Journal ArticleDOI
"Hit the primary": A paradigm shift in the treatment of metastatic prostate cancer?
TLDR
Preclinical data, clinical experience, and challenges in local treatment in de novo metastatic PC are reviewed and discussed, and modern radiation therapy can play a significant role owing to its intrinsic capability to act as a more general immune response modifier.Abstract:
Patients with metastatic prostate cancer (PC) represent a heterogeneous group with survival rates varying between 13 and 75 months. The current standard treatment in this setting is hormonal therapy, with or without docetaxel-based chemotherapy. In the era of individualized medicine, however, maximizing treatment options, especially in long-term surviving patients with limited disease burden, is of capital importance. Emerging data, mainly from retrospective surgical series, show survival benefits in men diagnosed with metastatic PC following definitive therapy for the prostate. Whether the irradiation of primary tumor in a metastatic disease might improve the therapeutic ratio in association with systemic treatments remains investigational. In this scenario, modern radiation therapy (RT) can play a significant role owing to its intrinsic capability to act as a more general immune response modifier, as well as to the potentially better toxicity profile compared to surgery. Preclinical data, clinical experience, and challenges in local treatment in de novo metastatic PC are reviewed and discussed.read more
Citations
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Stereotactic body radiotherapy in oligometastatic prostate cancer patients with isolated lymph nodes involvement: a two-institution experience.
Gianluca Ingrosso,Fabio Trippa,Ernesto Maranzano,Alessandra Carosi,Elisabetta Ponti,Fabio Arcidiacono,L. Draghini,Luana Di Murro,Andrea Lancia,Riccardo Santoni +9 more
TL;DR: This study demonstrates that SBRT is safe, effective, and minimally invasive in the eradication of limited nodal metastases, yielding an important delay in prescribing ADT.
Journal ArticleDOI
Liquid Biopsy in Oligometastatic Prostate Cancer-A Biologist's Point of View.
TL;DR: The presented review of the body of evidence suggests that additional research in molecular biology may help to establish novel treatments for oligometastatic PCa, and liquid biopsies offer a rapid, non-invasive approach whose use is expected to play an important role in routine clinical practice to benefit patients.
Journal ArticleDOI
Opportunistic dose amplification for proton and carbon ion therapy via capture of internally generated thermal neutrons
Mitra Safavi-Naeini,Andrew Chacon,Andrew Chacon,Susanna Guatelli,Daniel Franklin,Keith Bambery,Marie-Claude Gregoire,Marie-Claude Gregoire,Anatoly B. Rosenfeld +8 more
TL;DR: It is demonstrated that a typical proton or carbon ion therapy treatment plan generates an approximately uniform thermal neutron field within the target volume, centred around the beam path, and the proposed method is theoretically feasible and can provide a worthwhile improvement in the dose delivered to the tumour relative to healthy tissue.
Journal ArticleDOI
Using high throughput microtissue culture to study the difference in prostate cancer cell behavior and drug response in 2D and 3D co-cultures.
Eman Mohamed Othman Mosaad,Eman Mohamed Othman Mosaad,Eman Mohamed Othman Mosaad,Karen F. Chambers,Katarzyna Futrega,Katarzyna Futrega,Judith A. Clements,Michael R. Doran +7 more
TL;DR: Stromal cell composition and geometry influences PCa cell migration, growth and drug response, and the Microwell-mesh and microtissues are powerful tools to study these complex 3D interactions.
Journal ArticleDOI
Local Treatment of Metastatic Prostate Cancer: What is the Evidence So Far?
TL;DR: There is growing evidence supporting local treatment in cases of metastatic prostate cancer at diagnosis in the context of a multimodal approach, and it should be kept in mind that most of the existing studies are retrospective.
References
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Journal ArticleDOI
Absolute Prostate-Specific Antigen Value After Androgen Deprivation Is a Strong Independent Predictor of Survival in New Metastatic Prostate Cancer: Data From Southwest Oncology Group Trial 9346 (INT-0162)
Maha Hussain,Catherine M. Tangen,Celestia S. Higano,Paul F. Schelhammer,James Faulkner,E. David Crawford,George Wilding,Atif Akdas,Eric J. Small,Bryan J. Donnelly,Gary R. MacVicar,Derek Raghavan +11 more
TL;DR: A PSA of 4 ng/mL or less after 7 months of AD is a strong predictor of survival and should be used to tailor future trial design for D2 prostate cancer.
Journal ArticleDOI
Might Men Diagnosed with Metastatic Prostate Cancer Benefit from Definitive Treatment of the Primary Tumor? A SEER-Based Study
TL;DR: It is concluded that prospective trials are needed to further evaluate the role of LT in mPCa, and local therapy (LT) appeared to confer a survival benefit in this large population-based study.
Journal ArticleDOI
PD-1 Restrains Radiotherapy-Induced Abscopal Effect
Sean S. Park,Haidong Dong,Xin Liu,Susan M. Harrington,Christopher J. Krco,Michael P. Grams,Aaron S. Mansfield,Keith M. Furutani,Kenneth R. Olivier,Eugene D. Kwon +9 more
TL;DR: SABR induces an abscopal tumor-specific immune response in both the irradiated and nonirradiated tumors, which is potentiated by PD-1 blockade, and has the potential to translate into a potent immunotherapy strategy in the management of patients with metastatic cancer.
Journal ArticleDOI
Abscopal effects of radiotherapy on advanced melanoma patients who progressed after ipilimumab immunotherapy.
Antonio M. Grimaldi,Ester Simeone,Diana Giannarelli,Paolo Muto,Sara Falivene,Valentina Borzillo,Francesca Maria Giugliano,Fabio Sandomenico,Antonella Petrillo,Marcello Curvietto,Assunta Esposito,Miriam Paone,Marco Palla,Giuseppe Palmieri,Corrado Caracò,Gennaro Ciliberto,Nicola Mozzillo,Paolo A. Ascierto +17 more
TL;DR: RT after ipilimumab may lead to abscopal responses in some patients with advanced melanoma correlating with prolonged OS, and it is suggested that local responses to RT may be predictive of abscopy responses.
Journal ArticleDOI
Metastasis-directed Therapy of Regional and Distant Recurrences After Curative Treatment of Prostate Cancer: A Systematic Review of the Literature
Piet Ost,Alberto Bossi,Karel Decaestecker,Gert De Meerleer,Gianluca Giannarini,R. Jeffrey Karnes,Mack Roach,Alberto Briganti +7 more
TL;DR: MDT is a promising approach for oligometastatic PCa recurrence, but the low level of evidence generated by small case series does not allow extrapolation to a standard of care, and requires validation in randomised controlled trials.