Prostate cancer news reports: Tuesday, April 20, 2010
Posted Apr 20 2010 12:00am
In today’s news reports we note new articles dealing with:
Biopsy protocols, patient selection, and focal therapy
Tertiary Gleason pattern 4/5 and risk for progression post-RP
Evolving data on the uses of bisphosphonates and denosumab
SKIs in treatment of advanced forms of prostate cancer
Tsivian et al. have reviewed data on patient selection for focal and hemiablative therapy. This team at Duke University has significant experience in this area, so their conclusion is of some significance. They state clearly that, “there is insufficient scientific evidence to propose a specific biopsy scheme that could fit every candidate, providing accurate characterization of the disease in the individual patient. Further research is necessary to establish solid selection protocols that would reliably identify appropriate candidates” for focal therapy.
Servoll et al. have demonstrated that at least in a cohort of 151 Norwegian patients a tertiary Gleason pattern of 4 or 5 is an independent predictor for biochemical relapse among patients with no pathological indication of primary or secondary Gleason pattern any higher than 3 who receive a radical prostatectomy as treatment for localized disease. These data would appear to confirm the importance of careful review of the pathology of all surgical specimens to identify the possible presence of tertiary Gleason pattern 4 or 5. The presence of either tertiary pattern clearly has long-term prognostic impact.
Neville-Webbe and Coleman have reviewed evolving data on the roles of bisphosphonates like zoledronate and the RANK-L inhibitor denosumab in the prevention of fractures, significant bone loss, and pain for men with advanced prostate cancer who are being treated with hormone therapy. They also discuss the evolution of data suggesting that bisphosphonate therapy may be able to prevent or delay the onset of metastatic disease.
Edwards has reviewed available data on the potential of Src and Src family kinase inhibitors (SKIs) like dasatinib and saracatinib in the treatment of advanced forms of prostate cancer. Some early Phase II data on saracatinib have been published, but it seems unclear whether this product will be advanced into Phase III trials. In the case of dasatinib (Sprycel), a randomized Phase III clinical trial is currently enrolling patients with castration-resistant prostate cancer into a trial comparing dasatinib + docetaxel to a placebo + docetaxel.