https://ctep.cancer.gov/protocolDevelopment/docs/recist_guideline.pdf

New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1)

The number of cancer survivors continues to increase because of both advances in early detection and treatment and the aging and growth of the population. For the public health community to better serve these survivors, the American Cancer Society and the National Cancer Institute collaborate to estimate the number of current and future cancer survivors using data from the Surveillance, Epidemiology, and End Results cancer registries. In addition, current treatment patterns for the most prevalent cancer types are presented based on information in the National Cancer Data Base and treatment-related side effects are briefly described. More than 15.5 million Americans with a history of cancer were alive on January 1, 2016, and this number is projected to reach more than 20 million by January 1, 2026. The 3 most prevalent cancers are prostate (3,306,760), colon and rectum (724,690), and melanoma (614,460) among males and breast (3,560,570), uterine corpus (757,190), and colon and rectum (727,350) among females. More than one-half (56%) of survivors were diagnosed within the past 10 years, and almost one-half (47%) are aged 70 years or older. People with a history of cancer have unique medical and psychosocial needs that require proactive assessment and management by primary care providers. Although there are a growing number of tools that can assist patients, caregivers, and clinicians in navigating the various phases of cancer survivorship, further evidence-based resources are needed to optimize care. CA Cancer J Clin 2016;66:271-289. © 2016 American Cancer Society.

https://onlinelibrary.wiley.com/doi/pdf/10.3322/caac.21349

Cancer treatment and survivorship statistics, 2016.

Background Sipuleucel-T, an autologous active cellular immunotherapy, has shown evidence of efficacy in reducing the risk of death among men with metastatic castration-resistant prostate cancer. Methods In this double-blind, placebo-controlled, multicenter phase 3 trial, we randomly assigned 512 patients in a 2:1 ratio to receive either sipuleucel-T (341 patients) or placebo (171 patients) administered intravenously every 2 weeks, for a total of three infusions. The primary end point was overall survival, analyzed by means of a stratified Cox regression model adjusted for baseline levels of serum prostate-specific antigen (PSA) and lactate dehydrogenase. Results In the sipuleucel-T group, there was a relative reduction of 22% in the risk of death as compared with the placebo group (hazard ratio, 0.78; 95% confidence interval [CI], 0.61 to 0.98; P = 0.03). This reduction represented a 4.1-month improvement in median survival (25.8 months in the sipuleucel-T group vs. 21.7 months in the placebo group). The 36-month survival probability was 31.7% in the sipuleucel-T group versus 23.0% in the placebo group. The treatment effect was also observed with the use of an unadjusted Cox model and a log-rank test (hazard ratio, 0.77; 95% CI, 0.61 to 0.97; P = 0.02) and after adjustment for use of docetaxel after the study therapy (hazard ratio, 0.78; 95% CI, 0.62 to 0.98; P = 0.03). The time to objective disease progression was similar in the two study groups. Immune responses to the immunizing antigen were observed in patients who received sipuleucel-T. Adverse events that were more frequently reported in the sipuleucel-T group than in the placebo group included chills, fever, and headache. Conclusions The use of sipuleucel-T prolonged overall survival among men with metastatic castration-resistant prostate cancer. No effect on the time to disease progression was observed. (Funded by Dendreon; ClinicalTrials.gov number, NCT00065442.)

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Sipuleucel-T immunotherapy for castration-resistant prostate cancer.

The accidental discovery of the anticancer properties of cisplatin and its clinical introduction in the 1970s represent a major landmark in the history of successful anticancer drugs. Although carboplatin--a second-generation analogue that is safer but shows a similar spectrum of activity to cisplatin--was introduced in the 1980s, the pace of further improvements slowed for many years. However, in the past several years interest in platinum drugs has increased. Key developments include the elucidation of mechanisms of tumour resistance to these drugs, the introduction of new platinum-based agents (oxaliplatin, satraplatin and picoplatin), and clinical combination studies using platinum drugs with resistance modulators or new molecularly targeted drugs.

