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Radionuclide-based Diagnosis and Therapy of Prostate Cancer
Published in Michael Ljungberg, Handbook of Nuclear Medicine and Molecular Imaging for Physicists, 2022
Sven-Erik Strand, Mohamed Altai, Joanna Strand, David Ulmert
Amino acids are essential to cell metabolism and growth. Several amino acid transporter systems are overexpressed in PCa. Anti-1-amino-3-[18F]Flurocyclobutane-1-carboxylic acid (18F-fluciclovine-FACBC) is a non-naturally occurring amino acid, and its transport is primarily mediated by sodium-dependent amino acid transporters. Because the amino acid transporters that are most involved in 18F-fluciclovine transport mediate influx and efflux of amino acids, washout of the radiotracer occurs over time. The specificity of 18F-fluciclovine for PCa relies on altered metabolic pathways overexpressed in PCa. Studies have shown a detection rate of 40 per cent for patients with biochemical recurrence and a PSA level of 0.79 ng/mL or less. Direct comparison between 18F-fluciclovine and 11C-choline PET/CT has demonstrated overall superior imaging performance for 18F-fluciclovine in biochemically recurrent PCa. A good overview of 18F-Fluciclovine is found in Parent and Schuster and colleagues [71].
The Precision Medicine Approach in Oncology
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
A further study looked at how the assay could be used to predict Biochemical Recurrence (BCR) of prostate cancer. BCR is the gradual increase in levels of Prostate-Specific Antigen after treatment such as surgery or radiation. The study showed that the test could be used to predict both early and late BCR, which is important as early BCR is associated with a higher systemic recurrence of prostate cancer. Overall, the study evaluated 402 patients, and correctly identified 62 men who experienced BCR with five going on to develop metastatic disease.
Hereditary Prostate Cancer
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
Veda N. Giri, Jennifer Beebe-Dimmer, Kathleen A. Cooney
The association of family history of prostate cancer with aggressiveness of disease has been inconsistent. Some studies reported higher cancer-specific and overall mortality in familial cases compared to sporadic cases [59]. These findings were consistent with a study conducted in the pre-PSA era which reported greater risk of biochemical recurrence among patients with a family history of prostate cancer [60]. Other studies have not found an association of family history of prostate cancer and advanced disease. One study of 471 men undergoing radical prostatectomy evaluated biochemical recurrence after prostatectomy by family history of prostate cancer and first-degree relative with death from prostate cancer and found that those with first-degree relatives who died from prostate cancer did not have an increased likelihood of high-risk/aggressive prostate cancer or biochemical recurrence [61]. Greater studies in diverse populations are needed to lend insights into familial association to aggressive prostate cancer.
Utilizing clinical, pathological and radiological information to guide postoperative radiotherapy in prostate cancer
Published in Expert Review of Anticancer Therapy, 2023
Jerusha Padayachee, Simone Chaudhary, Brian Shim, Jonathan so, Remy Lim, Srinivas Raman
Presently, PSA and traditional clinicopathologic factors including Gleason grade and clinical staging set the foundation for patient stratification and disease management. However, biochemically recurrent prostate cancer in the setting of post-radical prostatectomy has a diverse natural history. Only a fraction of patients with biochemical recurrence develop tumor metastasis, and many patients will ultimately die of competing, unrelated causes [90,91]. There exists a biological diversity in prostate cancer that remains unaddressed in the postoperative clinical decision-making process, and tools to improve the stratification and prognostication of individual patients is needed to enhance outcomes and prevent overtreatment. Prognostic biomarkers would help clinicians identify patients who are likely to experience aggressive, recurrent, or metastatic disease, while predictive biomarkers would discriminate patients who are likely to benefit from different therapeutic modalities.
Prognosis of primary or metachronous prostate cancer in multiple primary genitourinary cancers; a single center experience with long-term results
Published in The Aging Male, 2021
Caner Ediz, Serkan Akan, Hasan Huseyin Tavukcu, Muhammed Esad Kayhan, Omer Yilmaz
Patients’ age at diagnosis, smoking status (pack-years), comorbidities, medications, PSA levels at the diagnosis of the primary and secondary tumour, primary and secondary tumour size (mm) or positive core number in a prostate biopsy, performed treatment for primary and secondary tumour, pathological results of treatment of primary or secondary tumour (e.g. degree of invasion or International Society of Urological Pathology [ISUP] classification for PCa grade), the interval between primary and secondary tumour, presence of tumour recurrence or metastasis which develop in the follow-up period, and follow-up period were recorded. Biochemical recurrence was defined as an increase in PSA concentration to ≥0.2 ng/mL with a second confirmatory value. Biochemical Recurrence Free Survival (BRFS) was defined from the date of the diagnosis to the date of the biochemical recurrence.
Adherence to guidelines for androgen deprivation therapy after radical prostatectomy: Swedish population-based study
Published in Scandinavian Journal of Urology, 2020
Magdalena Lycken, Linda Drevin, Hans Garmo, Anders Larsson, Ove Andrén, Lars Holmberg, Anna Bill-Axelson
The European Association of Urology (EAU) guidelines recommend early ADT after radical prostatectomy for men with a biochemical recurrence and a PSADT <6–12 months and/or a Gleason score 8–10, and a long life expectancy [15]. In this study, we used one measurement of PSA ≥ 0.2 ng/ml measured six weeks or more after radical prostatectomy as a proxy for biochemical recurrence and considered this as a prerequisite for adherent treatment with ADT. We applied the PSADT criteria as PSADT <12 months. The Gleason score was accessible as prostatectomy specimen Gleason for 682 men in the study, since we lacked most of this information before 2007. The decision to treat with ADT was exclusively referred to the PSADT first, the prostatectomy specimen Gleason next, and the biopsy Gleason last. If any of these could explain the treatment decision, the treatment with ADT was considered adherent to guidelines.