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Prostate Cancer, An Issue of Hematology/Oncology Clinics of North America, E-Book

Prostate Cancer, An Issue of Hematology/Oncology Clinics of North America, E-Book

Christopher Sweeney

(2013)

Additional Information

Book Details

Abstract

This issue of Hematology/Oncology Clinics is focused on Prostate Cancer and highlights topics such as: Prevention, Early Detection, Biomarkers, Risk stratification, Imaging in Prostate Cancer, Adjuvant hormonal therapy, Management of patient with biochemical relapse, Management of patient with newly metastatic disease, and Bone Health Management.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Prostate Cancer i
Copyright\r ii
Contributors iii
Contents vii
Forthcoming Issues x
Preface xi
Early Detection, PSA Screening, and Management of Overdiagnosis 1091
Key points 1091
Introduction 1091
PSA screening 1092
Randomized controlled trials of PSA screening 1093
PSA screening modifications to improve detection 1094
PSA refinements 1094
PSA Velocity 1094
Free PSA 1095
Complexed PSA 1095
PSA Density 1096
Risk-based screening 1096
Prediction tools 1096
Novel screening tests 1097
PCA3 1097
Prostate Health Index 1098
TMPRSS2:ERG Gene Fusion 1098
Current screening guidelines 1098
Overdiagnosis in prostate cancer 1101
Impact of overdiagnosis 1101
Watchful waiting and observation 1102
Active surveillance 1103
Summary 1104
References 1104
Surgical Management of Prostate Cancer 1111
Key points 1111
Introduction 1111
Patient selection 1112
Surgical technique 1113
Cavernosal nerve sparing 1113
Pelvic lymph node dissection 1114
Surgical margins 1115
Low-risk prostate cancer 1116
Definition of Low-Risk Prostate Cancer 1116
Outcomes for Low-Risk Disease Following Radical Prostatectomy 1116
High-risk prostate cancer 1117
Definition of High-Risk Prostate Cancer 1117
Outcomes for High-Risk Disease Following Radical Prostatectomy 1117
Neoadjuvant therapy before radical prostatectomy 1124
Is radical prostatectomy the preferred treatment for high-risk prostate cancer? 1124
Alternative Surgical Therapies 1125
Summary 1125
References 1125
Contemporary Issues in Radiotherapy for Clinically Localized Prostate Cancer 1137
Key points 1137
Introduction 1137
Principles of radiation therapy 1138
Patient selection for radiation therapy with curative intent 1138
Risk Stratification 1138
Assessment, Comorbidities, and Contraindications 1139
Defining the radiation target 1140
Prostate and Seminal Vesicles 1140
Whole Pelvic Irradiation 1141
External Beam Radiotherapy\r 1141
IMRT 1141
Image-Guided Radiation Therapy 1141
Dose-Escalated Radiotherapy 1142
Toxicity 1143
Role of Androgen Deprivation Therapy 1144
Brachytherapy 1144
LDR Brachytherapy 1145
Patient selection for brachytherapy 1145
Outcomes 1145
Toxicity 1146
HDR Brachytherapy 1146
Toxicity 1147
Postprostatectomy radiotherapy 1147
PPRT Volume Delineation 1147
Adjuvant Therapy 1147
Salvage Therapy 1149
PPRT Toxicity (Adjuvant and Salvage) 1149
Ongoing Trials 1150
Second malignancy risks from radiotherapy 1150
Future directions in prostate radiotherapy 1150
Anatomic and Molecular Imaging 1150
Hypofractionation 1151
Stereotactic Body Radiotherapy 1151
New Endocrine Therapies 1151
Summary 1152
References 1152
Imaging in Prostate Carcinoma 1163
Key points 1163
Introduction 1163
Imaging modalities commonly used to evaluate prostate cancer 1164
TRUS 1165
MRI 1165
CT 1166
Skeletal Scintigraphy (99mTc-MDP Bone Scan) 1166
PET 1167
Imaging in staging and management of prostate cancer: localized and metastatic disease 1168
Future directions 1170
DCE-MRI 1172
MRSI 1172
DWI 1173
mpMRI 1173
PET 1173
Summary 1178
References 1178
Neoadjuvant and Adjuvant Hormonal and Chemotherapy for Prostate Cancer 1189
Key points 1189
Introduction 1189
Adjuvant hormone therapy following prostatectomy 1190
