostate cancer at a young age: Underwood at 48 and Henry at 54.
Underwood in 2012 was diagnosed with a Gleason 3+4, known today as a favorable intermediate-risk prostate cancer. He qualified in some protocols for active surveillance (AS), monitoring the disease with prostate-specific antigen (PSA) tests, digital rectal exams, biopsies, and multi-parametric magnetic resonance imaging. ....

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Radiotherapy's Role in Metastatic Prostate Cancer Clarified


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Adding radiation therapy to standard treatment improved failure-free survival (FFS) and overall survival for prostate cancer patients with only a few bone metastases, an exploratory analysis of the multi-arm, multi-stage STAMPEDE trial found.
Among the nearly 2,000 men in the study, adding radiation to mostly androgen deprivation therapy (ADT) improved both FFS (HR 0.57, 95% CI 0.47-0.70) and overall survival (HR 0.62, 95% CI 0.46-0.83) in those with only non-regional lymph node metastasis or with fewer than three bone lesions and no visceral metastases, reported Noel Clarke, MBBS, of the Christie NHS Foundation Trust in Manchester, England, and colleagues.
Patients either with visceral metastasis or four or more bone lesions still had improved FFS (HR 0.87, 95% CI 0.76-0.99, ....

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