Later this week health care professionals and researchers will be meeting in Orlando, Florida, for the 2015 Genitourinary (GU) Cancers Symposium. From February 26–28, they will be discussing the latest strategies in the prevention, screening, diagnosis, and treatment of tumors of the prostate, bladder, kidney, and testis, as well as less common cancers, such as those of the penis, ureters, and other urinary organs.
Four studies that will be presented at the meeting address ways to improve the care of men with prostate cancer. These studies:
- Identify a potential risk factor for developing prostate cancer,
- Investigate ways to select the best treatment option, and
- Provide new insight into the debate over prostate-specific antigen (PSA) screening.
Prostate Cancer Risk
After analyzing data from nearly 180,000 men collected in the Surveillance, Epidemiology, and End Results (SEER) database, researchers have found that the risk of developing prostate cancer is higher in men who have already had testicular cancer than those who have not.
“It is too soon to make any recommendations based on this single study, but the findings provide groundwork for further research into the biologic link between the two diseases,” said senior study author Mohummad Minhaj Siddiqui, MD, an assistant professor of surgery at the University of Maryland School of Medicine and Director of Urologic Robotic Surgery at the University of Maryland’s Marlene and Stewart Greenebaum Cancer Center in Baltimore.
Prostate Cancer Treatment
For many types of cancer, doctors are able to run laboratory tests to identify specific genes, proteins, and other factors unique to the tumor that help determine the best treatment option for each patient. However, there are currently no tests to help doctors select the best treatment option for men with metastatic castration-resistant prostate cancer (mCRPC).
A group of researchers from the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University have been researching a blood test for a genetic change called AR-V7. They have found that although men with mCRPC that tested positive for the AR-V7 mutation did not benefit from hormone therapy with either abiraterone (Zytiga) or enzalutamide (Xtandi), AR-V7 status did not affect response to chemotherapy with either cabazitaxel (Jevtana) or docetaxel (Docefrez, Taxotere).
AR-V7 testing is not currently available outside of clinical trials. However, the researchers believe it “may be extremely valuable in guiding treatment decisions for men with hormone-resistant disease in the near future.” Read more about AR-V7 testing.
A separate study raises questions about recommending active surveillance to men with intermediate-risk prostate cancer. Based on data collected from 945 men, those with intermediate-risk disease had a nearly four-times higher chance of dying from prostate cancer within 15 years when their disease was managed using active surveillance compared to men with low-risk disease.
“For low-risk patients with prostate cancer managed with active surveillance, the risk of dying of prostate cancer is low, validating this approach for this group of patients,” said D. Andrew Loblaw, MD, a radiation oncologist at Sunnybrook Health Sciences Centre in Toronto, Canada. “However, more research is needed to better characterize those intermediate-risk patients who can safely be monitored on a surveillance program.”
Prostate Cancer Screening
The final study analyzed data from more than 87,500 men with prostate cancer. The results show that since 2011, the number of men diagnosed with either intermediate- or high-risk disease has increased by nearly 6%. According to the authors, this is the first study to measure changes in prostate cancer presentation after the implementation of the U.S. Preventive Services Task Force’s PSA screening recommendations.
“This study, while preliminary, adds new insight to the ongoing debate on the risks and benefits of PSA screening for prostate cancer,” said Charles Ryan, MD, ASCO Expert and GU News Planning Team Member. “These findings alone do not warrant changes in physician practice, but they do suggest that men should continue to be encouraged to talk with their doctors about screening to decide whether it is appropriate for them.”
To keep up with all of the research discussions surrounding the 2015 GU Cancers Symposium, be sure to follow #GU15 on Twitter.