Julio M. Pow-Sang, MD, Department of Genitourinary Oncology chair at Moffitt Cancer Center, Tampa, Florida, and colleagues have published two prostate cancer articles in the September issue of JNCCN – The Journal of the National Comprehensive Cancer Network. The articles review and clarify recent updates made to the National Comprehensive Cancer Network’s (NCCN) guidelines for the screening and treatment of prostate cancer.
The first article noted that two new agents—abiraterone acetate and immunotherapy sipuleucel-T—are welcome therapeutic additions for patients with late-stage disease and poor prognosis.
In a second article, Pow-Sang and co-author David D. Buethe, MD, a urologic oncology fellow at Moffitt, examine the controversy and criteria for implementing active surveillance for patients with asymptomatic prostate cancer and identify the triggers that would convert active surveillance patients to active treatment status.
The authors note that for those patients with prostate cancers at low-risk for progression, the active surveillance strategy was proposed a decade ago but is recently receiving more attention as a viable management option.
“However, critical uncertainties still surround active surveillance,” Pow-Sang said. “The criteria that qualify a patient as low or very low risk are not clear, nor is the definition of disease progression.”
In this article, Pow-Sang and Buethe reviewed recent literature regarding those uncertainties, examining criteria for assisting in selecting men for active surveillance, including PSA density, percent free versus percent total PSA, biopsy positive core results and “volume of involvement” data.
They also looked at studies on positive cores from biopsies and the extent to which core results could be used to develop criteria for treatment. Reports have shown the predictive value of positive biopsy cores, but the frequency for performing prostate biopsies remains controversial for outcomes of active surveillance patients, Pow-Sang said.
[Source: Florida Science Communications]
