Every month we collate a selection of the latest clinically-relevant research to help you keep up to date with the most important developments in the field of prostate cancer.

Articles have been selected based on impact factor of the journal, relevance to UK clinical practice and general interest. You may be able to access the full text from your Trust's library service or via ATHENS registration. Information from PubMed explains other ways to access full text articles. 

March 2015

Research round up from the clinic - top three articles from March 2015

1: Black men less willing than White men to be tested for prostate cancer

Researchers at the Universities of Exeter and Bristol and University College London conducted a study with more than 500 men, attending general practices in Bristol, in which they were presented with realistic hypothetical scenarios - each included a description of a prostate cancer symptom and the estimated risk of prostate cancer. Martins et al found that preference for investigation was lower in Black men irrespective of the risk presented in the scenario. This difference was strongest in relation to the scenarios associated with the lowest risk level, with just 44% of Black males opting for investigation compared with 91% of White males. In both groups, the most common reason for declining investigation was low risk, but significantly more Black men stated that they simply did not want to know if they had cancer. Read our reaction to this research.

2: Detecting cancer cells in blood can give an early warning of treatment failure

A blood test that measures the number of cells shed from prostate tumours into the bloodstream can act as an early warning sign that treatment is not working. Scher et al showed that measuring the numbers of circulating tumour cells and lactate dehydrogenase level in the blood predicted which men were benefitting least from abiraterone after 12 weeks of treatment.

3: Evidence that a family history of prostate cancer increases a women’s risk of breast cancer

Beebe-Dimmer at al followed 78,171 women between 1993 and 1998. By 2009, 3,506 of them had been diagnosed with breast cancer. Women whose fathers or brothers had prostate cancer had a 14% greater risk of being diagnosed with breast cancer, while women with a family history of both breast and prostate cancer had a 78% increased risk. Read more on this research.

February 2015

Research round up from the clinic - top four articles from February 2015

1: Increasing cancer rates

Ahmad and his colleagues estimated the lifetime risk of cancer in Britain for men and women born in each year from 1930 to 1960.  The article, published in the British Journal of Cancer, concluded the lifetime risk of cancer increase from 39% to 54% for men born in 1930 and 1960 respectively.  Cancer Research UK, who co-authored the paper, also featured details of the study in its Science blog.

2: Novel prostate cancer drugs which target protein receptors could provide effective treatments for advanced prostate cancer

Early state prostate cancer tumours depend on hormones called androgens. As the disease progresses, it becomes resistant to drugs that block androgen receptors. Researchers from the United States found that GPR158, unlike other members of the GPCR family, is stimulated by androgens, which in turn stimulates androgen receptor expression, leading to tumour growth. Patel and his colleagues conclude their data suggest GPR158 could provide a target for new prostate cancer drugs.
Dr Matthew Hobbs, deputy director of research at Prostate Cancer UK, said: "There's still so much we don't know about advanced prostate cancer. Working out why the disease stops responding to treatment over time is one of the big unanswered questions. The findings revealed in this paper provide us with another clue, but we've still got a long way to go."

3: American cancer society prostate cancer survivorship care guidelines endorsed

The American Society of Clinical Oncology (ASCO) has endorsed the American Cancer Society’s Prostate Cancer Survivorship Care Guidelines. The guidelines provide recommendations to primary care physicians on best practices in follow-up care for men after prostate cancer treatment.
The recommendations include health promotion, prostate cancer surveillance, screening for new cancers, long-term and late functional effects of the disease and its treatment, psychosocial issues, and coordination of care between the survivor’s primary care physician and prostate cancer specialist in the United States.

4: Final survival analysis of a phase 3 study of abiraterone and prednisone

Ryan and colleagues report the final analysis of overall survival from a randomised phase 3 trial of abiraterone and prednisone versus placebo plus prednisone in chemotherapy-naïve patients with advanced and aggressive prostate cancer. The results showed that lived more than four months longer on average if they received abiraterone before chemotherapy than if they did not.
Owen Sharp, chief executive of Prostate Cancer UK, said: "This data further confirms the huge benefits of abiraterone for men with incurable prostate cancer who haven't yet received chemotherapy. We want to see this additional evidence swiftly lead to this use of abiraterone being routinely available for all men who need it in the UK."

January 2015

Research round up from the clinic - top four articles from January 2015

1: Does screening save lives?

Saquib and colleagues from Stanford University conducted a systematic review of randomised controlled trials to evaluate whether screening decreases mortality from diseases. The study evaluated 39 screening tests for 19 diseases, including numerous cancers, heart and vascular diseases and type-2 diabetes. The authors concluded reductions in disease-specific mortality were uncommon and reductions in all-cause mortality were very uncommon, or even non-existent with the screening tests assessed. They also discussed the potential underlying reasons for the overall poor performance of screening in reducing mortality, some of which may coexist: screening tests may not have sufficient sensitivity and specificity to capture the disease early in its process; lack of effective treatment options for the disease; treatments are available but the risk-benefit ratio of the whole screening and treatment process is unfavourable.

2: Can testosterone help fight prostate cancer?

Scientists from the John Hopkins University School of Medicine in the United States conducted a pilot study investigating the effects of bipolar androgen therapy (BAT), a treatment strategy which involves alternating high and low testosterone levels, in 16 patients with asymptomatic castration-resistant prostate cancer (CRPC). The authors reported BAT was well tolerated and resulted in high rates of PSA and radiographic responses. They also suggested the data demonstrated BAT may have the potential to reverse resistance to androgen-ablative therapies, re-sensitising men to drugs to which their cancer had become resistant. Schweizer and his colleagues concluded BAT shows promise as treatment for CRPC and should be further evaluated in larger trials.

3: Does targeted biopsy increase detection of prostate cancer?

Siddiqui and colleagues from the National Cancer Institute in the United States compared targeted and standard biopsy approached alone, and in combination, in diagnosing intermediate- to high-risk prostate cancer. This prospective cohort study assessed the results of 1003 men who had been referred for elevated level of prostate-specific antigen (PSA) or abnormal digital rectal examination results. The authors reported the targeted biopsy technique detected 30% more high-risk cases and 17% fewer low-risk cases than standard technique. They also concluded the utility of standard biopsy in addition to targeted biopsy was limited  - 200 additional men would have to receive both biopsies in order to detect 1 additional case of high-risk cancer.. In addition, for every 1 additional high-risk tumour diagnosed, 17 additional low-risk tumours would also be diagnosed.

4: Variation in cancer risk: Nature, nurture or just bad luck?

Researchers, Tomasetti and Vogelstein, from the United States investigated how stem cell division takes place in different tissue types, to find out whether the sheer number of divisions can lead to more DNA mutations occurring. The results of the study showed that the lifetime risk of cancers is strongly correlated (0.81) with the total number of stem cell divisions. The authors concluded variation in the incidence of cancer across different tissues can be explained largely in terms of the differences in the rates of cell division between tissues: the greater the number of cell divisions, the greater the number of random mutations, hence the greater the incidence of cancer.

See below for more articles of interest published online this month (January 2015).