2. Regular aspirin use and the risk of lethal prostate cancer in the Physicians' Health Study

A study presented at the American Society of clinical Oncology 2016 Genitourinary Cancers Symposium, in San Francisco, reported that men who take aspirin regularly may have a lower risk of dying from prostate cancer.

As part of the prospective Physicians' Health Study 22,071 male physicians were enrolled and followed from 1982-2009. The investigators evaluated the relationship between regular aspirin intake (more than 3 tablets per week) and lethal prostate cancer (metastases or prostate cancer death), as well as looking at the incidence of total, high-grade (Gleason 8-10), and advanced cancers.

After adjusting for differences in age, race, body mass index, and smoking status analysis the researchers found that men who regularly took aspirin had a 24% lower risk of developing lethal cancer after being diagnosed with an early stage of the disease, and a 39% reduced risk of dying from prostate cancer.

But aspirin had little effect when researchers looked at overall incidence of prostate cancer among the participants. Although regularly taking aspirin seemed to affect the development of prostate cancer in men already diagnosed, it did not appear to affect the likelihood of being diagnosed with total prostate cancer, high-grade prostate cancer, or locally advanced prostate cancer.

The biological basis for this potential protective effect against prostate cancer progression is unknown and more research is needed to determine which men in particular would benefit from regular aspirin and what the optimal dose of aspirin is.

Regular aspirin use is also associated with protection against colorectal cancer and cardiovascular disease, but it comes with gastro-intestinal side effects including bleeding that can cause serious complications in some people. Patients considering an aspirin strategy to prevent progression of prostate cancer should discuss the risks and benefits with their doctors.

This information above is from an abstract presented at an annual conference/symposium and has not yet been published in a peer-reviewed journal. Data presented may not be complete and findings should be treated with caution.

3. Urinary toxicity due to brachytherapy for prostate cancer

According to Initial findings, presented at the American Society of Clinical Oncology 2016 Genitourinary Cancers Symposium, brachytherapy for prostate cancer controls spread of the disease, and urinary complications from the procedure appear to resolve after 1 year.

Meek at colleagues from Washington University School of Medicine reviewed medical records of patients with localised prostate cancer treated with low dose rate (LDR) brachytherapy from 1997-2011. The median follow-up was 5.8 years. Patient-reported genitourinary (GU) toxicity was evaluated by the American Urological Association Symptom Score (AUAS), at, 1, 6, and 12 months following brachytherapy treatment.

At 9 years, the biochemical relapse-free survival (bRFS) among the 400 patients in the study was 92.8%. In addition, the metastasis-free survival was 97.8% and the overall survival was 79.9%.

AUAS scores rose from 6 to 14 at 1 month following brachytherapy, but did not change from month 1 to month 6. However, scores decreased to a median of 8 by 12 months after brachytherapy. In the 69 patients with all values (17%), no factors were found significant for change in AUAS scores.

The investigators conclude LDR brachytherapy for localised prostate cancer offers excellent bRFS, metastatic-free survival and overall survival. Genitourinary toxicity, assessed by AUAS scores, appears to return to pre-treatment baseline by 12 months post-brachytherapy, and older age and neoadjuvant androgen deprivation therapy use may be associated with higher AUAS scores.

This information above is from an abstract presented at an annual conference/symposium and has not yet been published in a peer-reviewed journal. Data presented may not be complete and findings should be treated with caution.

4. Even after anti-androgen therapy, docetaxel remains useful in prostate cancer

In an abstract presented at the 2016 Genitourinary Cancers Symposium reported 40 percent of patients with castration-resistant metastatic prostate cancer (mCRPC) treated with docetaxel following abiraterone had a reduction in prostate specific antigen (PSA).

To assess treatment patterns after abiraterone, researchers from the United States analysed data from the clinical trial COU-AA-302 (chemotherapy-naïve men with mCRPC, abiraterone acetate plus prednisone (AA) significantly improved radiographic progression-free survival and overall survival vs placebo plus prednisone (P)). This multi-institution study conducted post-hoc analysis of patients in the abiraterone acetate plus prednisone (AA) arm (546 patients) who progressed.

The post hoc analysis, presented at the symposium earlier this year, indicates that treatment with subsequent therapy was common (67% and 80%) in patients with chemotherapy-naïve mCRPC who progressed with AA or P, respectively. 36 percent of patients in the AA arm received two additional therapies and 15 percent receiving three or more subsequent therapies. About half of all abiraterone-treated patients on the study were treated with docetaxel in the next subsequent line of therapy. Of these patients treated with docetaxel immediately after abiraterone, 40 percent had PSA decline by more than half, demonstrating the effectiveness of this chemotherapy even after treatment with androgen-deprivation therapy.

Despite limitations of a retrospective analysis, these data support further assessment of subsequent therapy following AA treatment for mCRPC.

This information above is from an abstract presented at an annual conference/symposium and has not yet been published in a peer-reviewed journal. Data presented may not be complete and findings should be treated with caution.

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