A new study published in JAMA Oncology, has found that stereotactic ablative radiation (SABR) is a better therapy for recurrent hormone-sensitive prostate cancer.
— JAMA Oncology (@JAMAOnc) March 26, 2020
In the U.S., prostate cancer is the third most common cancer overall and the most common in men, leading to 30,000 deaths per year. 1.3 million men around the world are diagnosed with prostate cancer every year and 20% have metastatic cancer properties.
Dr. Ryan Phillips, general surgery specialist in New Orleans, LA, and his colleagues conducted this study to figure out how effectively stereotactic ablative radiotherapy prevents progression of disease compared with observation in men with prostate cancer with 1 to 3 metastases.
SABR delivers a high radiation dose to target cancer cells. It is usually used to treat small tumors. It activates the immune system of the body and causes a systemic immune response. Oligometastasis refers to the growth of cancer cells from the original tumor and spread across the body to form the small number of new tumors. Observation describes a less intensive type of follow-up that may mean fewer tests and relying more on changes in a man’s symptoms to decide if treatment is needed. This treatment is most often meant to control symptoms from cancer, but not to cure it.
It was a randomized trial called ORIOLE Phase II, with 54 men with median age 68 that were the part of the trial. Disease growth in six months occurred in 7 of 36 patients (19%) receiving SABR and 11 of 18 patients (61%) undergoing observation.
When analysis of white blood cells in the blood of SABR treated patients were checked, it showed links with an increase in T cells showing that treatment activated full-body immune response in cancers. The scientists found a set of tumor mutations in genes known to be important for stopping cancer development even in those undergoing SABR.
Dr. Phouc Tran, professor of radiation oncology and molecular radiation sciences at John Hopkins University School of Medicine, says:
This may be a molecular signature which is indicative of underlying biology of patient’s cancer. The biomarker could help doctors to know which patients are going to benefit most from therapy like SABR.
The results conclude that SABR can be combined with other treatments to treat recurrent oligometastatic prostate cancers but such combined therapies would need more clinical trials. The results also suggest that SABR treatment could remove signals that allow the progression of cancer growth.
The study was aided by the Prostate Cancer Foundation, Movember Foundation, Commonwealth Foundation, Nesbitt McMaster, Ronald Rose, and Joan Lazar and NIH.
Screening Guidelines for Early Detection of Prostate Cancer
Digital Rectal Exam is recommended for screening of prostate cancer. If no prostate cancer is found as a result of screening, the time between future screenings depends on the results of the PSA blood test:
- Men with PSA levels less than 2.5 ng/ml may only need retesting every 2 years.
- With levels greater than 2.5 ng/ml,screening should be done yearly.
Men aged 50 are at greater risk of prostate cancer and are expected to live 10 years. African American men at age 45 who have first degree relatives with prostate cancer are at even higher risk. Men at the age of 40 are at the greatest risk if they have first degree relative with prostate cancer.