Prostate Cancer

As the year comes to a close, we revisit some of this year’s top content on prostate cancer.

The alert was issued to clarify that the devices should not be used for suction and irrigation.

“Our findings highlight the coordinated interplay between GCN2 and p53 regulation during nutrient stress and provide insight into how they could be targeted in developing new therapeutic strategies for [prostate cancer]," write the authors.

Pluvicto was approved by Health Canada in August 2022.

From baseline to 1 year, the Ki-67 index decreased in the dietary intervention cohort by 15% and increased in the control cohort by 24%.

“If approved, this approach has the potential to transform the treatment paradigm in prostate cancer, offering patients with localized disease an effective treatment option that may reduce the risk of disease recurrence," says Glen Gejerman, MD, MBA.

Specifically, 90% of patients in the HIFU arm vs 86% of patients in the radical prostatectomy arm were free from subsequent definitive treatment at 30 months.

The clearance is supported by data from the PRESERVE trial, which evaluated the safety and effectiveness of the NanoKnife System in patients with intermediate-risk prostate cancer.

PT217 is currently under investigation in the phase 1/2 SKYBRIDGE trial in patients with neuroendocrine cancers.

"That pan-tumor approval and this patient case really highlight that in prostate cancer, we should be checking HER2 by immunohistochemistry," says Maneesh R. Jain, MD.

Data showed that all patients achieved a PSA decline of at least 50%.

“The combination of pembrolizumab and chemotherapy presents a promising new treatment approach for these challenging-to-treat, rare cancers and could be a major breakthrough for patient care,” says Arnold I. Chin, MD, PhD.

"Most of the published data about HIFU tended to be with relatively short-term follow-up," says Ralph J. Miller Jr, MD.

The phase 2 CELLVX-230 trial is exploring the potential of FK-PC101 to delay or prevent prostate cancer recurrence following prostatectomy.

Data from the CAPItello-281 trial also showed a trend toward an improvement in overall survival.

"Every practice is going to be a little bit different on how they would like to approach this," says Michael Jenson, PA-C.

In the recent news release, Koelis reported that the final patient was enrolled in the VIOLETTE study in September 2024.

The sNDA is supported by data from the pivotal phase 3 ARANOTE trial.

“Prostate cancer patients with life expectancies of less than 5 or 10 years were being subjected to treatments that can take up to a decade to significantly improve their chances of surviving cancer, despite guidelines recommending against treatment," says Timothy J. Daskivich, MD.

Final completion of the ECLIPSE trial is anticipated for February 2029.

Oliver Sartor, MD, discusses how unmet needs and clinical challenges for PSMA imaging in prostate cancer patients include standardizing interpretation criteria, addressing false negatives in certain tumor phenotypes, improving accessibility and cost-effectiveness, and developing strategies for patients with low PSMA expression or PSMA-negative disease.

“Our study is distinguished by long follow-up, out to 12 years, looking at a broad spectrum of key complications," says Joseph M. Unger, PhD.

The decision was based on an interim readout from the trial, which showed that ONCT-534 did not lead to any clinically meaningful improvement of disease.

"Patients, in general, have been extremely happy, and the one thing that I think keeps them happy is I'm continually evolving with how I give the information," says Michael Jenson, PA-C.

"The 5-year data from STOMP showed that about a third of men could go 5 years without requiring ADT, which is exciting," says Bridget F. Koontz, MD, FASTRO.

In total, the study plans to enroll 84 adult patients across clinical trial sites in the United States and Australia.

Oliver Sartor, MD, discusses how 68gallium PSMA-11 PET is indeed the preferred imaging modality for confirming eligibility for lutetium therapy, but when unavailable, alternative options such as F-18 PSMA PET, conventional bone scintigraphy, or CT/MRI may be considered, albeit with potential limitations in sensitivity and specificity.

Panelists discuss how the increased use of androgen receptor–targeted therapy in clinical practice may impact the effectiveness of PARP inhibitor combinations like talazoparib in the TALAPRO-2 study, while also addressing safety concerns, potential differences in trial populations, and the need for future studies to optimize treatment approaches for various metastatic prostate cancer patient subgroups.

Panelists discuss how the PROfound trial (NCT02987543) demonstrated the efficacy and safety of olaparib monotherapy in metastatic prostate cancer patients with homologous recombination repair gene alterations, highlighting its potential as a targeted treatment option and its impact on the landscape of precision medicine in prostate cancer management.

Michael Jenson, PA-C, gives an overview of the Surgical Impotence Management Strategy program at Minnesota Urology.