Adjuvant RT following prostatectomy 1192
Adjuvant androgen deprivation therapy in combination with RT 1194
Adjuvant chemotherapy 1199
Neoadjuvant and adjuvant approaches with new hormonal agents 1200
Future directions 1201
References 1201
Management of Patients with Biochemical Recurrence After Local Therapy for Prostate Cancer 1205
Key points 1205
Introduction 1205
Definition of BCR 1206
BCR After RP 1206
BCR After RT 1207
Natural history of patients with prostate cancer experiencing BCR after surgery or RT 1207
Diagnostic evaluation after PSA recurrence 1208
Salvage radiation for BCR 1209
Salvage prostatectomy postradiation 1209
Hormonal therapy for biochemically recurrent prostate cancer 1212
Continuous Versus Intermittent Administration of ADT 1213
Concerns About Adverse Effects of ADT 1213
Drug development end points for patients with biochemically recurrent prostate cancer 1214
Summary 1215
References 1215
Management of Hormone-Sensitive Metastatic Prostate Cancer 1221
Key points 1221
Introduction 1221
Androgen synthesis and AR 1222
Molecular mechanism underlying prostate cancer progression despite ongoing ADT 1222
AR-Dependent Mechanisms 1222
AR-Independent Mechanisms 1225
Drugs targeting androgen synthesis and AR signaling in metastatic prostate cancer 1226
Targeting Hypothalamic-Pituitary-Testicular Axis 1226
GnRH analogues or agonists 1226
GnRH antagonist 1226
Targeting Androgen Synthesis 1227
Ketoconazole 1227
Abiraterone acetate 1227
TAK-700 (orteronel) 1227
Targeting AR 1228
Antiandrogens 1228
Enzalutamide (MDV3100) 1228
ARN-509 1229
TOK-001 (galeterone) 1229
EPI-001 1229
Systemic therapy for HSPC 1229
Castration Versus CAB Therapy 1229
Intermittent ADT Versus Continuous ADT 1230
Combining Chemotherapy with Castration in HSPC 1230
Predicting response to ADT in HSPC 1231
Ongoing studies of ADT in combination with novel agents in HSPC and future directions 1233
References 1235
Management of Patients with Castration-Resistant Disease 1243
Key points 1243
Introduction 1243
Overview of drug classes 1244
Sequencing and response assessment 1246
Targeting of androgen receptor 1247
Abiraterone 1247
Enzalutamide 1247
Novel Hormonal Therapies 1248
TAK-700 1248
VT 464 1248
ARN-509 1248
ODM-201 1249
TOK-700 1249
Immunotherapy 1249
Sipuleucel-T 1249
Prostvac 1250
Ipilimumab 1250
Chemotherapy 1250
Docetaxel 1250
Cabazitaxel 1251
Other Chemotherapies 1252
Mitoxantrone 1252
Satraplatin 1252
Novel therapies 1252
223Radium 1252
Cabozantinib 1252
Custirsen 1253
Tasquinimod 1253
OGX-427 1253
Other Promising Novel Therapies 1254
Resistance mechanisms 1254
Summary 1255
References 1255
Optimizing Bone Health and Minimizing Skeletal Morbidity in Men with Prostate Cancer 1261
Key points 1261
Introduction 1261
Normal bone physiology 1262
Treatment-related osteoporosis 1263
Bone metastases in prostate cancer 1264
Osteoclast-targeted therapies 1265
Bisphosphonates 1265
Receptor Activator of Nuclear Factor-κβ Ligand Inhibitors 1267
Management of treatment-related osteoporosis 1267
Defining Osteoporosis 1267
Who to Consider for Screening and Treatment? 1267
Pharmacologic Interventions for Treatment-Related Osteoporosis 1268
Bisphosphonates 1268
Receptor activator of nuclear factor-κβ ligand inhibitors 1268
SERMs 1270
Calcium and Vitamin D Supplementation 1270
Lifestyle Modifications 1270
Summary 1270
Use of osteoclast-targeted therapies in metastatic castration-sensitive prostate cancer 1271
Use of osteoclast-targeted therapies in metastatic CRPC 1271
Zoledronic Acid 1273
Denosumab 1273
Summary 1274
Prevention of bone metastases 1274
Zoledronic Acid 1274
Denosumab 1274
Summary 1275
Radiopharmaceuticals 1275
Strontium-89 1276
Samarium-153 1276
Radium-223 1276
Non-bone–targeted therapies documented to decrease SREs 1277
Abiraterone 1277
Enzalutamide 1277
Summary 1277
References 1278
Index 1285