Prostate Articles Flashcards
PCa Lit
PROMIS
576 biopsy naive men with elevated PSA
MRI then perineal saturation (template mapping) biopsy then TRUS (neither cognitive fusion)
Looking for GG3 or higher or caner >6mm
MRI wouldve avoided 27% biopsy
MRI missed 13% of 3+4 PCa
Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study
Ahmed, Hashim U et al.
The Lancet, Volume 389, Issue 10071, 815 - 822
PCa Lit
PRECISION
500 biopsy naive men with elevated PSA
MRI +/- targeted PBx (no standard cores) if (+)MRI vs TRUS Bx
Looking for GG2 or higher
28% avoided biopsy based on PIRADs 1/2 and 13% less GG1
MRI +/- biopsy non-inferior to TRUS PBx
Kasivisvanathan, V., Rannikko, A. S., Borghi, M., Panebianco, V., Mynderse, L. A., Vaarala, M. H., Briganti, A., Budäus, L., Hellawell, G., Hindley, R. G., Roobol, M. J., Eggener, S., Ghei, M., Villers, A., Bladou, F., Villeirs, G. M., Virdi, J., Boxler, S., Robert, G., Singh, P. B., … PRECISION Study Group Collaborators (2018). MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis. The New England journal of medicine, 378(19), 1767–1777. https://doi.org/10.1056/NEJMoa1801993
PCa Lit
HOXB13 X285k variant
- Codes for homeobox transcription factor
- Absolute risk of 32.9% (vs 15.9%)
- 2.4-fold increased odds of PCa
- Greater risk of Gleason >8, stage T3/T4 and metastatic disease
- Found only in West African decent
- Other variants are found in Chinese and Japanese men
Darst BF, Hughley R, Pfennig A, Hazra U, Fan C, Wan P, Sheng X, Xia L, Andrews C, Chen F, Berndt SI, Kote-Jarai Z, Govindasami K, Bensen JT, Ingles SA, Rybicki BA, Nemesure B, John EM, Fowke JH, Huff CD, Strom SS, Isaacs WB, Park JY, Zheng W, Ostrander EA, Walsh PC, Carpten J, Sellers TA, Yamoah K, Murphy AB, Sanderson M, Crawford DC, Gapstur SM, Bush WS, Aldrich MC, Cussenot O, Petrovics G, Cullen J, Neslund-Dudas C, Kittles RA, Xu J, Stern MC, Chokkalingam AP, Multigner L, Parent ME, Menegaux F, Cancel-Tassin G, Kibel AS, Klein EA, Goodman PJ, Stanford JL, Drake BF, Hu JJ, Clark PE, Blanchet P, Casey G, Hennis AJM, Lubwama A, Thompson IM Jr, Leach RJ, Gundell SM, Pooler L, Mohler JL, Fontham ETH, Smith GJ, Taylor JA, Brureau L, Blot WJ, Biritwum R, Tay E, Truelove A, Niwa S, Tettey Y, Varma R, McKean-Cowdin R, Torres M, Jalloh M, Magueye Gueye S, Niang L, Ogunbiyi O, Oladimeji Idowu M, Popoola O, Adebiyi AO, Aisuodionoe-Shadrach OI, Nwegbu M, Adusei B, Mante S, Darkwa-Abrahams A, Yeboah ED, Mensah JE, Anthony Adjei A, Diop H, Cook MB, Chanock SJ, Watya S, Eeles RA, Chiang CWK, Lachance J, Rebbeck TR, Conti DV, Haiman CA. A Rare Germline HOXB13 Variant Contributes to Risk of Prostate Cancer in Men of African Ancestry. Eur Urol. 2022 May;81(5):458-462. doi: 10.1016/j.eururo.2021.12.023. Epub 2022 Jan 12. PMID: 35031163; PMCID: PMC9018520.
PCa Lit
MRI-FIRST
251 biopsy naive men with elevated PSA
MRI then targeted PBx (fusion or cog-fus; TRUS or perineal) and standard (TRUS or perineal) looking for GG2 or higher
11% had GG2 with negative MRI
29.9% on standard, 32.3% on targeted and 37% on combined
Rouviere O, Puech P, Renard-Penna R, et al. Use of prostate
systematic and targeted biopsy on the basis of multiparametric MRI in
biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired
diagnostic study. Lancet Oncol 2019;20:100-109. Available at:
https://www.ncbi.nlm.nih.gov/pubmed/30470502.
PCa Lit
Embark
1068 men with high-risk BCR (PSADT <9m)
Randomized to enzalutimide only, ADT only or combo (int ADT allowed)
5y Fup
1: MFS 2: safety, QoL, OS
Combination and Enzalutimide monotherapy were both better than lupron monotherapy
ProtecT
1643 men with localized CaP (77% GG1)
Randomized to AS, RP or RT
1:PCSM 2:DFS, treatment failure
AS had higher rates of mets (30%) and treatment failure (53%) but equal PCSM
