Contemporary Management of High-risk Localized Prostate Cancer

Jemal A, Siegel R, Ward E, et al.: Cancer statistics, 2009. CA Cancer J Clin 2009, 59:225–249. Albertsen PC, Hanley JA, Fine J: 20-year outcomes following conservative management of clinically localized prostate cancer. JAMA 2005, 293:2095–2101. Andriole GL, Crawford ED, Grubb RL 3rd, et al.: Mortality results from a randomized prostate-cancer screening trial. N Engl J Med 2009, 360:1310–1319. Schroder FH, Hugosson J, Roobol MJ, et al.: Screening and prostate-cancer mortality in a randomized European study. N Engl J Med 2009, 360:1320–1328. D’Amico AV, Whittington R, Malkowicz SB, et al.: Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 1998, 280:969–974. Stephenson AJ, Scardino PT, Eastham JA, et al.: Postoperative nomogram predicting the 10-year probability of prostate cancer recurrence after radical prostatectomy. J Clin Oncol 2005, 23:7005–7012. Memorial Sloan-Kettering Cancer Center: Prediction tools: a tool for doctors and patients. Available at http://www.mskcc.org/mskcc/html/5794.cfm. Accessed February 2010. Greene KL, Albertsen PC, Babaian RJ, et al.: Prostate specific antigen best practice statement: 2009 update. J Urol 2009, 182:2232–2241. Mohler JL: The 2010 NCCN Clinical Practice Guidelines in Oncology on Prostate Cancer. J Natl Compr Canc Netw 2010, 8:145. Fuchsjager M, Akin O, Shukla-Dave A, et al.: The role of MRI and MRSI in diagnosis, treatment selection, and post-treatment follow-up for prostate cancer. Clin Adv Hematol Oncol 2009, 7:193–202. Harisinghani MG, Barentsz J, Hahn PF, et al.: Noninvasive detection of clinically occult lymph-node metastases in prostate cancer. N Engl J Med 2003, 348:2491–2499. Huang W, Li X, Morris EA, et al.: The magnetic resonance shutter speed discriminates vascular properties of malignant and benign breast tumors in vivo. Proc Natl Acad Sci U S A 2008, 105:17943–17948. •• Sonpavde G, Chi KN, Powles T, et al.: Neoadjuvant therapy followed by prostatectomy for clinically localized prostate cancer. Cancer 2007, 110:2628–2639. This paper concisely outlines the rationale and outcomes of recent studies using the neoadjuvant approach for high-risk prostate cancer. Future implications of ongoing studies are discussed. Lau WK, Bergstralh EJ, Blute ML, et al.: Radical prostatectomy for pathological Gleason 8 or greater prostate cancer: influence of concomitant pathological variables. J Urol 2002, 167:117–122. Pound CR, Partin AW, Eisenberger MA, et al.: Natural history of progression after PSA elevation following radical prostatectomy. JAMA 1999, 281:1591–1597. Bolla M, Collette L, Blank L, et al.: Long-term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer (an EORTC study): a phase III randomised trial. Lancet 2002, 360:103–106. Roach M, Lu J, Pilepich MV, et al.: Four prognostic groups predict long-term survival from prostate cancer following radiotherapy alone on Radiation Therapy Oncology Group clinical trials. Int J Radiat Oncol Biol Phys 2000, 47:609–615. (Erratum appears in Int J Radiat Oncol Biol Phys 2000, 48:313 Note: Mohuidden M [corrected to Mohiuddin M].) Walsh PC: 2008 Whitmore Lecture: radical prostatectomy–where we were and where we are going. Urol Oncol 2009, 27:246–250. Hull GW, Rabbani F, Abbas F, et al.: Cancer control with radical prostatectomy alone in 1,000 consecutive patients. J Urol 2002, 167(2 Pt 1):528–534. Ward JF, Zincke H, Bergstralh EJ, et al.: The impact of surgical approach (nerve bundle preservation versus wide local excision) on surgical margins and biochemical recurrence following radical prostatectomy. J Urol 2004, 172(4 Pt 1):1328–1332. Wagner M, Sokoloff M, Daneshmand