The resurgence of platinum-based cancer chemotherapy

BACKGROUND Biosynthesis of extragonadal androgen may contribute to the progression of castration-resistant prostate cancer. We evaluated whether abiraterone acetate, an inhibitor of androgen biosynthesis, prolongs overall survival among patients with metastatic castration-resistant prostate cancer who have received chemotherapy. METHODS We randomly assigned, in a 2:1 ratio, 1195 patients who had previously received docetaxel to receive 5 mg of prednisone twice daily with either 1000 mg of abiraterone acetate (797 patients) or placebo (398 patients). The primary end point was overall survival. The secondary end points included time to prostate-specific antigen (PSA) progression (elevation in the PSA level according to prespecified criteria), progression-free survival according to radiologic findings based on prespecified criteria, and the PSA response rate. RESULTS After a median follow-up of 12.8 months, overall survival was longer in the abiraterone acetate–prednisone group than in the placebo–prednisone group (14.8 months vs. 10.9 months; hazard ratio, 0.65; 95% confidence interval, 0.54 to 0.77; P<0.001). Data were unblinded at the interim analysis, since these results exceeded the preplanned criteria for study termination. All secondary end points, including time to PSA progression (10.2 vs. 6.6 months; P<0.001), progression-free survival (5.6 months vs. 3.6 months; P<0.001), and PSA response rate (29% vs. 6%, P<0.001), favored the treatment group. Mineralocorticoid-related adverse events, including fluid retention, hypertension, and hypokalemia, were more frequently reported in the abiraterone acetate–prednisone group than in the placebo–prednisone group. CONCLUSIONS The inhibition of androgen biosynthesis by abiraterone acetate prolonged overall survival among patients with metastatic castration-resistant prostate cancer who previously received chemotherapy. (Funded by Cougar Biotechnology; COU-AA-301 ClinicalTrials.gov number, NCT00638690.)

/pdf/abiraterone-and-increased-survival-in-metastatic-prostate-2zpqt2rwwy.pdf

Abiraterone and Increased Survival in Metastatic Prostate Cancer

Clinical outcome with radium-223 (Ra-223) in patients (pts) previously treated with abiraterone (Abi) or enzalutamide (Enza): A retrospective study of real-world (RW) data from pts with metastatic castration-resistant prostate cancer (mCRPC)

Novel hormonal therapy for castration-resistant prostate cancer

Bladder cancer is the fifth most common cancer in men and seventh in women, with an annual incidence of approximately 18–25 cases per 100,000 inhabitants in the Western world. The death rate is approximately 23%. The male to female occurrence is 3:1, but the ratio has decreased in recent years. It is primarily a disease of the elderly, with 80% of cases in the 50to 79-year age group, and a peak incidence in the 7th decade. About 70–80% of bladder tumors are superficial, and 20–30% infiltrate the bladder wall. In cases involving regional spread or distant spread, 5-year survival rates are 49 and 6%, respectively [1]. Radical cystectomy is the recommended treatment in most cases of infiltrating, nonmetastatic bladder cancer. However, external beam irradiation, with elective salvage cystectomy for residual or locally recurrent disease, is still preferred in some centers. Systemic chemotherapy is the only current modality which provides the potential for long-term survival in patients with metastatic or locally advanced transitional cell carcinoma (TCC). Carcinomas arising in the ureter and renal pelvis are mainly TCC and are usually treated with strategies directed towards metastatic bladder cancer. Since the introduction of modern combination chemotherapy, it has become apparent that TCC of the bladder is highly responsive to chemotherapy. Therefore, muscle-invasive bladder cancer is increasingly regarded as a systemic disease which requires systemic therapy in addition to local treatment. Response rates up to 70% with combination chemotherapy regimens have stimulated the use of these therapies as an integrated approach with Michele Pavone-Macalusoa Cora Sternbergb Urol Int 2000;64:61–69

Second-line chemotherapy in advanced bladder cancer.

Treatment and management of bladder cancer

7015 POSTER DISCUSSION Fatigue Improvement/Reduction With Abiraterone Acetate in Patients With Metastatic Castration-Resistant Prostate Cancer (mCRPC) Post-docetaxel – Results From the COU-AA-301 Phase 3 Study

Cora N. Sternberg

Papers

Clinical outcome with radium-223 (Ra-223) in patients (pts) previously treated with abiraterone (Abi) or enzalutamide (Enza): A retrospective study of real-world (RW) data from pts with metastatic castration-resistant prostate cancer (mCRPC)

Novel hormonal therapy for castration-resistant prostate cancer

Second-line chemotherapy in advanced bladder cancer.

Treatment and management of bladder cancer

7015 POSTER DISCUSSION Fatigue Improvement/Reduction With Abiraterone Acetate in Patients With Metastatic Castration-Resistant Prostate Cancer (mCRPC) Post-docetaxel – Results From the COU-AA-301 Phase 3 Study