PSA and Biomarker Testing Plus MRI Appears to Improve Prostate Cancer Screening
A single round of prostate cancer screening that included a prostate-specific antigen (PSA) test, a kallikrein panel, and an MRI detected one additional high-grade cancer per 196 men and one low-grade cancer per 909 men, according to preliminary results from the Finnish ProScreen randomized trial. The risk difference for the group randomized to the screening […]
Radioligand Therapy Continues to Show Promise for Metastatic CRPC
Radioligand therapy (RLT) with actinium-225 targeting prostate-specific membrane antigen (225Ac-PSMA) had a “substantial antitumor effect” in heavily pretreated metastatic castration-resistant prostate cancer (mCRPC), a large, retrospective, multicenter study showed. Data on 488 men showed an overall survival (OS) of 15.5 months and median progression-free survival (PFS) of 7.9 months. A third of the patients had […]
Apalutamide Makes Its Case in Biochemically Recurrent Nonmetastatic Prostate Cancer
A 1-year period of intensified androgen receptor blockade prolonged prostate-specific antigen progression-free survival (PSA-PFS) compared with androgen deprivation therapy (ADT) alone for patients with high-risk, biochemically recurrent prostate cancer, according to interim results from a phase III trial. In the three-arm PRESTO study, adding either apalutamide (Erleada) or apalutamide plus abiraterone acetate (Zytiga) and prednisone […]
Diagnostic Imaging Not Yet Enough for Biopsy-Free Radical Prostatectomy
While prostate-specific membrane antigen (PSMA)-PET may improve diagnostic accuracy in suspected prostate cancer, it may not be accurate enough to skip the biopsy when considering radical prostatectomy. In a retrospective review of 89 men with benign prostatic hyperplasia (BPH), PSMA-PET prior to biopsy had a false-positive rate of 30%, with subsequent needle biopsy revealing negative […]
Robust PSA Drops With Radionuclide Therapy in Castration-Resistant Prostate Cancer
ORLANDO — An investigational radionuclide therapy targeting prostate-specific membrane antigen (PSMA) achieved biochemical responses in 70% of patients with castration-resistant prostate cancer (CRPC), and prostate-specific antigen (PSA) reductions in all but one patient, enrolled in a small preliminary clinical trial. Overall, 22 of 23 patients had some degree of PSA decline in response to fractionated […]
MRI-Targeted Biopsy for Prostate Cancer Reduces Risk of Overdiagnosis
Excluding systematic biopsy in favor of MRI-targeted biopsy in men with elevated prostate-specific antigen (PSA) levels reduced the probability of detecting clinically insignificant cancers, but at the risk of missing some clinically significant cancers and delaying their diagnosis, the randomized GÖTEBORG-2 trial from Sweden showed. Among nearly 18,000 participants, 0.6% of men who underwent MRI-targeted […]
Just How Effective Is PSA Screening?
NEW ORLEANS — Prostate cancer screening with prostate-specific antigen (PSA) blood testing appears to have a more favorable benefit-to-harm trade-off than originally estimated, particularly among Black men, according to research presented here. Using the most conservative assumptions about the benefits of screening, investigators found that among men of all races, one death was prevented for […]
Genetic Score Shows Promise for Honing PSA Precision
NEW ORLEANS — Adjusting prostate-specific antigen (PSA) levels for normal genetic variations showed potential for making PSA testing more useful, including reducing unnecessary prostate biopsies, a large genome-wide association study (GWAS) suggested. A “polygenic score” (PGS) that accounted for noncancerous variations in PSA values explained 7.3%-8.8% of the variation in baseline PSA values in two […]
Are the Right Men Getting Screened for Prostate Cancer?
Prostate-specific antigen (PSA)-based screening for prostate cancer increased after the U.S. Preventive Services Task Force recommended individual decision-making for men ages 55 to 69 in 2017, reversing its 2012 guidance that advised against PSA screening in all men. Now, a retrospective cohort study found that from 2016 to 2019 the overall mean rate of PSA […]
PSMA PET Plus MRI Better Detects Clinically Significant Prostate Cancers
MRI combined with prostate-specific membrane antigen (PSMA) PET improved the detection of clinically significant prostate cancer compared with MRI alone, and can potentially allow for a reduction in the number of biopsies needed for diagnosis, according to results from the PRIMARY trial. The combined approach demonstrated an increase in negative predictive value for detecting prostate […]