S: The role of pelvic lymphadenectomy for prostate cancer–therapeutic? J Urol 2008, 179:408–413. • Briganti A, Blute ML, Eastham JH, et al.: Pelvic lymph node dissection in prostate cancer. Eur Urol 2009, 55:1251–1265. The importance of an adequate lymph node dissection for both staging and therapeutic reasons are discussed. A thorough understanding of pelvic anatomy with attention to the spread of metastases is essential to properly performing this component of the prostatectomy. Zietman AL, DeSilvio ML, Slater JD, et al.: Comparison of conventional-dose vs high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate: a randomized controlled trial. JAMA 2005, 294:1233–1239. de Crevoisier R, Kuban D, Lefkopoulos D: Image-guided radiotherapy by in-room CT-linear accelerator combination [in French]. Cancer Radiother 2006, 10:245–251. Lawton CA, Winter K, Murray K, et al.: Updated results of the phase III Radiation Therapy Oncology Group (RTOG) trial 85-31 evaluating the potential benefit of androgen suppression following standard radiation therapy for unfavorable prognosis carcinoma of the prostate. Int J Radiat Oncol Biol Phys 2001, 49:937–946. Bolla M, de Reijke TM, Van Tienhoven G, et al.: Duration of androgen suppression in the treatment of prostate cancer. N Engl J Med 2009, 360:2516–2527. •• Messing EM, Manola J, Yao J, et al.: Immediate versus deferred androgen deprivation treatment in patients with node-positive prostate cancer after radical prostatectomy and pelvic lymphadenectomy. Lancet Oncol 2006, 6:472–479. In this study, 3 years of androgen deprivation was compared with 6 months of treatment after radiation. This showed definitive improvements in overall and PCSM without an increase in cardiovascular morbidity, favoring the 3-year arm. Studer UE, Whelan P, Albrecht W, et al.: Immediate or deferred androgen deprivation for patients with prostate cancer not suitable for local treatment with curative intent: European Organisation for Research and Treatment of Cancer (EORTC) Trial 30891. J Clin Oncol 2006, 24:1868–1876. Aus G, Abrahamsson PA, Ahlgren G, et al.: Three-month neoadjuvant hormonal therapy before radical prostatectomy: a 7-year follow-up of a randomized controlled trial. BJU Int 2002, 90:561–566. Gleave ME, Goldenberg SL, Chin JL, et al.: Randomized comparative study of 3 versus 8-month neoadjuvant hormonal therapy before radical prostatectomy: biochemical and pathological effects. J Urol 2001, 166:500–506; discussion 506–507. Hurtado-coll A, Goldenberg SL, Klotz L, Gleave ME: Preoperative neoadjuvant androgen withdrawal therapy in prostate cancer: the Canadian experience. Urology 2002, 60(3 Suppl 1):45–51; discussion 51. Rabbani F, Perrotti M, Bastar A, Fair WR: Prostate specific antigen doubling time after radical prostatectomy: effect of neoadjuvant androgen deprivation therapy. J Urol 1999, 161:847–852. Soloway MS, Pareek K, Sharifi R, et al.: Neoadjuvant androgen ablation before radical prostatectomy in cT2bNxMo prostate cancer: 5-year results. J Urol 2002, 167:112–116. Pilepich MV, Winter K, John MJ, et al.: Phase III radiation therapy oncology group (RTOG) trial 86-10 of androgen deprivation adjuvant to definitive radiotherapy in locally advanced carcinoma of the prostate. Int J Radiat Oncol Biol Phys 2001, 50:1243–1252. Nanda A, Chen MH, Braccioforte MH, et al.: Hormonal therapy use for prostate cancer and mortality in men with coronary artery disease-induced congestive heart failure or myocardial infarction. JAMA 2009, 302:866–873. Hricak H, Schoder H, Pucar D, et al.: Advances in imaging in the postoperative patient with a rising prostate-specific antigen level. Semin Oncol 2003, 