Prostate Cancer

Raoul S. Concepcion, MD, FACS, director, Comprehensive Prostate Center, discusses takeaways from the ARAMIS study of darolutamide in patients with nonmetastatic castration-resistant prostate cancer.

Although African-American men are at a higher risk for metastatic castration-resistant prostate cancer and have worse survival outcomes compared with Caucasian men, findings of a recent retrospective study suggested they may have a better response to several prostate cancer treatments.

Treatment with the novel targeted radiation therapy lutetium-177 PSMA-617 demonstrated strong clinical activity and the potential to improve survival in heavily pretreated men with PSMA-positive metastatic castration-resistant prostate cancer, according to phase II findings to be presented at the 2019 Genitourinary Cancers Symposium.

In topline findings from the phase III TITAN trial announced today by Janssen, apalutamide in combination with androgen deprivation therapy significantly improved radiographic progression-free survival and overall survival versus placebo in patients with metastatic castration-sensitive prostate cancer.

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In November 2018, the FDA issued a draft guidance recommending metastasis-free survival as an endpoint in drug trials for nonmetastatic castration-resistant prostate cancer, suggesting a major change in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