GENITOURINARY CANCERS

General Cancer

Due to the significant decline in smoking and an increase in advances for early cancer detection and screening, the cancer death rate has declined 27% in the United States from 1991 to 2016, according to the American Cancer Society’s annual report on cancer rates.

In November 2018, the FDA issued a draft guidance recommending metastasis-free survival as an endpoint in drug trials for nonmetastatic castration-resistant prostate cancer, suggesting a major change in expectations for treatment of this tumor type.

The future of prostate cancer treatment will involve using biomarkers to identify which patients will respond to which medications and applying regimens currently in use for patients with advanced disease to men with earlier-stage disease, said Howard I. Scher, MD.

Up to 30% of men with prostate cancer could meet criteria for genetic evaluation for hereditary disease. The hard part, Sanjeev Kaul, MD, said at the 2018 Large Urology Group Practice Association Annual Meeting, is separating the mutations that are relevant from those that are not.

Hormone Sensitive Metastatic Castration-Resistant Prostate Cancer

For clinicians who treat men with early-stage prostate cancer in their clinical practice, a new clinical guideline on the use of external beam radiation therapy has been developed by a panel of experts representing the American Society of Clinical Oncology, American Society for Radiation Oncology, and American Urological Association.

James L. Wade III, MD, FACP, FASCO, discusses the importance of clinical trials in the community.