30:616–634. Scattoni V, Montorsi F, Picchio M, et al.: Diagnosis of local recurrence after radical prostatectomy. BJU Int 2004, 93:680–688. Stephenson AJ, Shariat SF, Zelefsky MJ, et al.: Salvage radiotherapy for recurrent prostate cancer after radical prostatectomy. JAMA 2004, 291:1325–1332. Bolla M, van Poppel H, Collette L, et al.: Postoperative radiotherapy after radical prostatectomy: a randomised controlled trial (EORTC trial 22911). Lancet 2005, 366:572–578. • Thompson IM Jr, Tangen CM, Paradelo J, et al.: Adjuvant radiotherapy for pathologically advanced prostate cancer: a randomized clinical trial. JAMA 2006, 296:2329–2335. • Swanson GP, Hussey MA, Tangen CM, et al.: Predominant treatment failure in postprostatectomy patients is local: analysis of patterns of treatment failure in SWOG 8794. J Clin Oncol 2007, 25:2225–2229. •• Thompson IM, Tangen CM, Paradelo J, et al.: Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term followup of a randomized clinical trial. J Urol 2009, 181:956–962. •• Petrylak DP, Tangen CM, Hussain MH, et al.: Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer. N Engl J Med 2004, 351:1513–1520. The above four papers highlight the need to improve upon local therapies for prostate cancer, as the risk of local recurrence is over 50% in high-risk cases. Tannock IF, de Wit R, Berry WR, et al.: Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med 2004, 351:1502–1512. Patel AR, Sandler HM, Pienta KJ: Radiation Therapy Oncology Group 0521: a phase III randomized trial of androgen suppression and radiation therapy versus androgen suppression and radiation therapy followed by chemotherapy with docetaxel/prednisone for localized, high-risk prostate cancer. Clin Genitourin Cancer 2005, 4:212–214. Montgomery B, Lavori P, Garzotto M, et al.: Veterans Affairs Cooperative Studies Program study 553: chemotherapy after prostatectomy, a phase III randomized study of prostatectomy versus prostatectomy with adjuvant docetaxel for patients with high-risk, localized prostate cancer. Urology 2008, 72:474–480. Hussain M, Smith DC, El-Rayes BF, et al.: Neoadjuvant docetaxel and estramustine chemotherapy in high-risk/locally advanced prostate cancer. Urology 2003, 61:774–780. Konety BR, Eastham JA, Reuter VE, et al.: Feasibility of radical prostatectomy after neoadjuvant chemohormonal therapy for patients with high risk or locally advanced prostate cancer: results of a phase I/II study. J Urol 2004, 171(2 Pt 1):709–713. Chi KN, Chin JL, Winquist E, et al.: Multicenter phase II study of combined neoadjuvant docetaxel and hormone therapy before radical prostatectomy for patients with high risk localized prostate cancer. J Urol 2008, 180:565–570; discussion 570 Eastham JA, Kelly WK, Grossfeld GD, Small EJ: Cancer and Leukemia Group B (CALGB) 90203: a randomized phase 3 study of radical prostatectomy alone versus estramustine and docetaxel before radical prostatectomy for patients with high-risk localized disease. Urology 2003, 62(Suppl 1):55–62. Garzotto M, Higano CS, O’Brien C, et al.: Phase 1/2 study of preoperative docetaxel and mitoxantrone for high-risk prostate cancer. Cancer 2010 Feb 8 (Epub ahead of print). Qian DZ, Huang CY, O’Brien CA, et al.: Prostate cancer-associated gene expression alterations determined from needle biopsies. Clin Cancer Res 2009, 15:3135–3142. Qian DZ, Rademacher BL, Pittsenbarger J, et al.: CCL2 is induced by chemotherapy and protects prostate cancer cells from docetaxel-induced cytotoxicity. Prostate 2010, 70:433–442. Zoubeidi A, Chi K, Gleave M: Targeting the cytoprotective chaperone, clusterin, for treatment of advanced cancer. Clin Cancer Res Feb 9 (Epub ahead of print).